National drug care plan funding announcement creates more questions

The federal government is setting the foundation for a national prescription drug plan by pledging $35 million towards the inaugural agency.

The plan, which was unveiled as part of Tuesday’s budget announcement, would determine what essential drugs should be accessible to all Canadians. The Liberals also committed $1 billion to help with the often-exorbitant price of medicine for rare illnesses.

While the feds have set the wheels in motion for a national pharmacare plan, many of the crucial details remain unknown. It’s unclear if the program will be funded through a single-payer plan, similar to how most Canadians pay for doctors and hospitals, or go by a “fill-in-the-gaps” approach, as they do in Quebec, where both public and private insurance is used.

Danyaal Raza, chair of Canadian Doctors for Medicare and an assistant professor at the University of Toronto, calls the announcement “an important building block”.

“It allows us to make evidence-based decisions on the prescription medications that we want to include in a pharmacare plan,” he told Yahoo Canada. “It also brings together some of the different public payers — the provinces — to do joint negotiations to pay better prices than what we pay right now for prescription drugs.”

Raza says there are already agencies within the country that have built the infrastructure for such a program. The Canadian Agency for Drug and Technology Health Assessment (CADTH), for example, has an expert committee that assesses whether recently introduced medications on the market are both more effective and accessible. There’s also the Pan-Canadian Pharmaceutical Alliance (PCPA), which pools resources and, for a small number of generic medications, bulk buy and jointly negotiate with drug companies to drive down the costs.

Raza predicts that the Canadian drug agency will take the work that CADTH and PCPA have done and bring it under one national agency, align the work and amplify it.

“These are important pre-conditions for a national pharmacare plan, but it’s not a national pharmacare plan,” he says. “There’s been no money announced…we’re still waiting to hear where the government will land on that.”

It’s likely these questions will be answered in the October election, where each party will have an opportunity to reveal where they stand on the issue.

Canada is the only high-income country with universal health care that doesn’t include a universal drug plan. Canadians also pay some of the highest costs for prescription drugs in the world.

Prescription medicine spending in Canada jumped from $2.6 billion in 1985 to $33.7 billion in 2018.

Raza says this is why the conversation needs to move forward and he suspects that there will be lots of pressure from all sides when it comes to funding the program.

“The evidence shows that doing it with a universal public plan is far more effective than doing it with a fill-in-the-gap approach,” he says.

The benefits for the average Canadian will not be immediate.

“In the medium-term, we will hopefully see drug prices come down, but only for those drugs covered by a public plan,” Raza says. “The greatest benefit will only come, if the creation of this agency is followed by a commitment from the government to a universal public drug plan.”