OTTAWA — As he lays the groundwork for the Liberals’ last budget before the fall election, federal Finance Minister Bill Morneau has been highlighting two themes for a national drug plan: the twin drives for lower costs and wider access.
Drugs are the fastest-growing component in health spending in Canada, according to the Canadian Institute for Health Information. New drugs have made it possible to live much longer with conditions such as diabetes and even cancer, and improve patients’ quality of life with afflictions such as arthritis. But unlike hospital care and doctors’ visits, most people’s medication needs aren’t covered by public health insurance.
The Liberals have assembled a team of advisers, led by former Ontario health minister Eric Hoskins, to consult the public and study options for a national pharmacare regime. The committee is to publish its final report this spring, but it’s unclear whether it will arrive before the budget, which is now widely expected to land the week of March 18.
Late last week, Morneau told a business crowd in Victoria that the Liberals want to address a rapid rise in drug costs that has made them more expensive in Canada than in other countries.
The other challenge on his mind is ensuring people can afford the pharmaceuticals they need most, he said.
“I’m not sure how far we’ll get in terms of the budget,” Morneau said during an event hosted by the Greater Victoria Chamber of Commerce. “But I’d watch those two issues. We need to deal with the cost (and) we need to deal with the coverage as two really important issues that are on our agenda.”
Canada now has drug plans administered by provinces (mainly for children and seniors and people on welfare or disability benefits), by the federal government (for Indigenous people, members of the military and the RCMP and veterans), and private insurance filling in gaps for some.
Morneau has said he’d like to preserve parts of Canada’s existing drug plans rather than abandon them in pursuit of a new, country-wide program, and Hoskins’ committee is to look at how best to do it.
“We’ve got an advisory committee that’s going to present to us options on how we can move forward and, yes, to your question we will inevitably need to have some negotiations with the provinces to make sure we get this right because this is going to be a shared area of jurisdiction,” Morneau said in an interview this week with Zoomer Radio. “So there is going to be some discussion of this, I hope, in the budget.”
In the lead-up to this year’s election, the Conservatives and New Democrats will also offer voters their visions for pharmacare.
This week, NDP Leader Jagmeet Singh said if elected his party would bring in a universal, public, comprehensive pharmacare system. Singh also accused the Liberals of being focused on a limited, industry-friendly model of pharmacare.
Last April, an all-party House of Commons committee agreed in a report that publicly funded prescription drugs, under a universal pharmacare program, would provide better health care to Canadians at a lower cost than the status quo.
The cost of national pharmacare is expected to be steep.
An analysis by the parliamentary budget officer estimated a broad coverage regime would carry a $20-billion-a-year price tag. Former federal budget watchdog Kevin Page has said that with provincial and federal treasuries all facing challenges, he believes tax hikes would likely be necessary.
The current government has taken steps to lower drug prices, which could allow Ottawa to create a pharmacare regime with less of a burden on taxpayers.
In late 2017, Health Canada proposed changes to the regulations governing patented medicines — newer drugs that, at their best, bring breakthrough health benefits, but that can be very expensive because they’re legally protected from attempts to copy them. The government regulates prices to try to balance pharmaceutical companies’ incentives to develop new drugs and patients’ ability to get them.
These would be the first major update to those rules in more than two decades. The potential amendments included an expanded list of countries Canada can use when comparing patented drug prices as well as new factors the Patented Medicine Prices Review Board can take into consideration when assessing whether a drug is overpriced.
The effort to bring in the reforms has been unexpectedly sluggish, the board acknowledged in its newsletter last fall.
“Progress on the issues under discussion has been slower than anticipated, owing to the complexity of the subject matter and conflicting views of participants on the merits of the underlying policy,” the document said.
When it announced its proposals, the government said only the United States and Mexico had higher patented-medicine prices than Canada, when compared with the 35 members of the Organization for Economic Co-operation and Development. The government said the amendments could save consumers about $12.6 billion over 10 years.
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Andy Blatchford, The Canadian Press