Each year, HealthPRO’s Pharmacy Advisory Council (PAC) gathers pharmacy experts from across the country to discuss issues impacting hospital pharmacies, industry trends and to review contract awards.  From September 12 to 14, pharmacy experts, including HealthPRO members and suppliers came together for the event located in Oakville, Ontario. Participants took advantage of this important opportunity to network and explore various approaches for the advancement of HealthPRO’s procurement strategy.

As part of the annual meeting, HealthPRO hosted Katie Heelis, Vice President of Enterprise Health, who provided a presentation on the state of a national Pharmacare in Canada—and the latest developments on the program’s implementation by the Federal Government.  

Katie provided historical context on the idea of a national healthcare system. In 2002, calls for Pharmacare reform resurfaced from Roy Romanow's report of the Commission on the Future of Health Care in Canada—but until 2015 there was not much activity with the file.  With the election of Justin Trudeau and the Liberal Party in 2015, Pharmacare was thrust back into the political sphere, with a promise from the Trudeau Liberals to introduce a system for bulk drug purchasing.  This led to the commencement of the National​ Pharmacare Advisory Council, including the Hoskins Report (2019), which recommended a universal, single-payer model.  The first initiative was the creation of a Canadian drug agency tasked with creating a national formulary.  The most recent development from the federal government is the launch of a pilot program in Prince Edward Island, where the Federal government is pledging PEI with $35M over four years to add new drugs to its list of covered drugs, and lower costs for drugs  under existing public plans​.

But as we know, Canada is made up of a complicated landscape of provinces and territories who all have different priorities for their healthcare. While it is clear that Canadians overwhelmingly support a national Pharmacare system, the landscape across Canada is a complicated one to implement this system. The federal government will have to find a way to satisfy the needs and requirements of each province and territory which is not an easy feat. There is also the question of how the federal government will implement Pharmacare—through a single payer model, or a fill-the-gaps model?

That’s the multi-billion-dollar question—whether we’ll be looking at a single-payer system, or a “fill-the-gaps” model remains unclear. In the single-payer system, recommended in the Hoskins Report, the government would cover the costs of all medications for all citizens, with employer-directed benefits being terminated. The “fill-the-gaps” model would see that employer-directed drug benefits and government-directed benefits remain unchanged.  In this model, the National Pharmacare Plan would provide drug benefits to citizens who do not have employer-directed benefits and do not qualify for existing public drug plans​.  Currently there is no clarity on which of these models the government will use.  What we do know is that extensive work and collaboration between the federal government and provinces/territories is needed to identify an approach that works for everyone.   

The ongoing current political context is also an important factor to keep in mind. In early 2022, the governing Liberal party and the NDP came to a parliamentary agreement to maintain the minority government until at least 2025, as long as certain policy priorities are met. The agreement included a commitment to introduce a national Pharmacare act by the end of 2023.

So what can Canadians expect? We can expect that there will be political predictability over the short-term, as well as a further discussion and focus on National Pharmacare.  Most recently, the liberal government has stuck to its promise to the NDP to implement a national dentalcare program, and so one can reasonably expect the government will follow through on its Pharmacare promise as well. The question is – in what form?