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 The Liberals won the most seats in the election but fell short of a
majority, which means Prime Minister Justin Trudeau will need the
support of rivals like the left-leaning New Democratic Party (NDP)
to govern. Both the Liberals and NDP have promised a new national
drug plan.
Canada is the only developed country with a universal health care
system that does not cover prescription drugs for all, though a
patchwork of provincial programs support the elderly and people with
low income or very high drug costs. Most Canadians rely on
employer-funded drug plans.
Steve Morgan, a University of British Columbia health economist and
leading advocate for a universal drug plan, or pharmacare, said the
election results created a "window of opportunity" to change the
system.
Universal drug coverage has been proposed before, but the rise of
high-cost drugs has given the idea new urgency, as some patients
struggle to pay for medication, and employer-funded plans shift
high-cost patients to provincial plans, straining budgets without
creating the negotiating power that a single federal buyer could
wield against drugmakers.
"I think this is our best chance, the best opportunity we've ever
had to bring pharmacare into the healthcare system," said Eric
Hoskins, who led a federal advisory council on the issue. "I feel
even more strongly about that today. I am confident that the
Liberals will follow through on their commitment."
Speaking to supporters after the election, NDP leader Jagmeet Singh
outlined his party's goals in the next parliament.
"If you need medication in our country, we want to make sure you use
your health card, not your credit card," he said. "That means a
national, publicly-delivered single-payer pharmacare program."
Universal drug coverage would shake up the country's C$39.8 billion
($30.4 billion) prescription drug market, and cut drugmakers'
revenue by some C$4.8 billion a year by 2027. It may draw opposition
from drugmakers, and from private insurers, who could also lose
revenue, as well as deficit hawks.
"We believe that any national pharmacare program must ensure
Canadians maintain access to at least the same range of cutting-edge
medicines they rely on today to survive and maintain their quality
of life," pharmaceutical industry group Innovative Medicines Canada
said in a statement.
The Canadian Life and Health Insurance Association said it looks
forward to working with the government.
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"We continue to believe strongly that any reform should use
government resources wisely and build on what works well today,"
Canadian Life and Health Insurance Association President Stephen
Frank said in a statement.
A DEAL WITH PROVINCES?
The Liberals promised a new national plan ahead of the election, but
only committed a total of C$6 billion for all health initiatives.
The NDP and the Green Party of Canada were more aggressive.
Earlier this year, the advisory council led by Hoskins, a former
provincial Liberal minister, recommended a universal, single-payer
public pharmacare system, to be implemented no later than 2027 and
costing C$15.3 billion a year in new government spending.
But it said cost-saving measures, including new negotiating power
with pharmaceutical companies, would reduce overall spending by an
estimated C$4.8 billion by 2027, saving provincial governments,
employers and individuals money at drugmakers' expense.
The Liberals' platform stopped short of pledging a single-payer
system, which left some advocates unsure whether Trudeau was fully
endorsing the Hoskins' recommendation.
The NDP pledged to implement pharmacare for all as soon as possible.
To follow the Hoskins model, the federal government would need to
strike a deal with provincial governments, to fund prescription drug
plans as long as the provinces run plans that meet certain minimum
standards.
The negotiations may be difficult, as key provinces are led by rival
parties. But the promise of billions in new federal funding could
make a deal possible. It is possible that some provinces would opt
out, weakening the program, as lower participation means less
bargaining power in buying drugs.
Morgan, of the University of British Columbia, expects
pharmaceutical lobbyists to mobilize against the plan.
"I think we are going to see a lobbying effort by the pharmaceutical
industry in Canada the likes of which we've never seen," he added.
(Additional reporting by Anna Mehler Paperny in Toronto and Evan
Duggan in Vancouver; Editing by Denny Thomas and Paul Simao)
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