Canada's healthcare system has long been a source of pride for Canadians, offering universal access to essential medical services regardless of one's financial status. However, one significant gap has always persisted: the absence of comprehensive coverage for prescription medications. This gap is about to be closed, slightly, with the introduction of a national Pharmacare plan, marking a pivotal moment in the evolution of Canadian healthcare.

Pharmacare (also known as a universal single-payor drug plan) aims to provide Canadians with access to necessary prescription drugs without financial barriers. With the rising costs of medications and an ageing population, the need for such a program has become increasingly evident. The implementation of Pharmacare promises to enhance the accessibility, affordability, and sustainability of healthcare in Canada.

Bill C-64, which introduces legislation for the first phase of a national Pharmacare plan in Canada, was passed by Parliament on Monday, June 3. It will now be sent to the Canadian Senate for their approval. A roll-out date for the implementation of the plan has not yet been announced.

Why Do We Need Pharmacare?

One of the key motivations behind Pharmacare is to alleviate the financial burden faced by individuals and families who struggle to afford the medications they need. According to statistics, millions of Canadians either lack prescription drug coverage altogether or have inadequate coverage, forcing them to make difficult choices between their health and other necessities. Pharmacare seeks to eliminate this dilemma by ensuring that all Canadians have equitable access to essential medications, regardless of their socioeconomic status.

Moreover, Pharmacare has the potential to improve health outcomes across the country. By ensuring that individuals can afford the medications prescribed to them, the program can facilitate better management of chronic conditions, reduce the incidence of preventable illnesses, and ultimately enhance overall well-being. This preventive approach not only benefits individuals but also contributes to the sustainability of the healthcare system by reducing the need for costly interventions down the line.

The introduction of Pharmacare appears to be rolling out gradually. The first prescriptions to receive coverage will include contraceptives and certain medications and equipment used to treat and monitor diabetes (though coverage for newer, expensive, and effective antidiabetic medications such as Ozempic, Mounjaro, and Rybelsus have been glaringly excluded). ARTA will be monitoring additional drug classifications as they are added.

What is the Cost?

On a national level, the government is spending considerably less on a national pharmacare plan than its Canadian Dental Care Plan (CDCP), which is currently being rolled-out for all lower-income Canadians – the CDCP is expected to cost $13B over the next five years, whereas the national pharmacare plan is only costing $1.5B over the next five years.

On an ARTA level, the implementation of a national pharmacare plan would save ARTA over 1.9% of paid claims, since these costs would be borne by the plan, almost entirely due to the reduction in costs for insulin and diabetic supplies; unsurprisingly ARTA doesn’t pay for a lot of contraceptive medications.

The continued, gradual rollout of Pharmacare coverage would see even more savings for ARTA in the future, meaning lower rates for members, and more potential funding for paramedical services and other products not yet covered by the national plan.

No Pharmacare for Albertans?

While a national Pharmacare plan stands to benefit many Canadians, and the majority of seniors, there is one major problem facing Alberta residents who might wish to make use of the plan. The provincial government of Alberta has already gone on the record to declare that they would not allow Alberta to participate in the national pharmacare plan.

If you believe implementation of such a plan would benefit all Canadians, and you want your voice heard, we have provided a link to a letter template below you may use to send to your MLA to voice your concerns. Together the voice of ARTA is strong.

Find your MLA:

Pharmacare advocacy letter template