On Monday, members of the Standing Committee on Health will privately review the wording of a draft report on pharmacare that is the result of two years of hearings that included 99 witnesses.

It's a report that MP Bill Casey's own government didn't actually ask for, but the Liberal chair of the committee said his fellow committee members agreed that Canadians are concerned about being able to afford and access prescription drugs.

While neither Casey nor the two opposition vice-chairs are willing to spill the beans about whether the report will call for the creation of a national pharmacare plan, he said most of the witnesses agreed that ensuring all Canadians had drug coverage would lead to "better health care for Canadians."

Conservative vice-chair Marilyn Gladu said, "I can't predict the outcome. I know there were various testimonies that we heard at committee about a national program. Some talked about putting people on existing provincial programs. So I think we'll have to have those conversations."

Canadians are currently covered by a patchwork of public and private drug plans, while a minority pay completely out of pocket for their prescriptions.

It's completely dysfunctional. - Marc-André Gagnon, Carleton University, expert witness

Government-run plans cover about 40 to 45 per cent of Canadians, and are for the most part only available to seniors, Ontarians under 25, otherwise uninsured Quebecers, welfare recipients, Indigenous people and members of the RCMP and Canadian Forces.

The plans are cheaper to run than private drug plans, because governments negotiate low prices with drug companies and they don't cover as many drugs, research has shown.

'If it's done right, everybody should save money'

When the committee asked the Parliamentary Budget Officer to research how much would be saved on prescriptions if Canadians were covered by these cheaper provincial drug plans, he concluded it would be $4.2 billion annually. That doesn't include the cost to government of extending insurance coverage to everyone.

NDP committee vice-chair Don Davies, who has called for a national pharmacare plan, said it's unlikely people who already pay for private drug coverage would end up paying more by switching to a public system.

"Everybody would be redirecting their dollars to the government. That's true. But then the savings would be amortized over everybody who's paying. If it's done right, everybody should save money."

Canadians currently pay among the highest prices for prescription drugs in the world. Canada is also the only country with universal health care that doesn't include prescription drugs.

"It's completely dysfunctional," said Marc-André Gagnon, a professor of health and pharmaceutical policy at Carleton University in Ottawa, who was called as an expert witness by the parliamentary committee.

Gagnon said because there are multiple drug buyers in the country, including hospitals, provinces and the private system, it's led to several middlemen, needless price mark-ups and overall higher prices.

"For me, this doesn't make any sense. This is money that should not be taken out of the health-care system."

Pharmacare was part of the original plan for universal health coverage in 1964. While the Liberals endorsed "pharmacare as a long-term national objective" in their 1997 election campaign platform, the current government has said it will instead focus on trying to lower prescription drug costs.