National Pharmacare in Canada: Equality or Equity, Accessibility or Affordability; Comment on “Universal Pharmacare in Canada: A Prescription for Equity in Healthcare”

Document Type: Commentary

Author

1 Eastlake Research Group, Oakville, ON, Canada

2 Canadian Health Policy Institute, Toronto, ON, Canada

3 Fraser Institute, Vancouver, BC, Canada

Abstract

Canada’s federal government intends to take steps to implement national pharmacare so that all Canadians have prescription drug coverage they need at an affordable price. Relatively limited funds have so far been pledged to support national pharmacare, which raises the question: what kind of program is envisioned? Since the government has already introduced regulations intended to reduce new drug prices drastically, national pharmacare seems likely to be a basic system designed to assist low-income Canadians with accessing primary care medicines. What Canadians actually need is a system that provides access to the medicine considered appropriate by the patient and their healthcare provider for the patient’s specific condition. Equitable national pharmacare will not be achieved if patients are denied access to new high-cost specialized medicines that can improve or extend their lives, any more than if patients who cannot afford basic drugs are not helped.

Keywords


  1. Lewis S. It won’t be easy: how to make universal pharmacare work in Canada. Int J Health Policy Manag. 2020;9(1):1-5. doi:10.15171/IJHPM.2019.82
  2. Hajizadeh M, Edmonds S. Universal pharmacare in Canada: a prescription for equity in healthcare. Int J Health Policy Manag. 2020; In Press. doi:10.15171/ijhpm.2019.93.
  3. Rawson NSB, Adams J. Do reimbursement recommendation processes used by government drug plans in Canada adhere to good governance principles? Clinicoecon Outcomes Res. 2017;9:721-730. doi:10.2147/CEOR.S144695
  4. Seucharan C. Class action suit raises questions about how Canada funds drugs to treat rare diseases. Vancouver: Toronto Star, July 26; 2018. https://www.thestar.com/vancouver/2018/07/26/class-action-suit-raises-questions-about-which-rare-diseases-drugs-are-funded.html. Accessed December 19, 2019.
  5. Richter T, Janoudi G, Amegatse W, Nester-Parr S. Characteristics of drugs for ultra-rare diseases versus drugs for other rare diseases in HTA submissions made to the CADTH CDR. Orphanet J Rare Dis. 2018;13:15. doi:10.1186/s13023-018-0762-1
  6. Rawson NSB. Health technology assessment of new drugs for rare disorders in Canada: impact of disease prevalence and cost. Orphanet J Rare Dis. 2017;12:59. doi:10.1186/s13023-017-0611-7
  7. Rawson NSB. Drug Safety: Problems, Pitfalls and Solutions in Identifying and Evaluating Risk. Victoria, BC: Friesen Press; 2016.
  8. Nelson J. The high-stakes battle of medications, insurers and the government. Toronto: Globe & Mail; July 31, 2015. https://www.theglobeandmail.com/report-on-business/the-high-stakes-battle-of-medications-governments-and-insurers/article25807404/. Accessed December 19, 2019.
  9. MacLeod C. Twitter, August 20, 2019. https://twitter.com/macleodscanada. Accessed December 19, 2019.
  10. Rawson NSB. National pharmacare: equity, equality, affordability? Montreal: Policy Options, January 23; 2019. https://policyoptions.irpp.org/magazines/january-2019/national-pharmacare-equity-equality-affordability. Accessed December 19, 2019.
  11. Remarks from the Honourable Jane Philpott, Minister of Health, to the Economic Club of Canada – May 16, 2017. Ottawa: Government of Canada; May 24, 2017. https://www.canada.ca/en/health-canada/news/2017/05/economic_club_ofcanada-may162017.html. Accessed December 19, 2019.
  12. Regulations Amending the Patented Medicines Regulations. Ottawa: Government of Canada;  2019. http://www.gazette.gc.ca/rp-pr/p2/2019/2019-08-21/html/sor-dors298-eng.html. Accessed December 19, 2019.
  13. Rawson NSB. New patented medicine regulations in Canada: a case study of a manufacturer’s decision-making about regulatory submission for a rare disorder treatment. Can Health Policy. Toronto: Canadian Health Policy Institute; 2018. https://www.canadianhealthpolicy.com/products/new-patented-medicine-regulations-in-canada--case-study-of-a-manufacturer---s-decision-making.html. Accessed December 19, 2019.
  14. Ascending to the peak of biopharmaceutical innovation: Biopharmaceutical Competitiveness and Investment Survey. 4th ed. Washington, DC: Pugatch Consilium; 2017. https://www.pugatch-consilium.com/reports/BCI_2017_Report.pdf. Accessed December 19, 2019.
  15. PMPRB survey: interim quantitative report. Toronto: Life Sciences Ontario; 2019. https://lifesciencesontario.ca/wp-content/uploads/2019/12/PMPRB-survey-interim-Report-2019_12_08.pdf. Accessed December 19, 2019.
  16. Della Barca C. Funding medicines in New Zealand: revision of the medicines waiting list to 30 June 2018. Auckland: Subscripts Ltd; 2018. https://www.medicinesnz.co.nz/fileadmin/user_upload/Information_Leaflets/New-Zealands-Medicines-Waiting-List-July-2018.pdf. Accessed December 19, 2019.
  17. Rawson NSB. Comparison of numbers and timing of new medication regulatory approvals in Canada and New Zealand. Regul Toxicol Pharmacol.2019;101:24-28. doi:10.1016/j.yrtph.2018.10.019
  18. LeLorier J, Rawson NSB. Lessons for a National Pharmaceuticals Strategy in Canada from Australia and New Zealand. Can J Cardiol. 2007;23:711-718. doi:10.1016/s0828-282x(07)70815-2
  19. Arnold M, Rutherford MJ, Bardot A, et al. Progress in cancer survival, mortality and incidence in seven high-income countries 1995-2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol. 2019;20:1493-1505. doi:10.1016/S1470-2045(19)30456-5
  20. A prescription for Canada: achieving pharmacare for all. Final report of the Advisory Council on the Implementation of National Pharmacare. Ottawa: Government of Canada; 2019. https://www.canada.ca/en/health-canada/corporate/about-health-canada/public-engagement/external-advisory-bodies/implementation-national-pharmacare/final-report.html. Accessed December 19, 2019.
  21. Universal pharmacare risk analysis report. Regina: Canadian Taxpayers Federation; 2019. http://www.taxpayer.com/media/CTF_National_Pharmacare_Risk_Analysis_Report.pdf. Accessed December 19, 2019.
  22. Aiello R. What the premiers think about a national pharmacare plan. Ottawa: CTV News; December 2, 2019. https://www.ctvnews.ca/politics/what-the-premiers-think-about-a-national-pharmacare-plan-1.4711882. Accessed December 19, 2019.