The post-pandemic future: Universal pharmacare will save Canadians billions of dollars per year
Eric Hoskins is a former Ontario minister of health and long-term care
Even before Covid-19, the case for a publicly funded drug system was strong. Canada is the only country in the world with universal health care that doesn’t also have national pharmacare. Instead, we pay some of the highest prescription drug prices in the world. One-fifth of Canadians struggle to pay for their medicines. One million people report cutting back on food and heat to afford their prescriptions, while other families remortgage their homes to cover the costs of expensive life-saving drugs. In contrast to our public health care, we still maintain a patchwork of prescription drug plans that is grossly inequitable and punishes the poor, part-time workers, contract workers and many others who cannot afford the medications they desperately need.
And now, in the midst of a pandemic, millions more Canadians are out of work. They have lost their incomes as well as their work-based drug benefits, and prescription medicines are further out of reach for them than ever before. This is why we must invest in national pharmacare, despite the unprecedented levels of debt caused by the economic impact of the pandemic. The human and financial costs of not doing so will be even greater in the months and years ahead, and will inevitably lead to deeper health and social inequalities.
Last year, as the chair of the federal Advisory Council on the Implementation of National Pharmacare, I released a blueprint for universal public pharmacare that would guarantee access to prescription medicines for every Canadian. Once fully implemented, national pharmacare would save Canadians $5 billion in the first year alone (and even more annually after that) by having a single entity—the government—negotiating with drug companies. It would also save families, on average, $350 a year in out-of-pocket drug costs, and businesses approximately $750 per employee annually by reducing drug plan premiums. Business owners would no longer have to worry about whether they can afford private drug coverage for their employees. Canada would have a healthier, more productive workforce. And we would save billions in health care costs. Looking at just three diseases—diabetes, cardiovascular disease and chronic respiratory conditions—experts estimate that pharmacare would result in 220,000 fewer visits to emergency departments per year and 90,000 fewer hospitalizations. That’s a potential savings of up to $1.2 billion a year.
A phased implementation of pharmacare is both realistic and achievable, and will have a significant and permanent impact on the lives of Canadians as we brace for more uncertainty surrounding the pandemic. The first phase of this plan would cover essential medicines—roughly half of all prescriptions written. It would cost the federal government $3.5 billion annually, roughly one per cent of the amount already expended on stabilizing jobs and the economy through CERB, wage subsidies, corporate relief and other critical interventions. Once essential medicines are covered, the shift to full pharmacare will happen within five years by adding more drugs to the list, based on evidence and value for money.
Covid-19 has taught us that when the need is great, we can come together as a country and make choices that help protect and secure the health and economic well-being of all Canadians. The pandemic has proven why this country needs public health care more than ever—and that government-funded medication is crucial to its success.