The pharmacare bill tabled by the Trudeau/Singh coalition government could lead to worse prescription drug insurance coverage for millions of Canadians, according to a Montreal Economic Institute (MEI) researcher.Bill C-64, tabled Thursday, would offer free contraception to nine million Canadians of reproductive age and free diabetes medication for 3.7 million Canadians, according to a government press release. However, Emmanuelle B. Faubert, economist at the MEI, believes this spending is misplaced.“The New Democrats have been very clear about their intent with this legislation: they see it as a Trojan horse to implement a federal monopoly on drug insurance,” said Faubert. “Unfortunately, as can be seen in every province, government-run prescription insurance plans cover only a fraction of what private plans do.“There’s a very decent chance that this federal pharmacare plan could lower coverage quality for the millions of Canadians who rely on private insurance plans for their prescription medication.”The legislation creates a federal monopoly on insurance coverage for birth control and diabetes medication. A newly created Canadian Drug Agency would be in charge of creating a national bulk-purchase strategy for said drugs and creating a national list of reimbursed medication.The leader of the NDP, Jagmeet Singh, has already indicated his party intends to try and add more categories of drugs to this legislation over time.Between 2018 and 2021, private drug insurance plans covered 51% more drugs on average than public plans. In Quebec, the province with the most generous public coverage, this difference was 59.6%.Even if a public plan as generous as Quebec’s was extended across the country, 21.5 million Canadians would risk seeing the quality of their insurance coverage fall, according to an MEI study published last week.The study also points out that the Act risks delaying Canadians’ access to new drugs. The average approval delay for the coverage of a new drug by private insurers is 226 days after approval by Health Canada. For public plans, this delay is 732 days.Alberta and Quebec have already signalled their intention to opt out of a federal pharmacare program. They point out health care is not an area of federal responsibility, but a provincial matter.It is unclear at this point whether provinces will have the ability to opt out or not.“Ottawa needs to start trusting provincial governments to take care of their own responsibilities, rather than repeatedly overstepping into their jurisdiction,” concludes Faubert.But Minister of Health Mark Holland says Ottawa is giving Canadians what they are due."Each and every Canadian should have access to the prescription drugs they need. That’s why we’re working with our partners towards the first phase of national universal pharmacare," Holland said in a press release."This important next step will provide universal access to contraception and diabetes medication that will be transformational in improving health outcomes in Canada."Previous estimates from the Parliamentary Budget Officer (PBO) and the Hoskins Report suggests a fully-universal national pharmacare program could cost between $13.4 billion and $15.3 billion in 2027/28.The legislation is the latest in a succession of announcements. On December 18, 2023, Ottawa announced the creation of the Canadian Drug Agency to cost $89.5 million over five years, starting in 2024/25. On March 22 2023, Ottawa designated up to $1.5 billion over three years for its National Strategy for Drugs for Rare Diseases program.
