Understanding the Battle for Universal Pharmacare in Canada Comment on "Universal Pharmacare in Canada"

Abstract

<jats:p>Drug coverage in Canada is a patchwork; an inequitable inefficient and unsustainable patchwork with no coherence or purpose. Some people think that we can solve the problem by adding more patches, but the core of the problem is that it is a patchwork. For the working population, access to medicines is still organized as privileges offered by employers to their employees. Universal pharmacare would not only provide better access to needed prescription drugs, but also eliminate waste, ensure value-for-money and help improve drug safety and appropriate prescribing. Opponents fear that a universal pharmacare plan would ration drugs, and impede drug access for some patients. However, these claims misunderstand the reality of drug coverage, pricing and access. Opponents propose, instead, to "fill the gap" of current drug coverage by implementing catastrophic coverage, which would serve commercial interests without maximizing health outcomes for the Canadian population. In spite of overwhelming evidence and consensus in the academic community in favour of universal pharmacare, the battle is far from over.</jats:p>

Prescription drug coverage in Canada: a review of the economic, policy and political considerations for universal pharmacare

“…A number of recent studies have attempted to quantify the potential savings that a single-payer pharmacare program would provide Canada [ 38 – 43 ]. Published studies have indicated that a single-payer system could generate between $4 billion and $11 billion in annual savings for Canada [ 42 – 44 ].…”

“…A number of proposals arguing for the enactment of particular policy frameworks for universal pharmacare, put forward by various sources in recent years, have enabled some political traction on the issue [ 38 – 43 ]. Five of the most recent pharmacare simulation models, with their associated cost reduction estimates, are briefly summarised in Table 2 .…”

“…Gagnon et al made the economic case for universal pharmacare in 2010 which was later updated in 2014 [ 42 , 43 ]. He asserts that a universal ‘first-dollar’ model would save between $2.7 and $11.5 billion annually, dependent upon whether favorable pricing reforms were implemented in tandem by the Patented Medicine Prices Review Board (PMPRB) [ 43 ].…”

“…Gagnon et al made the economic case for universal pharmacare in 2010 which was later updated in 2014 [ 42 , 43 ]. He asserts that a universal ‘first-dollar’ model would save between $2.7 and $11.5 billion annually, dependent upon whether favorable pricing reforms were implemented in tandem by the Patented Medicine Prices Review Board (PMPRB) [ 43 ]. Morgan et al, in a 2015 simulated cost study found that, even in their “worst-case” scenario model, $4.2 billion would be saved overall on prescription drug spending with implementation of universal ‘first-dollar’ pharmacare [ 44 ].…”

“…Nurses have also been active in advocating for national pharmacare [ 43 ]. Since 1991, the Canadian Federation of Nurses Unions have campaigned for universal pharmacare through a variety of organizational activities [ 39 , 43 , 63 , 64 ].…”