Earlier this month, the Canadian Press published an article about the current state of plans for a national pharmacare program in Canada based on a report by Dr. Marc-André Gagnon (“A Roadmap to A Rational Pharmacare Policy in Canada”).
The way things stand now, health care, including the partial coverage of medication for people who are disabled, retired and/or on extremely expensive life-saving medication, is the responsibility of the provinces and territories. So when I’m writing about the Trillium Drug Program and the Exceptional Access Program, the programs that cover the costs of my Remicade, I’m specifically referring to the situation in Ontario. As problematic as these programs may be at times, many other provinces’ programs are even less organized, making it hard for people in many places to afford the medication that they need. On top of this, every province has its own formulary — meaning that not all of the same medications are even available in each province. The fragmented nature of drug availability and coverage across the country is confusing, costly, and hard on patients.
It would therefore make sense logistically and economically for all the provinces and territories to band together to ensure equal access to medications, both in terms of what’s available and what’s covered, across the country. Working together would also give Canada’s regions a stronger position in negotiations for getting better prices on medications from pharmaceutical companies.
Some of the most interesting aspects of the report, from my perspective, were its emphasis on how the mishmash of public and private coverage in Canada today is wasteful. It argues that private coverage should be abolished in order to save money for both the individuals who need medications and the government/taxpayers at large. While the author does not mention biologic drugs specifically, or refer explicitly to the kind of situation I’m in — where using private insurance would cost me much more than if I pass all of my drug costs on to the government — the solutions he argues for would get rid of the perverse incentives in the current system and streamline the whole thing.
I hope that the recommendations in the report are adopted across the country.