TORONTO — Ontario’s health minister does not want a full federal pharmacare overhaul, and will be urging her new counterpart in Parliament to focus instead on drugs for rare and orphan diseases.

One day after MP Patty Hajdu was named as the new Minister of Health in Ottawa, her Ontario parallel — Christine Elliott — expressed wariness around the idea of the federal government fully adopting the recommendations of a June report by Eric Hoskins.

“I don’t know that I would agree with adopting every aspect of Dr. Hoskins’ report,” Elliott said in a Thursday afternoon phone call. Later in the conversation, when asked to clarify whether she was saying the Ontario government wasn’t looking for a full pharmacare overhaul, Elliott confirmed the interpretation of her remarks. “That’s correct. We’re looking for some specific solutions,” she told iPolitics.

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Hoskins’ report in June acknowledged provinces’ and territories’ recent work on providing increased drug coverage, but urged further actions to be taken with “federal support.” His report makes multiple mentions of the collaboration that would be required from the provinces and territories in order to bring forward changes to the pharmacare system, with joint governance required for the likes of a national drug agency.

“As with medicare, it will be up to individual provinces and territories to opt in to national pharmacare by agreeing to the national standards and funding parameters of pharmacare,” Hoskins wrote.

Later, he noted that significant support would be required from other jurisdictions to make alterations to the system. “Any changes to the key elements of pharmacare, including funding, should require approval by the Parliament of Canada and 70 per cent of participating provinces and territories, representing two-thirds of their combined populations.”

Trudeau pledged to bring forward a national pharmacare program on the campaign trail this fall, after taking the first step towards one in his spring budget. (Trudeau promised $6 billion for the effort in September, which is a fraction of the $19.3 billion that the Parliamentary Budget Office estimated for a national pharmacare program two years ago.)

“Yes, that will involve negotiation with the provinces,” Trudeau said at the time. The Liberals committed to implementing a national formulary with the provinces, territories and other stakeholders, as well as a rare drug strategy for high-cost medications and a Canada Drug Agency.

The pharmacare file is one that’s expected by many strategists to move quickly in the new iteration of Parliament — in light of the relative consensus on the file from the federal Liberals, NDP and Greens.

But Elliott is hesitant. “We believe that we have quite a comprehensive plan for pharmaceuticals in Ontario, and we already do have assistance for people who find that unaffordable,” she said on Thursday. “I would rather speak about the areas where we really do have a true concern.”

In Ontario right now, she said, rare and orphan disease drugs are becoming “extraordinarily expensive” — and she anticipates the issue will only grow in the coming years, as new medications move to market and become available to patients. “It’s wonderful that these advancements are being made, because they save lives, but we are going to see more of them come on the market in the next few years. We will be looking to the federal government to help us with that,” Elliott said.

When Health Canada authorizes a so-called orphan drug, funding is not guaranteed through benefit programs, according to the feds. The responsibility for sorting out what drugs can be reimbursed, and under what conditions, falls on the provincial or territorial body that handles drug plans. (Assisting provinces and territories in finding ways to reduce the cost of orphan drugs, which treat rare diseases, was among the platform planks offered this fall by the federal Conservatives, in a similar vein as the Liberals’ promised rare drug strategy implementation.)

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There are no formal meetings or calls set at this point between Elliott and Hajdu, with Elliott saying she wanted to give her Ottawa counterpart time to settle into her new role. But Elliott intends to focus their first conversation on the pharmacare file, at which point she aims to glean a better understanding of what the federal Liberals have planned.

Congratulations @PattyHajdu on your appointment as @CDNMinHealth. I look forward to working with you on key issues like youth vaping and ensuring access to new and affordable medications while preserving the long-term sustainability of provincial drug programs. Félicitations! — Christine Elliott (@celliottability) November 20, 2019

“I am certainly hopeful that we will have a full discussion about it with all of the provinces and territories, discussing their views of it and that a final decision will be made based on those views as expressed,” she said.

(The provincial NDP, meanwhile, campaigned in the recent Ontario election on a pledge to create a universal pharmacare program.)

Beyond pharmacare, Elliott will also be asking Hajdu in their coming interactions to introduce new controls on advertisements for vaping products. “My preference would be to restrict the advertising to places where only adults can go, which would be cannabis shops or vaping shops, to make sure that it is only people of age of majority or older that are there, and they can then make their own decisions,” she said.

The PCs recently reversed a controversial decision they made last year, which had allowed outlets like convenience stores to display and advertise vaping products. Instead, the promotion of such products will now be banned in convenience stores and gas stations.

“That’s where provincial jurisdiction lies. But when you get to some of the other advertising that might be on television, or on billboards, or the advertising that you see at union station for example? That’s more a matter of federal jurisdiction,” Elliott said.