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In support of universal pharmacare

15 August 2019

Dear leaders of federal political parties,

We are experts in health care and public policy concerned, as you are, with the quality, equity, and sustainability of Canada’s health care system. As you head into the 2019 federal election, we are asking you to make a firm commitment to implementing a universal, comprehensive, public pharmacare plan – starting with necessary legislation and budget commitments in 2020. Such a pharmacare plan would be the most positive transformation of our health care system since the establishment of “Canadian Medicare” in the 1950s and 1960s.

We believe that ensuring universal access to appropriately prescribed, affordably priced, and equitably financed medicines should not be a partisan issue, and that applying the principles of Canadian Medicare to necessary medicines is not a radical idea.

Pharmaceuticals are so important to health and well-being that the United Nations and World Health Organization have repeatedly declared that all nations should ensure universal and equitable access to them. To fulfil that obligation, every high-income country with a universal health care system provides universal coverage of medically necessary prescription drugs – every such country except Canada, that is.

In Canada, universal public health insurance effectively ends as soon as a patient receives a prescription to fill. Although many Canadians have access to public or private drug insurance, the patchwork of drug plans in Canada creates inequities in access to medicines, exposes households and businesses to considerable financial risk, fragments our purchasing power on the global pharmaceutical market, and isolates the management of prescription drugs from other key components of Canadian Medicare. None of these things is good for the health care system or the economy.

Canadians deserve better.

Since the 1960s, five separate national commissions have recommended that medically necessary prescription drugs be included in Canada’s universal, public health insurance system. They all recommended such a program because it is the most equitable and affordable way to ensure universal access to necessary medicines in Canada. The latest of such reports - the June 2019 report of the Advisory Council on the Implementation of National Pharmacare – provides sufficient detail to guide implementation over a feasible timeline that begins with federal legislation and investments in 2020.

As experts in health care and public policy, we can state unequivocally that national pharmacare does not need to be studied further before proceeding with implementation. In addition to the many government studies that have drawn the same conclusion, credible, peer-reviewed research indicates that a universal, comprehensive, public pharmacare program would improve access to necessary medicines and significantly reduce financial strains on Canadian households and businesses. Government and academic studies estimate that such a program will reduce total prescription drug spending in Canada by $4 billion to $11 billion per year.

Canada already has the knowledge, expertise, and institutional capacity needed to run a world-class universal pharmacare system. The history of Canadian Medicare shows that such a program can be implemented in our federation, provided there is adequate federal financing and oversight. The only ingredient missing is the leadership to act.

This is why we are asking you to commit to implementing a universal, comprehensive, public pharmacare plan, starting immediately in 2020. Such a program will improve the quality, equity, and sustainability of Canada’s universal health care system and the competitiveness of the Canadian economy. It will also leave a lasting, positive legacy that will be yours if your government is the one to see it through.

You can count on our support in moving this forward.



More than 1,200 academic experts in health care and public policy.