Pharmacare – a prescription for national drug coverage

“In Alberta, seniors over 65 are covered for medications but, it really is, I would say, the people under 65 who may have precarious or part-time employment, or who don’t have drug coverage through their employer – those people who have chronic diseases, are slipping through the cracks and not getting their drugs covered.”

Nowry says there are a lot of advocacy groups which are pushing for a national pharma-care program and Canadian Doctors for Medicare is trying to get the word out through media, and participated in the recent House of Commons Standing Committee on Pharmacare, in an effort to get evidence-based information in front of the public and politicians that a pharma-care program would make sense – both for cost savings for medication and improved healthcare which would improve quality of life for those in need and cut unnecessary visits to emergency rooms.

A pharma-care plan would encompass:

— a national, public plan that would provide prescription drugs to everyone in a fair an equal manner, with oversight and some funding by the federal government.

— drug prices would be negotiated at the national level and take advantage of the ‘economy of scale’. With the power to provide access to the whole population of 36 million people, there would be a roughly $11 Billion in savings.

— a national drug agency would improve drug safety by providing independent, accurate information to doctors, independent analysis of new drugs and a national database to track adverse reactions.

Nowry says the lack of a pharma-care program is the unfinished portion of Canada’s healthcare program.

“When medicare first came in, a lot of the care was through hospitals and physicians but, now we’re caring for people with chronic conditions in their communities and a lot of that care is through medication, so if our patients can’t afford their medications, we’re not helping them be as healthy as they can and that has down-stream effects on the [health] systems as well.”

According to Nowry, recent statistics were released from Pharmacare 2020, which is a big advocacy campaign. They looked at countries which have a national pharma-care program and countries that don’t – and not surprisingly, countries that do have a pharma-care program have a much lower rate of people not taking their medications because they can’t afford them. She noted that one in five Canadian families have said that they don’t fill a prescription because they can’t afford it.

The down side of the statistic is that these patients have a reduced quality of life and/or a shorter life. The doctor says the other element, form a dollars-and-cents perspective, is that if you are not able to control your chronic medical conditions because you can’t afford the required medications, you are more likely to end up in the hospital, where care is much more expensive.

“Quite a significant percentage of hospital admissions are actually because people aren’t taking their medications because they can’t afford them, and they end up in the hospital, where all their care is paid for, but that is much more expensive care, so having those downstream effects are a cost to the system as well.”

As for what is needed to move the pharma-care program forward, Dr. Nowry says it comes down to federal leadership.

“Although [Federal] Minister [Jane] Philpot has made a commitment to get drug prices down, which is an important part of the picture, we just haven’t heard from the federal government yet on a commitment to a national pharma-care program and we really feel that to have a pharma-care program that’s robust and gives us benefits to all Canadians, it really needs federal leadership.”

Regarding ‘economy of scale, Nowry referred to one particular country that does have a pharma-care plan.

“In New Zealand, they pay way less for their drugs than we do because they have a national pharma-care program, even though they are a relatively small country, they are able to negotiate down drug prices because they’re buying for such a large population, whereas right now, we have individual provincial drug plans, individual private drug plans, we have a federal plan that covers the military and first nation individuals, so we have multiple plans right now but, if we put that buying power and negotiating power together for the whole country, we will have a huge cost savings for medication costs.”

For example, drug expenses per capita in New Zealand in 2012 were $340 compared to $947 in Canada.

How the public can help?

“There needs to be a push on our politicians to look at this and seriously figure out a way that we can make this work and I think incremental steps are in the right direction but, we really need some federal leadership to stand up and say that we’re going to put this program into place.”

Members of the public can also sign the National Drug Program petition.

Other information can be found at http://www.healthcoalition.ca/

by Dori Modney (@Dori_Modney on Twitter)

Pharmacare – a prescription for national drug coverage

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