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 Prime Minister Justin Trudeau's Liberal Party, which was reduced to
a minority government following the October election, made a
universal pharmacare program a key campaign promise of their
re-election bid, without offering much detail on how it might work.
The details will need to be negotiated with provincial and
territorial governments, responsible for delivering most healthcare.
"I think that we should start with where we see a real problem, and
Ontario sees a real problem with the rare and orphan disease drugs,"
Christine Elliott, the provincial health minister, said in an
interview.
"On the other issues, we don't see that there's a problem, with
respect to Ontario."
There is likely room for consensus on rare diseases, as the federal
government promised a new national strategy to improve access to the
drugs in the last budget. But since by definition few patients have
rare diseases, a program focused there would not get Canada much
closer to the universal coverage Trudeau promised.
While rare disease treatments face small markets, the extremely high
prices they command and policies that speed their approval have made
them a hot and profitable niche for drugmakers.
Elliott said she told new federal Minister of Health Patty Hajdu
during a call on Friday that provincial and territorial ministers
would like to teleconference early in the new year and meet in the
spring on a number of issues, including drug costs.
Canada is the only developed country with a universal healthcare
system that does not cover prescription drugs for all, although a
patchwork of programs support older Canadians and people with low
income or very high costs. Most rely on employer-funded plans to pay
for medicines.
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Trudeau's Liberals will need the support of rivals like the
left-leaning New Democratic Party (NDP) to govern. The NDP has
pushed for a comprehensive, single-payer drug program.
Ontario, with a right-wing populist premier, Doug Ford, is one of
several provinces led by rival parties.
If too many provinces opt out of pharmacare, that would weaken the
program as lower participation means less bargaining power in buying
drugs. As Canada's most populous province, Ontario is particularly
important, but the promise of billions in new federal funding could
make a deal possible.
Elliott also said the province needs to make a decision on whether
to switch patients to biosimilars, cheaper near copies of expensive
biotech drugs for which exact generic copies are not possible.
The decision by the province of British Columbia in May to switch
thousands of patients on its public drug plan to biosimilars kicked
off a backlash among some drugmakers and patient groups, who argue
that switching therapies might hurt some patients doing well on the
older, more expensive drugs.
Health Canada disagrees. The agency has said patients should not
expect any change in the efficacy or safety when they switch to a
biosimilar.
"Any decision that we make in health is going to be based on
evidence," Elliott said.
(Reporting by Allison Martell; Editing by Bill Berkrot)
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