pharmacare: is it finally time for universal drug coverage?


With the recent promises of pharmacare made for the upcoming provincial elections in Ontario, I thought it would be a great time to discuss what pharmacare is, its history in Canada, and more importantly, if it is finally time that we received universal drug coverage in Ontario.

Although Canadians across the nation are decidedly proud of medicare, our healthcare system lacks a vital feature: pharmacare. The Royal Commission on Health Services first recommended the implementation of pharmacare in 1964 to complete our healthcare system. Despite falling in and out of popularity over the following decades, the idea of pharmacare continued to be supported by national reviews on the subject, including the influential Romanow Commission. Over 60 years later however, little progress has been made and pharmacare remains to be adopted in Canada.

Prescription drugs are an important part of our healthcare, with the ability to cure diseases and improve one’s quality of life. According to a declaration by the World Health Organization (WHO), all member states are required to ensure equitable access to essential medicines as part of their healthcare systems, as such access fulfills one’s fundamental right to health. Essential medicines, defined by the WHO, are “those that satisfy the priority healthcare needs of the population”.

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Source: World Health Organization

Quite surprisingly, Canada is the only developed nation with a universal healthcare system that lacks pharmacare. Among other OECD nations, Canada pays some of the highest (ranked 4/29) out-of-pocket fees for prescription drugs at $713 (US) a person – $198 (US) above the average. The Canadian Institute for Health Information also found that prescription drug expenditure was the second-largest health expenditure category, totalling an annual $33.9 billion in 2014. With the introduction of universal pharmacare though, Canadians would see an outstanding  $7.3 billion reduction in annual prescription drug expenditure, due increased purchasing power.

Source: OECD

Currently, we have a fragmented patchwork pharmacare system in place across the nation. While provinces cover some low-income residents and seniors, and provide drugs in hospital, many Canadians receive prescription drug coverage through private insurance plans that requires co-payments or are left paying out-of-pocket. Across Canada, 3.5 million people lack any prescription drug insurance and 10% of Canadians cannot afford the out-of-pocket costs for prescribed medications. Often, this leaves the most vulnerable among us at risk, including those individuals from low-income households. As such, this patchwork system is exactly what the name implies: it’s incomplete with many gaping holes, leaving many to foot their own bills and thus, face serious barriers to receiving comprehensive healthcare.

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In recent days, both the Liberal Party and the NDP of Ontario have presented their own pharmacare plans. Ontario has 2.2 million residents without pharmaceutical drug coverage, with about 25% of patients unable to afford the cost of prescribed medications. To tackle this issue, the Liberal Party has proposed to implement a youth pharmacare plan to cover the cost of 4,400 prescription drugs for all residents under the age of 24. In contrast, if elected, the NDP party promises to implement a more comprehensive pharmacare plan by 2020 to cover the expense of 125 essential pharmaceutical drugs, keeping existing government prescription programs in place and allowing individuals to keep their private drug insurance policies as well. Although both have their trade-offs, we are moving in the right direction to complete our healthcare system by implementing pharmacare.

All in all, pharmacare is an essential aspect of a truly comprehensive healthcare system. Support for pharmacare should be universal and it should make its way into Ontario if we truly stand behind the belief, propagated by Tommy Douglas, that all Canadians deserve the right to healthcare because without access to essential medicines, many Canadians lives are put at risk.

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