{"id":77193,"date":"2019-11-08T09:05:06","date_gmt":"2019-11-08T14:05:06","guid":{"rendered":"https:\/\/huntsville.dopperonline.ca\/?p=77193"},"modified":"2019-11-08T09:24:58","modified_gmt":"2019-11-08T14:24:58","slug":"will-canada-finally-get-pharmacare-commentary","status":"publish","type":"post","link":"https:\/\/doppleronline.ca\/huntsville\/will-canada-finally-get-pharmacare-commentary\/","title":{"rendered":"Will Canada finally get pharmacare? | Commentary"},"content":{"rendered":"<p>&nbsp;<\/p>\n<p><em>By <span style=\"text-decoration: underline;\"><a href=\"https:\/\/theconversation.com\/profiles\/catherine-carstairs-446992\">Catherine Carstairs<\/a><\/span>, <span style=\"text-decoration: underline;\"><a href=\"http:\/\/theconversation.com\/institutions\/university-of-guelph-1071\">University of Guelph<\/a><\/span><\/em><\/p>\n<p>When I had lymphoma 12 years ago, I needed to take <a href=\"http:\/\/chemocare.com\/chemotherapy\/drug-info\/Neupogen.aspx\" target=\"_blank\" rel=\"noopener noreferrer\">the drug <span style=\"text-decoration: underline;\">pegfilgrastim (Neulasta)<\/span><\/a> to get my white blood cell count high enough that I could take my next chemotherapy treatment on time. Before prescribing it, my oncologist asked if I had insurance. I did. And so, I took the drug, which at that time cost well over $2,000 per syringe.<\/p>\n<div style=\"float: left; margin-right: 14px;\"><strong><broadstreet-zone zone-id=\"45658\" keywords=\"\" soft-keywords=\"true\" zone-alias=\"\"><\/broadstreet-zone><\/strong><\/div>\n<p>I was lucky. I had a type of lymphoma that often affects young people. Many other young people with cancer have no insurance and are <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.theglobeandmail.com\/news\/national\/time-to-lead\/the-cost-of-drugs-breaking-the-bank-to-stay-alive\/article4263623\/\" target=\"_blank\" rel=\"noopener noreferrer\">unable to take the drug or have to go into debt to afford it<\/a><\/span>.<\/p>\n<p>Personal stories like these are one of the reasons why many Canadians are demanding pharmacare. <span style=\"text-decoration: underline;\"><a href=\"https:\/\/election.ctvnews.ca\/low-income-canadians-struggling-to-pay-for-medications-plead-for-pharmacare-1.4630206\" target=\"_blank\" rel=\"noopener noreferrer\">One in five Canadian families<\/a><\/span> struggle to pay for their prescription drugs. <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.cbc.ca\/news\/canada\/british-columbia\/canadians-give-up-food-heat-to-afford-prescriptions-study-says-1.4533476\" target=\"_blank\" rel=\"noopener noreferrer\">Nearly one million Canadians are turning down their heat or eating less<\/a><\/span> to afford prescription medicines. <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.canada.ca\/en\/health-canada\/corporate\/about-health-canada\/public-engagement\/external-advisory-bodies\/implementation-national-pharmacare\/final-report.html\" target=\"_blank\" rel=\"noopener noreferrer\">Three million leave their prescriptions unfulfilled<\/a> because of cost<\/span>.<\/p>\n<p><em><strong>Read more: <span style=\"text-decoration: underline;\"><a href=\"http:\/\/theconversation.com\/leave-the-patchwork-to-the-quilts-the-case-for-pharmacare-122284\" target=\"_blank\" rel=\"noopener noreferrer\">Leave the patchwork to the quilts: The case for pharmacare<\/a><\/span><br \/>\n<\/strong><\/em><\/p>\n<p>Just two months before the 2019 federal election, Dr. Eric Hoskins, chair of the Advisory Council on the Implementation of National Pharmacare, released <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.canada.ca\/en\/health-canada\/corporate\/about-health-canada\/public-engagement\/external-advisory-bodies\/implementation-national-pharmacare\/final-report.html\" target=\"_blank\" rel=\"noopener noreferrer\">A Prescription for Canada: Achieving Pharmacare for All<\/a><\/span>, which recommended a universal pharmacare program.<\/p>\n<p>In the recent election, both the Greens and the NDP promised universal pharmacare. The <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.cbc.ca\/news\/politics\/liberal-health-care-pharmacare-2019-1.5293645\" target=\"_blank\" rel=\"noopener noreferrer\">Liberals promised to take \u201ccritical next steps\u201d to implement pharmacare<\/a><\/span>. Of the national parties, only the <span style=\"text-decoration: underline;\"><a href=\"https:\/\/globalnews.ca\/news\/6026500\/scheer-ford-spending-pharmacare\/\" target=\"_blank\" rel=\"noopener noreferrer\">Conservatives remained unenthusiastic<\/a><\/span>.<\/p>\n<p>Pharmacare would allow Canadians to access life-saving drugs. It could also save money. A 2015 report published in the <em>Canadian Medical Association Journal<\/em> showed that <span style=\"text-decoration: underline;\"><a href=\"https:\/\/doi.org\/10.1503\/cmaj.141564\" target=\"_blank\" rel=\"noopener noreferrer\">universal pharmacare could reduce total spending on prescription drugs by $7.3 billion<\/a><\/span>. The savings would come through bulk purchasing.<\/p>\n<h2>Why has pharmacare taken this long?<\/h2>\n<p>The 1964 Hall Commission that helped create Canada\u2019s medicare system <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.canada.ca\/en\/health-canada\/services\/health-care-system\/commissions-inquiries\/federal-commissions-health-care\/royal-commission-health-services.html\" target=\"_blank\" rel=\"noopener noreferrer\">recommended that prescription drugs be included<\/a><\/span>, but the focus at the time was on physician services.<\/p>\n<div id=\"attachment_77198\" style=\"width: 610px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-77198\" class=\"size-full wp-image-77198\" src=\"https:\/\/media-doppleronline-ca.s3-accelerate.amazonaws.com\/2019\/11\/Justin-Trudeau-makes-a-health-care-policy-announcement-in-Hamilton-Ont.-in-September-2019-THE-CANADIAN-PRESS-Ryan-Remiorz.jpg\" alt=\"Justin Trudeau makes a health-care policy announcement in Hamilton, Ont., in September 2019 (THE CANADIAN PRESS Ryan Remiorz)\" width=\"600\" height=\"450\" srcset=\"https:\/\/media-doppleronline-ca.s3-accelerate.amazonaws.com\/2019\/11\/Justin-Trudeau-makes-a-health-care-policy-announcement-in-Hamilton-Ont.-in-September-2019-THE-CANADIAN-PRESS-Ryan-Remiorz-300x225.jpg 300w, https:\/\/media-doppleronline-ca.s3-accelerate.amazonaws.com\/2019\/11\/Justin-Trudeau-makes-a-health-care-policy-announcement-in-Hamilton-Ont.-in-September-2019-THE-CANADIAN-PRESS-Ryan-Remiorz.jpg 600w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\" \/><p id=\"caption-attachment-77198\" class=\"wp-caption-text\">Justin Trudeau makes a health-care policy announcement in Hamilton, Ont., in September 2019 (THE CANADIAN PRESS Ryan Remiorz)<\/p><\/div>\n<p>Today, private and public spending on drugs is almost equal to what Canadians pay for physician services. But in the late 1950s and early 1960s, Canadians spent more than three times as much on doctors than they did on prescription drugs. As a result, <span style=\"text-decoration: underline;\"><a href=\"https:\/\/ourspace.uregina.ca\/bitstream\/handle\/10294\/6603\/SIPP%20The%20Scholar%20Series%20Fall%202001.pdf?sequence=1&amp;isAllowed=y\" target=\"_blank\" rel=\"noopener noreferrer\">physician services seemed more urgent<\/a><\/span>.<\/p>\n<p>The Hall Commission also expressed concern about the high price of drugs in Canada. Canadian drug prices were skyrocketing as new drugs were developed. But the industry was also highly profitable. Drug companies were spending more and more on advertising and promotion. Other countries that had included drugs in their public health systems, including New Zealand, Norway and the United Kingdom, were struggling to control costs.<\/p>\n<p>The Liberal government at the time was already worried about the cost of funding physician services. <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.canada.ca\/en\/health-canada\/services\/health-care-system\/commissions-inquiries\/federal-commissions-health-care\/royal-commission-health-services.html\" target=\"_blank\" rel=\"noopener noreferrer\">Leaving drugs out at this stage just made sense<\/a><\/span>.<\/p>\n<p>In the 1970s, <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.researchgate.net\/publication\/11213719_Beneficiary_cost_sharing_under_Canadian_provincial_prescription_drug_benefit_programs_History_and_assessment\" target=\"_blank\" rel=\"noopener noreferrer\">provincial drug plans grew rapidly, usually covering seniors and people in receipt of social assistance<\/a><\/span>. A number of provinces also established universal schemes, although these usually only covered drug costs over a certain threshold and were subject to budget cuts in the late 1980s and early 1990s.<\/p>\n<p>The most extensive pharmacare program is in Qu\u00e9bec, which requires employers to provide drug benefits to their workers. People not eligible for insurance through their workplace <span style=\"text-decoration: underline;\"><a href=\"https:\/\/doi.org\/10.1503\/cmaj.170726\" target=\"_blank\" rel=\"noopener noreferrer\">must enrol in a government-administered plan<\/a><\/span>. Today, <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.canada.ca\/en\/health-canada\/corporate\/about-health-canada\/public-engagement\/external-advisory-bodies\/implementation-national-pharmacare\/final-report.html\" target=\"_blank\" rel=\"noopener noreferrer\">most provinces offer catastrophic drug coverage<\/a><\/span>.<\/p>\n<h2>Costs in Qu\u00e9bec higher than anticipated<\/h2>\n<p>By the late 1990s, after years of cuts, Canadians were worried about the health-care system. In 1997, the <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.canada.ca\/en\/health-canada\/services\/health-care-system\/ehealth\/canada-health-infostructure\/national-forum.html\" target=\"_blank\" rel=\"noopener noreferrer\">National Forum on Health<\/a><\/span>, an advisory body established by the prime minister, recommended national pharmacare. The Liberals included pharmacare in their platform that year.<\/p>\n<p><em><strong>Read more: <span style=\"text-decoration: underline;\"><a href=\"http:\/\/theconversation.com\/national-pharmacare-will-save-money-and-lives-118974\" target=\"_blank\" rel=\"noopener noreferrer\">National pharmacare will save money and lives<\/a><\/span><br \/>\n<\/strong><\/em><\/p>\n<p>But as political scientist Katherine Boothe has shown, there was <a href=\"https:\/\/utorontopress.com\/us\/ideas-and-the-pace-of-change-3\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"text-decoration: underline;\">little appetite for implementing pharmacare<\/span><\/a>. Governments were worried about maintaining existing programs, not introducing new ones. The provinces and the federal government also looked to Qu\u00e9bec, which had the most comprehensive program in Canada. <span style=\"text-decoration: underline;\"><a href=\"https:\/\/doi.org\/10.1503\/cmaj.170726\" target=\"_blank\" rel=\"noopener noreferrer\">Costs in Qu\u00e9bec were proving to be much higher than anticipated<\/a><\/span>.<\/p>\n<p>In 2002, two important reports were released: <span style=\"text-decoration: underline;\"><a href=\"http:\/\/publications.gc.ca\/site\/eng\/237274\/publication.html\" target=\"_blank\" rel=\"noopener noreferrer\">The Royal Commission on the Future of Health Care in Canada<\/a><\/span> (the Romanow report) and <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.canada.ca\/en\/health-canada\/services\/health-care-system\/health-human-resources\/strategy\/kirby-report.html\" target=\"_blank\" rel=\"noopener noreferrer\">The Health of Canadians \u2014 the Federal Role<\/a><\/span> (the Kirby report). These reports shifted the conversation from national pharmacare to catastrophic drug coverage and a national purchasing program.<\/p>\n<p>In 2004 at a meeting of the Council of the Federation (a gathering of the 13 provincial and territorial leaders), <span style=\"text-decoration: underline;\"><a href=\"https:\/\/scics.ca\/en\/product-produit\/news-release-premiers%E2%80%99-action-plan-for-better-health-care-resolving-issues-in-the-spirit-of-true-federalism\/\" target=\"_blank\" rel=\"noopener noreferrer\">the premiers recommended a national pharmacare plan<\/a><\/span>. But support for the plan was weak. The <span style=\"text-decoration: underline;\"><a href=\"https:\/\/healthydebate.ca\/2011\/04\/topic\/cost-of-care\/part-2-lessons-from-the-2004-health-accord-for-2014\" target=\"_blank\" rel=\"noopener noreferrer\">2004 Health Accord<\/a><\/span>, which promised substantial new funds to the provinces for health care, only agreed to cost-out options for catastrophic drug coverage.<\/p>\n<h2>Liberals need to negotiate with provinces<\/h2>\n<p>Will we finally get pharmacare with this just-elected minority government? It was a minority government under Lester B. Pearson that delivered medicare. The <span style=\"text-decoration: underline;\"><a href=\"https:\/\/www.theglobeandmail.com\/politics\/article-ndp-lays-down-requests-for-trudeau-while-beginning-its-own-election\/\" target=\"_blank\" rel=\"noopener noreferrer\">NDP have made it clear that pharmacare is a priority<\/a><\/span>.<\/p>\n<p>But the Liberals will need to negotiate with the provinces, and the mostly Conservative premiers are unlikely to make that easy. The insurance industry also has a lot to lose.<\/p>\n<p>The Canadian public, the vast majority of whom have access to drug benefits through their workplace, will be sensitive to any tax increases that might result.<\/p>\n<p>It will be a struggle, but national pharmacare would <span style=\"text-decoration: underline;\"><a href=\"https:\/\/theconversation.com\/national-pharmacare-will-save-money-and-lives-118974\" target=\"_blank\" rel=\"noopener noreferrer\">save money, reduce unnecessary hospitalizations, keep Canadians healthier<\/a><\/span> and protect families from catastrophic drug costs.<\/p>\n<p>Let\u2019s hope that the time has finally come.<\/p>\n<p>This article is republished from <a href=\"http:\/\/theconversation.com\">The Conversation<\/a> under a Creative Commons license. Read the <a href=\"https:\/\/theconversation.com\/will-canada-finally-get-pharmacare-126248\">original article<\/a>.<\/p>\n<h5 style=\"text-align: center;\">Don\u2019t miss out on Doppler!<\/h5>\n<p style=\"text-align: center;\"><strong>Sign up <a href=\"https:\/\/doppleronline.ca\/huntsville\/dont-miss-out-on-doppler\/\"><u>here<\/u><\/a> to receive our email digest with links to our most recent stories.<br \/>\nLocal news in your inbox three times per week!<\/strong><\/p>\n<p style=\"text-align: center;\"><broadstreet-zone zone-id=\"45657\" keywords=\"\" soft-keywords=\"true\" zone-alias=\"\"><\/broadstreet-zone>\n<p><!-- Below is The Conversation's page counter tag. 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