Universal Pharmacare in Canada: A Prescription for Equity in Healthcare

Abstract

Despite progressive universal drug coverage and pharmaceutical policies found in other countries, Canada remains the only developed nation with a publicly funded healthcare system that does not include universal coverage for prescription drugs. In the absence of a national pharmacare plan, a province may choose to cover a specific sub-population for certain drugs. Although different provinces have individually attempted to extend coverage to certain subpopulations within their jurisdictions, out-of-pocket expenses on drugs and pharmaceutical products (OPEDP) accounts for a large proportion of out-of-pocket health expenses (OPHE) that are catastrophic in nature. Pharmaceutical drug coverage is a major source of public scrutiny among politicians and policy-makers in Canada. In this editorial, we focus on social inequalities in the burden of OPEDP in Canada. Prescription drugs are inconsistently covered under patchworks of public insurance coverage, and this inconsistency represents a major source of inequity of healthcare financing. Residents of certain provinces, rural households and Canadians from poorer households are more likely to be affected by this inequity and suffer disproportionately higher proportions of catastrophic out-of-pocket expenses on drugs and pharmaceutical products (COPEDP). Universal pharmacare would reduce COPEDP and promote a more equitable healthcare system in Canada.

National Pharmacare in Canada: Equality or Equity, Accessibility or Affordability Comment on "Universal Pharmacare in Canada: A Prescription for Equity in Healthcare"

“…FPT government plans have complex systems of deductibles, copayments and premiums and, for many medications, restricted access criteria that result in variation in patient eligibility, out-of-pocket expenses and coverage, which has led to inequalities in what drugs are covered, who gets access, and out-of-pocket costs between plans. 7 Hajizadeh and Edmonds 2 see national pharmacare as a way to reduce variation in out-of-pocket expenditures.…”

“…In the belief that national pharmacare would reduce inequalities in existing government programs, Lewis 1 and Hajizadeh and Edmonds, 2 like many other Canadian academics, politicians, government officials and patients, want pharmacare incorporated within the existing healthcare system, although Lewis recognizes that stakeholder interests in keeping the status quo will present challenging difficulties. Equality means treating everyone exactly the same way.…”

“…Two recent IJHPM articles focused on issues around the creation of national pharmacare in Canada. Lewis 1 discussed issues in establishing a single-payer government drug insurance program, while Hajizadeh and Edmonds 2 examined existing differences in out-of-pocket expenditures on pharmaceuticals. Both articles raise important concerns.…”

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

“…The outcomes are problematic. Overall, 18% of Canadian households face catastrophic out-of-pocket expenses on pharmaceutical products, 2 and around 10% of Canadians declared not having filled a prescription or skipped doses in the last 12 months due to financial reasons. 5 While many Canadians cannot access the drugs they need, Canadians spend on average 43% more per capita on retail pharmaceuticals than the median of Organisation for Economic Co-operation and Development countries, 6 mostly due to the fact that Canadian drug plans pay higher prices for the same drugs and are less effective in implementing costcontainment measures.…”

The Challenges of Canadian Pharmacare Are More Complicated Than Acknowledged Comment on "Pharmacare in Canada"

“…n response to an invitation from the editors, it is my pleasure to provide this commentary on two pieces on Universal Pharmacare in Canada that recently appeared in this journal. 1,2 The first editorial, by Hajizadeh and Edmonds, focuses on the social inequities in the burden of catastrophic out-of-pocket expenses on drugs and pharmaceutical products (COPEDP) and the ways in which universal pharmacare would reduce COPEDP and promote greater equity in the Canadian healthcare system. The second piece, a perspective by Lewis, identifies five constituencies that must be involved in the development of a national program, and describes the conditions under which a genuinely fair, effective and efficient universal pharmacare plan can be developed for Canada.…”