On Oct 10 Bill C-64, better known as the Pharmacare bill, passed at the federal level. The bill lays out, among a few other items, a mandate to set up single payer pharmaceutical coverage for Canadians, for two initial categories: contraception and diabetes medication and equipment.
Advocates of pharmacare across the country (including health coalitions, unions, civil society groups, and more) are wanting this legislation to pave the way for other categories to eventually be covered, and enable a national bulk purchasing strategy so that lower drug prices can be more easily negotiated. Canada currently pays the third-highest drug prices among OECD countries.
So now that the bill has passed, what's the next step to rolling out the program?
Now the federal government will begin negotiating bilateral agreements with the provinces about how the program will roll out. BC already signed an MOU with the feds about the program in September, a sort of pre-commitment ahead of the legislation passing. Some provinces have shown interest while others have outright dismissed it before negotiations have even started. The Saskatchewan government has simply stated that it will wait and see what is being proposed to them.
We want to make sure that the province negotiates in good faith and doesn't drag its feet on getting pharmacare coverage up and running here, so that people can start benefitting from it as soon as possible. In the spring we launched a letter writing campaign for residents to contact their MLA and ask for their support of this, either with their own writing or using a template we had drafted.
Stay tuned for another letter campaign from us once the provincial election is over, to put pressure on whoever forms government to ensure this happens.
What does Pharmacare mean for people in Saskatchewan?
Reducing the cost of medications makes access to health care more affordable and address several equity issues, and also reduces the likelihood of health complications down the road if conditions are not treated earlier - which can add more burden to our healthcare system. It is for both of these reasons and more that the Saskatchewan Health Coalition is in favour of universal Pharmacare.
Diabetes
Direct cost to Sask healthcare system (2023): $114 million (2023, source)
27% live with diabetes or prediabetes and 9% live with diagnosed diabetes, a figure that climbs to 13% when cases of undiagnosed type 2 diabetes are included (source)
Type 1: Highest ($7745) and lowest ($623) out-of-pocket costs, and Type 2: Highest ($6055) and lowest ($414) out-of-pocket costs (2022, source)
Other factors not quantified in report: Costs following initial diagnosis, visits to doctors and other healthcare specialists, mental health, long-term health implications, career choices and income potential, family and caregiver support, undocumented medications and supplies, food and nutrition (2022, source)
Contraception
Saskatchewan currently has the highest rates adolescent pregnancy and birth across Canadian provinces. Coverage for long acting birth control would make things more manageable and reduce contraception failure due to inconsistent or improper use. It is currently much more expensive than other forms of birth control so less accessible
Young adults also have a low contraception use rate. According to the Canadian Campus Wellbeing Study in 2021, fewer than 50% of Saskatchewan post secondary students reported using contraception consistently - well below national average.
Saskatchewan has the highest rates of IPV across provinces - free and independent access to contraception is vital for the safety of survivors regardless of their readiness to leave a violent or abusive situation.
Of course, there are detractors to this legislation, and a recent exposé by the Council of Canadians has shown that many of the folks on that side are being funded by pharmaceutical or health insurance companies or their lobbying groups. Additionally, Breach Media published an investigative piece about industry-funded patient groups influencing the discussion. These groups know that this will impact their bottom line, so naturally are coming out swinging - but we don't think their intentions are in the best interests of health equity in Canada, as private industry will always have a profit motive. Here are some of the biggest pieces of misinformation you may see floating around, from an Aug 2023 article by Steve Morgan and Nav Persaud.
Things in favour of making Pharmacare happen:
In poll after poll Canadians have indicated that want universal pharmacare, and they are proud of medicare (despite its existing faults). They recognize the value of everyone having access to what they need, rather than only themselves
If even a couple of categories of medications are covered for now, once people start accessing it and seeing benefits it will make it harder for successive governments to try to dismantle
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