Ottawa unveils national pharmacare plan that covers diabetes, contraception to start

Health Minister Mark Holland released the long-awaited details of the federal government's pharmacare plan on Thursday, with a commitment to cover some diabetes treatments and contraception.

If the bill, C-64, passes Parliament, Holland will begin negotiating with the provinces and territories on a funding commitment that would cover the cost of providing these medications to people for free.

The federal government says it also will establish a fund to support Canadian diabetics who need access to syringes and glucose test strips to manage their condition but struggle to afford them.

The government says one in four Canadians with diabetes — about 3.7 million people have the condition — have reported they're not following their treatment plans due to the cost.

The "first-dollar" coverage for these drugs — an insurance industry term which means the government foots the bill entirely — will help those diabetics in particular.

The pharmacare plan also will give the nine million Canadians of reproductive age better access to contraception to ensure "reproductive autonomy, reducing the risk of unintended pregnancies and improving their ability to plan for the future," the government said in its media release.

The exact types of contraception covered by this program have not yet been chosen but the government is promising that "a comprehensive suite" of drugs and devices eventually will be covered in the provinces and territories that sign on.

This is the first step in what could be a much more robust regime in the years ahead, although its future is uncertain. Some provinces are already demanding the chance to opt out of the federal program, or are rebuffing Ottawa's efforts entirely.

The federal government says that, beyond diabetes treatments and contraception, it intends eventually to implement universal, single-payer coverage for other medications.

The government says it will strike a committee of experts to advise it on how to implement such a program and will then pursue bilateral deals with each of the provinces and territories before proceeding a larger pharmacare plan.

A 'step-by-step' approach

The government said it wants to take a "step-by-step" approach to implementing a larger program, which could come with a multi-billion dollar price tag and upend the country's existing drug coverage network.

Most Canadians already have coverage for prescription drugs through a patchwork of public and private insurance plans. It's not immediately clear what effect a national, universal program might have.

The plan announced Thursday also includes a plan to create a national formulary — a list of essential drugs that could be eventually covered by the government — and develop a national bulk purchasing strategy.

Federal officials speaking to reporters during a background briefing said the government does not know how much this pharmacare program will cost taxpayers.

The final price tag will be determined after negotiations with the provinces and territories, the officials said.

Some sort of national pharmacare program has been a long-time demand of pharmacists, health-care professionals and progressive activists who say Canada's single-payer health-care system should be paired with coverage for drugs and other treatments to improve population health.

The details were announced after months of protracted negotiations with the NDP, which demanded the government launch pharmacare as a condition of the supply-and-confidence agreement that keeps the minority Liberal government in power until 2025.