It Won’t Be Easy: How to Make Universal Pharmacare Work in Canada

Document Type : Perspective


1 Simon Fraser University, Burnaby, BC, Canada

2 University of Saskatchewan, Saskatoon, SK, Canada


One of the glaring gaps in Canada’s universal healthcare system is the low level of public financing of prescription drugs - 42.7% of total spending in 2018. At the federal level there is renewed interest in moving towards universal coverage, supported by a recently commissioned report on how to achieve it. It will take superb political navigation to extract Canadian pharmaceutical policy and practice from the grasp of interests that profit handsomely from the status quo. This perspective suggests the conditions under which a genuinely fair, effective, and efficient pharmacare plan can emerge.


Commentaries Published on this Paper and Hajizadeh & Edmonds Paper


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

            Abstract | PDF


  •  It’s Time to Finally Kill the Zombies; Comment on “Universal Pharmacare in Canada”

             Abstract | PDF


  • The Challenges of Canadian Pharmacare Are More Complicated Than Acknowledged; Comment on “Pharmacare in Canada”

            Abstract | PDF


  • Separated at Birth: The Politics of Pharmacare for All in Canada and Medicare for All in the United States; Comment on “Universal Pharmacare in Canada"

          Abstract | PDF


  • Understanding the Battle for Universal Pharmacare in Canada; Comment on “Universal Pharmacare in Canada”

          Abstract | PDF


Main Subjects

  1. United Nations High Commissioner for Refugees. Global Trends: Forced Displacement in 2018. Geneva: UNHCR; 2019.
  2. US News and World Report. Best Countries 2019.
  3. Reputation Institute. The world’s most reputable countries. 2018 Country RepTrak®.  Published June 21, 2018.
  4. Canadian Institute for Health Information. Prescribed Drug Spending in Canada, 2018: A Focus on Public Drug Programs. Ottawa, ON: CIHI; 2018.
  5. Brandt J, Shearer B, Morgan S. Prescription drug coverage in Canada: a review of the economic, policy and political considerations for universal pharmacare. J Pharm Policy Pract. 2018 Nov 7;11:28. doi:10.1186/s40545-018-0154-x
  6. Morgan SG, Boothe K. Universal prescription drug coverage in Canada: Long-promised yet undelivered. Healthcare Management Forum 2016;29(6):247-254. doi:10.1177/0840470416658907
  7. Morgan SG, Daw JR. Canadian pharmacare: looking back, looking forward. Healthcare Policy. 2012;8(1):14-23.    
  8. 8.     Kelly LT, Tenbensel T, Johnson A. Ontario and New Zealand pharmaceuticals: Cost and coverage. Healthcare Policy. 2018;13(4): 23–34. doi:  10.12927/hcpol.2018.25496.
  9. Candian Institute for Health Information. Drug Spending at a Glance – Information Sheet; 2017. p. 1–2. document/nhex2017-drug-infosheet-1-en.pdf. 
  10. A prescription for Canada: achieving pharmacare for all. Final report of the Advisory Council on the Implementation of National Pharmacare. Ottawa: Health Canada; 2019.
  11.  Blomqvist A, Woolley F. Filling the Cavities: Improving the Efficiency and Equity of Canada’s Dental Care System. C.D. Howe Institute Commentary No. 5. Published May10, 2018.
  12. Blachford P. How to retain eyewear sales and boost revenue. Canadian Journal of Optometry. 2015;77(4):35-36.
  13. Brandt J, Shearer B, Morgan SG. Prescription drug coverage in Canada: a review of the economic, policy and political considerations for universal pharmacare. J Pharm Policy Pract. 2018;11:28.  doi:10.1186/s40545-018-0154-x
  14. Almashat S, Lang R, Wolfe SM, Carome M. Twenty-seven years of pharmaceutical industry criminal and civil penalties: 1991 through 2017. Public Citizen. 2018.
  15. Lexchin J. (2018). Pharmaceutical company spending on research and development and promotion in Canada, 2013-2016: a cohort analysis. J Pharm Policy Pract. 2018;11:5  doi:10.1186/s40545-018-0132-3 
  16. Abacus Data. National Pharmacare in Canada: A survey of Canadian attitudes towards developing a national pharmacare program. Published July 2015.
  17. Black CD, Thavorn K, Coyle D, et al. The health system costs of potentially inappropriate prescribing: a population-based, retrospective cohort study using linked health administrative databases in Ontario, Canada. Pharmacoeconom Open. 2019. doi:10.1007/s41669-019-0143-2
  18. Morgan SG, Hunt J, Rioux J, et al. Frequency and cost of potentially inappropriate prescribing for older adults: a cross-sectional study. CMAJ Open. 2016;4(2):E346-E351.
  19. Oscanoa TJ, Lizaraso F, Carvajal A. Hospital admissions due to adverse drug reactions in the elderly. A meta-analysis. Eur J Clin Pharmacol .2017;73(6):759-770.
  20. Brill S. America’s Bitter Pill: Money, Politics, Backroom Deals, and the Fight to Fix Our Broken Healthcare System. New York: Random House; 2015.
Volume 9, Issue 1
January 2020
Pages 1-5
  • Receive Date: 04 September 2019
  • Revise Date: 26 September 2019
  • Accept Date: 28 September 2019
  • First Publish Date: 01 January 2020