The Journey Towards National Pharmacare: Dr Eric Hoskins on Canada’s Next Steps
Education and Advocacy Dr. Eric Hoskins is Chair of the Advisory Council on the Implementation of National Pharmacare. He spoke with Mediaplanet about the work of the Council and Canada’s next steps towards increasing health care access for all.
Mediaplanet: What are the primary considerations that have to be made when recommending a national pharmacare strategy for Canada?
Dr. Eric Hoskins: The two main considerations that the Pharmacare Advisory Council is working on are that firstly, too many Canadians are left behind with the current patchwork of drug coverage and are unable to afford the medicines prescribed to them and that secondly, Canadians are paying the highest prices for prescription drugs compared to almost every other country in the world. Our challenge is to recommend a national pharmacare program that will help solve those two issues and work in the Canadian context. Throughout our engagement with Canadians over the past several months we were guided by three central questions: who will be covered and under what circumstances; which drugs should be covered; and finally, how we should go about paying for a national program.
MP: What role can a national pharmacare program play in widening access for Canadians?
EH: National pharmacare can ensure that all Canadians have the ability to access the medicines they need. Right now, two to three million Canadians say that they did not fill one or more prescriptions in the last year because of affordability issues. More than one million Canadians forgo necessities like food or heat so that they can afford their prescription drugs. To put this into perspective, one million Canadians populate a city the size of Winnipeg. Imagine for a moment, if all the people in Winnipeg could not afford their medication. This is the challenge the Council has been tasked with solving and this is the problem that National Pharmacare can address. That is why the Council will give the Government a blueprint on how to implement National Pharmacare in a way that respects provincial and territorial jurisdiction in health care, and delivers comparable access to prescription drugs at an affordable cost.
MP: What would you say are the main barriers to its implementation?
EH: I am not sure I would like to characterize any one thing that we’ve come across as a barrier to national pharmacare — there are certainly numerous challenges in terms of the design and implementation due to the way health care is currently delivered in Canada. These challenges are, of course, part of those key questions that we have been meeting with our partners to discuss and work through. Ultimately, it is up to the Council to recommend something to the federal government which addresses these challenges, like cost, but keeps its focus on Canadians’ best interest. Of course, it is important to choose a model that is both affordable for Canadians and reduces the barriers that prevent people from having access to prescription medicines.
MP: What role could private payers play in the National Pharmacare strategy?
EH: I don’t want to get ahead of the Council’s work just yet as we are still working on our recommendations to the Government. What I can tell you, however, is that the role of private insurance is one of the factors that we are continuing to look at. Private insurers deliver benefits to millions of Canadian workers and their families, but at the same time, not all Canadians with private insurance have the same coverage. We know that many Canadians, despite having private coverage, struggle to afford their medicines. Some programs are very generous and cover almost all drugs with no co-pays, while others are more restrictive with significant deductibles, co-pays, spending caps and a limited number of insured medications.
MP: How can we ensure the widest possible access for those with rare diseases to the medication they need?
EH: Again, I don’t want to get to ahead of the report and our recommendations. However, I will say that the Council heard from many Canadians who struggle with a lack of coverage for rare diseases or the cost of that coverage. We also heard from employers and governments about the significant challenge the cost of these drugs can pose. This is something that the Council will be considering as we formulate our recommendations to the Government.