National PharmacarePublished on 10 April 2014 Your Question Period by Senator James Cowan (retired)
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Hon. James S. Cowan (Leader of the Opposition):
Honourable senators, my question today comes from Dr. Danielle Martin, a family physician in Toronto. Dr. Martin was the founding board chair of Canadian Doctors for Medicare and is currently Vice President, Medical Affairs and Health System Solutions at Women’s College Hospital in Toronto. Colleagues will know that her recent presentation to the U.S. Senate has received enormous attention and support in Canada.
Dr. Martin’s question is as follows:
As a family physician working in the trenches of Canadian health care, I often see patients who do not take their medications because they cannot afford them. One of my patients is a taxi driver whose South Asian heritage and sedentary job have predisposed him to his current medical problems of diabetes and high blood pressure. In spite of working long shifts and being careful in his spending, he cannot support his family and pay for his medically necessary medications. I worry, as he does, about the complications he may experience in the coming decades, some of which could be devastating such as heart attacks, strokes, and blindness, because he cannot both feed his family and buy his needed medicine.
Stories like this are all too common across Canada. A recent study by Law and colleagues found that 1 in 10 Canadians does not fill a prescription or take medication as prescribed because of concerns about costs. This turns out not only to be an issue that adversely affects self-employed and precariously employed Canadians, but also an issue of profound regional inequity that should be of deep interest to our federal government. A patient with congestive heart failure might face out-of-pocket costs for prescriptions varying between $74 and $1,332, depending on which province she calls home.
At the time that our cherished Medicare system was developed in the 1950s and 1960s, and even into the 1980s with the passage of the Canada Health Act, the bulk of health care was provided by physicians and in hospitals. Today our systems are rapidly transforming to meet the needs of an aging population that is living longer with chronic disease. Indeed, we know that 2/3 of Canadians over the age of 65 take 5 or more medications. The needs of Canada’s aging population cannot possibly be met without appropriate access to life-saving medications in the community. By far the most administratively simple and equitable solution would be to expand our public insurance plans to include coverage of medically necessary medications alongside those things currently mandated under the Canada Health Act.
Furthermore, pharmaceutical costs are rapidly increasing across both public and private insurance plans in Canada. National Pharmacare, with a national formulary and bulk buying of medications, could reduce costs by between 10 and 42 per cent, saving up to $10.7 billion annually.
The 2003-2004 Health Accords called for a National Pharmaceutical Strategy that would represent baby steps toward this vision, but the NPS died on the vine and the Health Accord has not been renewed.
My question is: Will this government put National Pharmacare on the agenda?