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 Summary

This paper proposes a national Pharmacare plan for Canada that would provide equal access to prescription drugs, be publicly funded and controlled, and cover essential drug costs in the same way that Medicare now covers hospitals and physicians.

Our current patchwork of public and private drug plans is inequitable, because obtaining coverage for drug costs is not determined by need, but by where you live and work. The present system is also incapable of resisting the negative influence of pharmaceutical companies on cost and safety, and has not ensured that our use of drugs is safe and appropriate. We urgently need a new system that would be accessible, safe, and affordable.

All Canadians should have access to the drugs necessary for healthy living. The goal of a public Pharmacare plan would be to provide essential drugs approved on a national formulary to all Canadians on a first dollar basis, that is, with all costs covered. Seniors, children, those with disabilities and those on low incomes should be immediately relieved of any drug costs. For a phase-in period, while cost-saving mechanisms would be coming into effect, others would contribute a limited proportion of their drug costs.

A public Pharmacare plan must include an independent agency to approve drugs on a more rigorous basis, set research standards and ensure that research findings are available to health care professionals and to the public. Post-marketing safety must also be strictly monitored. Drug company advertising and promotion to the public and to health care professionals must be replaced with more reliable and independent information.

The proposals for safety would reduce costs by restricting new, more expensive drugs to situations where they offer a therapeutic advantage and by ensuring that drugs are used for appropriate and tested therapeutic reasons. We also need a national formulary of essential drugs, approved in a process that considers both safety and cost effectiveness. Patent laws need to be reviewed to allow the earlier introduction of cheaper generic drugs.