Canada is about to take a critical shot at a national approach to pharmacare \u2014 ensuring that every citizen is able to fill a doctor\u2019s prescription regardless of income, age or health.<\/p>\n
This reform is badly needed. Today, drugs often provide the most effective medical treatments, sometimes eliminating the need for major surgical procedures and preventing manageable conditions from developing into critical ones. Yet not all Canadians can afford the drugs they\u2019ve been prescribed. Public drug benefits cover seniors, and only three provinces have specific public drug programs for children.<\/p>\n
Ensuring universal drug coverage at a reasonable cost for government is a worthy public policy goal, but there are various ways the federal government can achieve it.<\/p>\n
The foundations for Canada\u2019s first national pharmacare system are expected to be set after the federal budget is handed down on March 19. The final report of the Advisory Council on the Implementation of National Pharmacare<\/a> is expected to be delivered sometime soon afterwards, offering recommendations for what measures the federal government should take.<\/p>\n One jurisdiction public policy-makers should be encouraged to look at is Quebec. It has made remarkable achievements with its unique hybrid pharmacare plan<\/a>, which it introduced in 1997 as a framework to improve accessibility and better control public drug costs. It is the only province using a hybrid model that effectively leverages both public and private insurers to achieve universal coverage.<\/p>\n The model has been criticized<\/a> periodically over the years, and again recently<\/a> for being expensive. But it has been fine-tuned and is very much worth building on.<\/p>\n Quebec policy-makers began their pharmacare journey with an ambitious set of goals:<\/p>\n In a nutshell, they wanted to achieve the holy grail of health policy: more for less.<\/p>\n So how did they do?<\/p>\n Quebec\u2019s pharmacare hasn\u2019t met all its objectives, but it has achieved something remarkable.<\/p>\n The evidence is in a study I did in the summer of 2018<\/a> for the Canadian Life and Health Insurance Association. For it, I assessed the financial performance of Quebec\u2019s pharmacare in relation to its features and underlying policies. It was not a simple task given the limited availability of granular data over such a relatively short period of time. What I found is also supported by the most recent statistics by the Canadian Institute for Health Information<\/a>.<\/p>\n All citizens now have first-dollar access to the most comprehensive list of drug therapies in Canada, which means no deductible must be paid for seniors and children, and adults pay a low deductible \u2014 $19.90 a month.<\/p>\n When private expenditures on drug treatments are tallied up with public expenditures, the total spent on drug treatments is 10 to 12 percent higher per capita than in the rest of Canada. But when calculated alone, public expenditures for drugs have gone down on a per capita basis.<\/p>\n A lot of adjustments have been made over the years to get there. For one, R&D incentives for drug manufacturers were abandoned in 2005 as companies continued to shift away from Canada. Policy-makers also came to acknowledge the significant progress in reducing drug costs made by other Canadian provinces through the program listing agreements (PLAs) of the pan-Canadian Pharmaceutical Alliance<\/a> (pCPA); Quebec joined the program in 2016. Also, health officials eliminated a policy called BAP-15<\/a> in 2013 that extended certain brands\u2019 drug product patents by roughly three years, and removed roadblocks<\/a> to generic substitutions in 2015.<\/p>\n These changes have reduced costs so much that Quebec\u2019s hybrid system of pharmacare could well be the most effective drug plan in Canada, once the effects of joining pCPA\u2019s PLA program are more fully reflected.<\/p>\n\n