A universal pharmacare is the unfinished business of our national healthcare system.
Unifor advocates for the creation of a public, national pharmacare program. Providing a robust social system that includes universal access to health care is critically essential for Canada to succeed in a global economy. However, Canada remains the only developed country with a universal health care system that has no universal prescription drug coverage. The latest polls show 91 per cent of Canadians want a national drug plan. The time to act is now – together we need to demand universal pharmacare for everyone, regardless of income, age, or where the person works or lives.
A Healthier Population
As many as 8.4 million Canadians have no prescription drug coverage at all, disproportionately affecting women and young workers. The lack of universal access often results in real harm - with non-adherence or drug interactions resulting in hospital admissions, the loss of life and additional public costs. What’s worse is the more precariously employed you are, the less likely you are to have coverage.
The 2015 Angus Reid survey found that 23 per cent of Canadians reported that in the last year, someone in their household did not take their medication as prescribed because of the cost. A universal pharmacare plan including an evidence-driven drug assessment process could also help distinguish and discriminate between drug products in order to ensure the quality, safety, and cost-effectiveness of prescribed medicines.
Canadians face a bewildering patchwork of prescription drug coverage programs and plans. An estimated 43 per cent of spending on prescription drugs is through publicly-funded plans providing coverage for the elderly, people with disabilities and/or low-income Canadians. More than one third, or 35 per cent, is funded by private insurance, with the remainder including another 22 per cent that is paid out-of-pocket by Canadians, when possible.
Our spotty prescription coverage system is inefficient and expensive, with Canadians paying wildly different rates and receiving grossly inconsistent coverage. A universal pharmacare plan for Canada would improve access and affordability and would eliminate duplication and cost-shifting amongst existing payers while promoting integration amongst health care providers.
Recent research has documented a significant international difference in average per capita expenditures on primary care pharmaceuticals across other high-income nations with universal health systems. Spending was consistently lower among single-payer pharmaceutical systems due to lower prices and selection of lower cost treatment options. Compared to the 10 countries with universal coverage of outpatient prescription drugs, Canada recorded list prices about 61 per cent higher despite having a comparable volume - representing an estimated $2.3 billion ‘overspend’ relative to average costs in these other countries.
Canadians (and often employers on their behalf through workplace drug plans) pay more for pharmaceuticals than almost any country in the world. Our country’s drug spending on a per capita basis is 30 per cent above the OECD average, and second amongst OECD countries only after the United States. This is clearly unsustainable in the longer term and workplace drug plans are under enormous pressure to contain, if not shift costs (possibly onto the workforce).
Recent studies show a national drug plan through bulk purchasing and negotiated pricing with drug manufacturers could lower the costs of drugs enough to finance a full pharmacare system with no increase to government costs. In fact it would amount to a net savings of up to $11 billion a year for federal, provincial and territorial governments, the private sector and individual Canadians. Even the federal Parliamentary Budget Office (PBO) estimates minimum savings of at least $4 billion annually based on the most comprehensive drug coverage.