The right path forward for national pharmacare

For generations, the idea of national pharmacare in Canada has been treated a bit like an old photo album, hauled out for special occasions, but otherwise tucked away and forgotten. Universal drug coverage for all Canadians was considered with the birth of medicare in 1964 and was revisited in the 90s and 2000s. Another report joined these studies this past week. This one called on the federal government to adopt a universal, single-payer public program that would cover patient costs for a national list of medicines. The plan, costing $15 billion a year when fully implemented, would be phased in over eight years and would essentially result in the elimination of private coverage for 25 million Canadians.

There’s good reason to be concerned about the current gaps in access to medications for some Canadians. Prescription drugs are an integral part of medical therapies; more than ever before. But they are also becoming increasingly expensive and out of reach for those without adequate drug plans. Canadians pay some of the highest pharmaceutical costs in the world – second only to the United States and Switzerland. We know too that many Canadians struggle to access their needed medications. We can do much better.

Canada’s life and health insurers believe that no one should go without the drugs they’ve been prescribed because of costs. We are prepared to do our part to help close any gaps that exist and to help reduce costs in the system. But reform needs to be done in a way that is fiscally responsible, is focused on where the issues are and that doesn’t jeopardise what is already working well for over 90% of Canadians.

The Canadian Life and Health Insurance Association is urging the federal government to work with all stakeholders on smart and balanced reforms. We have four specific measures in mind:

First, government plans and insurer-based plans should cooperate to negotiate lower drug prices for all Canadians. This would put the full buying power of the Canadian market across the table from pharmaceutical companies. Governments could do this right now by including private payers in the existing pan-Canadian Pharmaceutical Alliance.

Second, we support the creation of a minimum standard list of drugs that all plans, whether public or private, should meet or exceed so there is more consistency across Canada and that existing gaps in coverage are closed.

Third, insurers support measures announced in the 2019 federal budget including the creation of a new Canadian Drug Agency and the existing funds that have been earmarked to improve access to high-cost drugs for rare diseases.

And fourth, we believe it’s crucial to move forward quickly with the planned modernization of the federal Patented Medicine Prices Review Board to bring drug prices in line with global averages.

The move to national pharmacare needn’t cost people the benefits they count on today. Today, more than 25 million Canadians access prescription medicines through workplace health benefit plans. These plans provide thousands of pharmaceuticals that even the most generous public plans do not provide. We estimate that 7.7 million Canadians would risk losing access to drugs for cancer, pain management, depression and diabetes if their private plan was replaced by even the best government-run public plan.

We know Canadians want government to fix what isn’t working and leave what is. Recent public opinion research has found that a large majority of Canadians – 83 per cent – want government to focus tax dollars to provide prescription drug coverage to those who need it, not those who have coverage through workplace plans.

Canadians need to be able to afford the medicines they’ve been prescribed now. Not in eight years and not at the risk of existing benefits. The four steps we’re suggesting represent an achievable and affordable path forward while avoiding some of the more expensive and unnecessary steps envisioned in last week’s report.

Submitted by:

Stephen Frank,


President and CEO, Canadian Life and Health Insurance Association (CLHIA)