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Canada’s Pharmacare Act needs to be changed

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Canada’s Pharmacare Act, Bill C-64 is merely a fill-the-gaps approach rather than a universal public program and should be amended, argue authors of a commentary published in CMAJ (Canadian Medical Association Journal).

Bill C-64, which will cover contraceptives and diabetes medications, is currently awaiting final approval by the Senate.

“A fill-the-gaps pharmacare system will not give Canada the institutional capacity needed to fairly and efficiently provide universal access to appropriately prescribed, affordably priced, and equitably financed medicines in a global context of powerful players and growing challenges regarding the reasonableness and transparency of pharmaceutical pricing,” writes Steven Morgan, professor at University of British Columbia, Vancouver, BC, with Matthew Herder, professor of law and medicine at Dalhousie University, Halifax, Nova Scotia. 

“National pharmacare that would function like and integrate with Canada’s existing medicare system has been advised and desired for decades.”

In Canada, there are currently more than 100 public drug plans and thousands of private plans. Prescription drugs account for almost half (45%) of health care spending by private
insurance plans.

A fill-the-gaps plan will continue the country’s fragmented pharmaceutical buying practices, which increase drug costs. It will also add administrative complexity and higher premiums that will especially affect lower-income households, as private insurance plans will finance nearly half of the costs of the fill-the-gaps plan. 

Further, Bill C-64 fails to clarify the powers, functions, and responsibilities of the Canadian Drug Agency. The omission of these key details is a missed opportunity to ensure that national pharmacare remains accountable, first and foremost, to Canadians.

“National pharmacare that would function like and integrate with Canada’s existing medicare system has been advised and desired for decades. Although the preamble of Bill C-64 promises this, as written it will not deliver such a system and should therefore be amended,” the authors urge. 

“Pharmacare Act does not prescribe universal, public pharmacare” was published August 12, 2024. 

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