qotd: Canada’s NDP supports path to Pharmacare

CBC News
September 18, 2015
Tom Mulcair commits $2.6B to support pharmacare plan

A New Democratic government would use the purchasing power of the
federal government to negotiate lower prices for prescription drugs and
pass those savings on to the provinces and territories, NDP Leader Tom
Mulcair says.

The NDP plans to spend $2.6 billion over the next four years to "work
towards a plan to support universal comprehensive public drug coverage
for all Canadians," if it takes the Oct. 19 vote.

The party is not committing to implement full coverage by the end of its
first mandate, but Mulcair said he hopes to achieve average savings of
30 per cent in prescription drug costs through bulk buying.

Once in place, the plan would save the provinces and territories up to
$3 billion annually.

Health care is a provincial and territorial responsibility, so an NDP
government would have to negotiate precise arrangements with the other
various governments. It would not have the power to impose a free
coverage scheme. Some provinces, however, have been pushing for such a
scheme for some time.

http://www.cbc.ca/news/politics/canada-election-2015-mulcair-seniors-medication-prices-1.3234173

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OECD

In US dollars, adjusted for price differences (PPP)

Total health expenditure, per capita:

$8,713 - United States (Ranks highest of 34 countries listed)

$4,351 - Canada (Ranks tenth of 34 countries listed)

$3,453 - OECD average

Expenditure on pharmaceuticals, per capita:

$1,034 - United States (Ranks highest of 31 countries listed)

$761 - Canada (Ranks second of 31 countries listed)

$517 - OECD average

http://www.compareyourcountry.org/health?cr=oecd&cr1=oecd&lg=en&page=2

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Pharmaceutical Policy Research Collaboration, University of British Columbia
July 15, 2015
Pharmacare 2020
By Steven G. Morgan, PhD, Danielle Martin, MD, CCFP, MPP, Marc-André
Gagnon, PhD, Barbara Mintzes, PhD, Jamie R. Daw, MSc, Joel Lexchin, MD, MSc

We are pleased to present this report, Pharmacare 2020, which is the
culmination of many years of research and collaboration involving
academics, health professionals, policy-makers, and public interest groups.

The vision is of a public drug plan that follows four policy
recommendations:

1. Provide universal coverage of selected medicines at little or no
direct cost to patients through Pharmacare.

2. Select and finance medically necessary prescription drugs at a
population level without needs-based charges — such as deductibles,
coinsurance, or risk-rated premiums — on individuals or other plan
sponsors (e.g., businesses).

3. Establish a publicly accountable body to manage Pharmacare, one that
integrates the best available data and evidence into decisions
concerning drug coverage, drug prescribing, and patient follow-up.

4. Establish Pharmacare as a single-payer system with a publicly
accountable management agency to secure the best health outcomes for
Canadians from a transparent drug budget.

Canada has been waiting for Pharmacare since the 1960s. The vision is
now clear. Thus, the task turns to the art and science of program
development and implementation. This will be difficult and will require
political leadership and inter-jurisdictional collaboration — but it is
not impossible, as Canadian Medicare has shown. This led to our fifth
policy recommendation:

5. Fully implement Pharmacare — a public drug plan that is universal,
comprehensive, evidence-based, and sustainable — by 2020.

http://pharmacare2020.ca/assets/pdf/The_Future_of_Drug_Coverage_in_Canada.pdf

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Comment by Don McCanne

The United States and Canada were following the same health care cost
trajectory until Canada established single payer systems in each of
their provinces. They elected not to cover pharmaceuticals. The OECD
data demonstrate that this omission was a mistake.

The total health expenditure trajectories diverted, with the United
States continuing to hold first place and Canada declining to tenth
place amongst 34 OECD nations. But in pharmaceutical expenditures,
Canada is second of 31 OECD nations, with per capita drug expenditures
exceeded only by the United States.

Drug costs have become intolerable - now 17.5% of their health care
spending (calculation using the OECD numbers). Although there has long
been much interest in establishing a universal drug program in Canada,
the efforts have intensified - culminating in the Pharmacare 2020 report
prepared by some of Canada's more gifted policy experts. The report
makes a compelling case for establishing a Pharmacare program.

The concept has gained traction. Canada's New Democratic Party (NDP),
led by Tom Mulcair, has now committed to taking major steps toward
making Pharmacare a reality. The three major parties - Conservative,
NDP, and Liberal - are very close in the projected results for their
election to be held October 19. Whether or not NDP wins, at least
Pharmacare is now part of the national political discourse in Canada.

And the United States?