Heart & Stroke is calling on the federal government to implement a national, universal pharmacare program. Here's why this matters and what a program could look like.
Q: Why do people in Canada need a national pharmacare program?
A: Canada is the only country in the world that has a universal healthcare system that does not have universal coverage for prescription drugs outside of hospitals. In fact, 7.5 million Canadians have insufficient or no coverage. Recent polling shows that people in Canada support a national pharmacare program, with 93% saying equal access for all is important.
Lack of coverage is causing people to take risks with their health. That means doing things like cutting a pill in half to make a prescription last longer, or not filling a prescription at all due to the high cost. That same poll shows nearly one in four Canadian households has done something like that in the past year.
Q: Why is this issue so important for Heart & Stroke?
A: Diseases of the circulatory system are the leading causes of death for people in Canada. These diseases — including heart disease, stroke and vascular cognitive impairment—claim a life in Canada every five minutes. In 2019, Canadian pharmacies dispensed roughly 101 million prescriptions for medications to treat cardiovascular disease — more than any other category of prescription drugs.
We need better prevention, treatment and management of heart disease and stroke. One of the ways we can achieve that is through improvements in access to medications by implementing a national, universal pharmacare program.
Q: Why is it important for people who are at risk of or who have experienced heart disease or stroke to have access to prescription medication?
A: Prescription drugs are a really important component for treating and managing a lot of different heart and brain conditions. When used properly, they can save lives. But it isn’t just about people who have experienced something already. For example, medication for high blood pressure, which is the number one risk factor for stroke and a major risk factor for heart disease, can help prevent serious health problems later on.
And we know that 16% of Canadians have gone without medication for heart disease, cholesterol and high blood pressure due to cost.
Making sure that people have access to medication they need will lead to better health outcomes, less time spent in hospitals and decreased costs for health care.
Q: What is the issue with the current system? Don’t most people have prescription drug coverage already?
A: There are two critical problems with how things are right now. The first is a question of equitable access. The second is long-term sustainability.
On the matter of equitable access, the current system leaves a lot of gaps. Women, recent immigrants and racialized Canadians are more likely to be unemployed and less likely to have jobs that offer extended health benefits such as drug coverage.
Additionally, not taking medication because of cost is much more common among Indigenous people, people aged 18-44 years, people with lower health status and people with lower incomes.
Indigenous people also face numerous other challenges accessing prescription medications. Many face long delays or are even denied when they try to access drugs through the Non-Insured Health Benefits (NIHB) Program administered by the federal government.
The COVID-19 pandemic has increased the need for national, universal single-payer pharmacare. Canadians are twice as likely to have lost prescription drug coverage than to have gained it over the past year.
Sustainability is also a critical issue. Heart & Stroke recommends the development and implementation of an equitable and universal pharmacare program that doesn’t just address access to medication but also helps to lower drug costs by increasing buying and negotiating power and reducing administration.
Canada’s healthcare system would also benefit because non-adherence to prescriptions — which would likely be reduced with a universal program — has been associated with significant increases in mortality, hospitalizations and costs.
In fact, studies suggest that between $4.2 billion and $9.4 billion per year could be saved on public spending with the implementation of a national pharmacare program.
Q: What should a national pharmacare program look like?
A: Heart & Stroke believes the best way forward is the development and implementation of a program designed to improve access to cost-effective medications for all people in Canada. This means people can get the medicine they need regardless of where they live, how old they are or their ability to pay.
We believe that it should include a comprehensive common formulary — a list of approved drugs — and that the public payer should be the first payer. This would allow private insurance to supplement the common formulary with brand name medicine or other medicines not available through the public plan.
See our policy statement on improving access to medicine.