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This article was published 17/10/2019 (345 days ago), so information in it may no longer be current.

Opinion

Some call national pharmacare "unfinished business," and say that without it, we don’t have truly universal medicare. Others believe we should make do with our current system of public and private drug coverage and just fill in existing gaps.

New drugs have, over the past few decades, made a profound difference in reducing the burden of our diseases. Canadians are living longer thanks to drugs that treat and prevent cardiovascular diseases, such as medications for high blood pressure and cholesterol. But medicines are of absolutely no use if people don’t have reliable, affordable access to them and take them as they are supposed to.

There are two critical problems with how things are right now. The first is a question of equitable access. The second is long-term sustainability.

On the matter of equitable access, the current system leaves a lot to be desired. Fewer women have employer health benefits when compared to men, and women are more likely to skip prescription medications because of cost.

Additionally, not taking medication because of cost is much more common among Indigenous people, people aged 18 to 44 years, people with lower health status and people with lower incomes.

Indigenous people also face numerous other challenges accessing prescription medications. Many face long delays or are even denied when they try to access drugs through the Non-Insured Health Benefits Program administered by the federal government.

Sustainability is also a critical issue. Our current system is increasingly inefficient and expensive. In 2017, Canadian pharmacies dispensed roughly 94 million prescriptions for medications to treat cardiovascular disease, up 3.2 per cent over the previous year, representing more than any other category of prescription drugs.

We need an equitable and universal pharmacare program that doesn’t just address access to medication but also helps lower drug costs by increasing buying and negotiating power and reducing the costs of administration.

Our health-care system would also benefit because non-adherence to prescriptions — which would likely be reduced with a universal program — is associated with significant increases in mortality, hospitalizations and costs.

Studies suggest that between $4 billion and $9.4 billion per year could be saved on public spending with the implementation of a national pharmacare program. That’s money that can be re-invested in providing critical programs and services for people in Canada.

In a recent public opinion poll conducted on behalf of the Heart and Stroke Foundation, about a quarter of Canadians said they face cost challenges in getting the medicines they need: 24 per cent said in the past year that due to cost reasons, they or someone in their household hadn’t filled or renewed a prescription, or had done something such as skipping a dose or splitting a pill.

That’s a recipe for a lot of unnecessary medical problems. For more than a third of Canadians (35 per cent), the cost of prescription drugs is a cause of stress to their household budget.

Additionally, one-quarter of Canadians (25 per cent) said they or someone in their household has hesitated about quitting or changing jobs because of worries about losing prescription drug coverage they have through their work. That inhibits economic mobility.

There is also a broad consensus about how to solve these issues. More than nine out of 10 Canadians (93 per cent) believe it is important everyone across Canada has the same access to prescription drug coverage, and 88 per cent believe the federal government has a responsibility to make that happen.

The foundation supports the creation of a national, universal pharmacare program where the public payer is the first payer, in order to achieve cost efficiencies in drug pricing.

The program should be available to all Canadians and include a robust national formulary.

The program should also allow Canadians to have additional support provided by private insurance plans where appropriate.

The benefits are clear: a national, universal pharmacare program will drive down costs, provide better value for money and reduce the burden on the health system.

But even more importantly, it will help Canadians stay in better health. Better health for less money. That, surely, is something everyone can agree on.

Yves Savoie is CEO of the Heart and Stroke Foundation.