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

Document Type : Commentary


Department of Economics and Business, Colorado College, Colorado Springs, CO, USA


This commentary considers two editorial pieces, written by Hajizadeh and Edmonds, and Lewis, which address universal pharmacare in Canada. The pieces focus on the social inequities of the existing system and the challenges of successful implementation. After identifying the significant strengths of both articles, this commentary then delves into the reasons why universal pharmacare may not be the solution, and identifies numerous thorny issues that will complicate the implementation of such a publicly funded program. Both discussions point to the need for caution and transparency going forward.


  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. Organisation for Economic Co-operation and Development (OECD). OECD Health Statistics 2017. Published 2017.
  4. Canadian Institute for Health Information (CIHI). Drug Spending at a Glance. CIHI website. Published 2017.
  5. Barua B, Moir M. Comparing Performance of Universal Health Care Countries, 2019. Fraser Institute; 2019.  
  6. A prescription for Canada: achieving pharmacare for all. Final report of the Advisory Council on the Implementation of National Pharmacare. Ottawa: Health Canada; 2019.
  7. Canadian Institute for Health Information (CIHI). Trends in Income-Related Health Inequalities in Canada. Ottawa, ON: CIHI; 2015.
  8. Allin S. Does Equity in Healthcare Use Vary across Canadian Provinces? Healthc Policy. 2008;3(4):83-99.
  9. Barua B. Universal Insurance for Pharmaceuticals in Switzerland and the Netherlands.  Fraser Institute; April 2015.
  10. Law MR, Cheng L, Kolhatkar A, et al. The consequences of patient charges for prescription drugs in Canada: a cross-sectional survey. CMAJ Open. 2018;6(1):E63-E70. doi:10.9778/cmajo.20180008
  11. Conference Board of Canada. Understanding the Gap. A Pan Canadian Analysis of Prescription Drug Insurance Coverage.  Published 2017.
  12. Canada, Standing Committee on Health. Pharmacare Now: Prescription Medicine Coverage for All Canadians. Government of Canada; 2018.
  13. Barua B, Jacques D, Esmail N. Provincial Drug Coverage for Vulnerable Canadians. Fraser Institute; 2018.
  14. Esmail N. Drug Coverage for Low-Income Families. Fraser Institute; April 2015.
  15. Acri KML.  The Unintended Consequences of National Pharmacare Programs: The Experiences of Australia, New Zealand, and the UK. Fraser Institute; 2018.
Volume 10, Issue 3
March 2021
Pages 152-154
  • Receive Date: 07 January 2020
  • Revise Date: 30 January 2020
  • Accept Date: 01 February 2020
  • First Publish Date: 01 March 2021