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OTTAWA — Publicly funded prescription drugs under a universal pharmacare program would provide better health care to Canadians at a lower cost than the status quo, the House of Commons health committee said Wednesday after two years of work and evidence from 99 witnesses.

"Canadians can save money and have better health outcomes with a national pharmacare program," committee chairman Bill Casey said in releasing the long-awaited report.

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After hearing from health-care advocates and expert witnesses, Casey said he was surprised to learn just how many Canadians are not taking crucial medication they need for serious health conditions.

"They know they’re going to remain ill, and they know they’re not going to get better because they just can’t afford those pharmaceuticals."

The current "erratic" patchwork of drug coverage in Canada means drug prices are higher than in 26 other Organization for Economic Co-operation and Development countries, Casey said.

There are nearly 80 different drug plans under provincial, military and Indigenous programs.

The committee made 18 recommendations it said could form a blueprint for a new single-payer, publicly funded prescription drug program for all Canadians.

The report calls for an opt-in approach, where provinces would decide whether to be part of a national drug formulary that would be cost-shared between the federal government, the provinces and territories.

Winnipeg Liberal MP Doug Eyolfson, a former surgeon, said that would help Manitoba get health spending under control.

"The ability to bulk-buy would save billions of dollars a year," he said.

He said it would also introduce provinces to newer, cheaper medications that are more effective. Currently, not every province proactively monitors what’s on the market.

He rejected the idea that provinces with younger populations, such as Manitoba, would pay more to support the Atlantic provinces, which have an older population.

"This goes across all age demographics," Eyolfson said, adding that treating illnesses earlier in life is cheaper for society than having low-income families not taking drugs because they can’t afford them.

The all-party committee disagreed about how much a national program would cost, and how it should be implemented.

Conservative health critic Marilyn Gladu said she fears the costs could be far higher than the $19-billion annual estimate put forward in a recent report by the parliamentary budget officer.

It’s also unclear how many Canadians who are currently covered by private drug plans would be willing to give up their coverage in exchange for a publicly funded model, she added.

"I think it’s important to answer the questions that remain — there was some conflicting data within the report — and also to talk to the provinces, because they have jurisdiction in this area," she said.

NDP MP Daniel Blaikie said his Transcona-Elmwood constituents are concerned about drug prices. He wants a bolder plan that gets the provinces on board, so they can negotiate lower drug prices together.

"It’s not enough to just say ‘We’re going to have a mismatch of different programs.’ I think the federal government needs to be providing stronger leadership than that," he said.

"This is not an example of where going halfway saves you half the money, because it’s based on economies of scale."

The Liberals have promised that an advisory group established in February would review the recommendations. That group will work with provinces and territories and Indigenous groups on the feasibility of a national pharmacare plan.

Advocates who have long called for a national pharmacare program cheered the committee report, and urged the government to act quickly on its recommendations.

Eyolfson said he’s concerned about rising co-payments. Many drug plans used to cover all expenses, but now only pay 80 per cent and have hinted at lower thresholds. He’s concerned that if the system doesn’t change, employers will hire more temporary workers to save on rising benefit costs.

"There’s always the possibility that they might start hiring people as contract workers as opposed to employees."

— with files from The Canadian Press

dylan.robertson@freepress.mb.ca