Why pharmacare plans keep stalling in Canada — even as research suggests billions in savings

While the federal Liberals have pledged to make progress toward a national pharmacare program through a recent deal with the NDP, health care advocates warn those efforts are moving too slowly — putting people's health at risk and taking a financial toll on Canada's hospital system.

The government recently announced a "supply-and-confidence" agreement that could see the Liberals stay in power until 2025 in exchange for action on several NDP priorities, including dental care and pharmacare programs.

But there's little to suggest drug access will be a major focus in the latest federal budget expected on Thursday.

The Liberals intend to pass a Canada Pharmacare Act by the end of 2023, then task the National Drug Agency with developing a national formulary of essential medicines and a bulk purchasing plan by the end of their agreement with the NDP.

It's "concerning" that such an open-ended timeline means building a national pharmacare program likely won't happen until the next election cycle, said Dr. Nav Persaud, Canada research chair in health justice and a staff physician at St. Michael's Hospital in Toronto.

"Multiple reports have detailed how including medicines in our publicly funded system would improve access, improve health, reduce the need for hospitalizations, emergency room visits, and also save billions of dollars both through direct savings, through lowering prices and through the need for health care," he said.

"But much more important than that saved money would be the improved health, and avoided death."

Back in 2019, a sweeping report on pharmacare from the federal Advisory Council on the Implementation of National Pharmacare, led by Dr. Eric Hoskins, stressed how people's lives can suffer if they skip needed prescription drugs, and noted a Canada-wide program could eventually lead to system-wide savings of nearly $5 billion annually.

Other research from a University of British Columbia and University of Toronto team suggested those savings could be even higher, at more than $7 billion each year.

"Even though many Canadians have some form of coverage, Canada relies on a confusing patchwork of over 100 public prescription drug plans and over 100,000 private plans — with a variety of premiums, copayments, deductibles and annual limits," Hoskins wrote in his report.

"For a family or a single patient with a complex condition, those costs can add up to a significant barrier."

Roughly 20 per cent of Canadians have inadequate drug coverage or no coverage at all and must pay out of pocket, he continued.

The Liberals made universal pharmacare a core piece of their election platform in 2019, but by the 2021 campaign, it was barely mentioned by the party.

On the campaign trail that year, NDP leader Jagmeet Singh claimed a federal pharmacare program that would allow Canadians to access drugs with their health card could cost roughly $10 billion, while saving the provinces around $4 billion.