The start of national pharmacare

A breakdown of what the new pharmacare system means for Canadians
Ranz Bontogon – Argosy Photographer

On February 29, 2024, Minister of Health Mark Holland tabled a plan in the House of Commons in what is the start of a new pharmacare program in Canada. After negotiations with the NDP, Holland announced that Bill C-64, “an Act Respecting Pharmacare” will cover some diabetes treatments and contraception. If the bill passes, the federal government can negotiate with provinces and territories on each of their plans and implement the system in what Holland hopes will be this year.


For diabetics, this is a landmark announcement. Annual costs for type 1 diabetes can range between $531–5,264 while type 2 can be from $2,529–2,868 according to Olympia Benefits. Of the 3.7 million Canadians with diabetes, one in four have reported that they do not follow their treatment plans due to cost. This means that people will ration insulin usage, estimate their glucose levels, or take oral medication less than required to save costs, which is a deadly risk. In a 2022 study, New Brunswick held the highest out-of-pocket costs for type 2 diabetics with the highest being $18,306 that year, and was the most expensive province for diabetic adults with an income of over $150,000. The governments of New Brunswick, Nova Scotia, and Alberta do not cover type 2 diabetes costs for adults.


Access to contraceptives is another critical aspect of Bill C-64. While Holland has not yet said what products will be covered, he promised a “comprehensive suite” will be covered under the pharmacare plan for provinces and territories that agree to take part in the program. The NDP’s health critic, Don Davies said, “Every young woman [sic] who needs contraception, we want to make sure she [sic] can get the contraception she needs. These are the kinds of things that we are working toward.” Currently, British Columbia is the only Canadian province that has universal pharmacare coverage. While all provinces and territories have some sort of coverage, improving pharmacare will especially assist Newfoundland and Labrador, Yukon, and New Brunswick as they are ranked the lowest in Canada for access to modern contraception according to Action Canada for Sexual Health and Rights.


Holland hopes that this change is the first of many, saying that he wants to take a “step-by-step” approach before implementing a universal pharmacare program. Holland stressed that the federal government is committed to providing “full coverage so that everybody can afford their medication.” While it is unclear how long this process will take, it is known that a full pharmacare program will be valued at $40 billion annually. This initial program will cost the taxpayers $1.5 billion annually according to Holland, however, an anonymous source close to the negotiating table told CBC that the Liberals have $800 million to spend on the program. Deputy Prime Minister and Fiscal Minister, Christia Freeland said four days before the deal that pharmacare will not endanger Canada’s fiscal policy and they will stand by its current spending rules.


One who has not been incredibly vocal about the program is Conservative leader Pierre Poilievre. In an interview by AM 800 CKLW in Windsor, Ontario, Poilievre said: “They make these promises and then in the end they deliver exactly the opposite of what they say […] so let’s see what actually comes out, who actually qualifies, and who can qualify, and let’s find out what it will cost.” When asked by reports on February 29 if he would dismantle the pharmacare system, Poilievre remained silent.


Canada is the only country in the world with a universal healthcare system that does not have a universal pharmacare system outside of hospitals; and now, it has taken its first step to leave this behind. No longer will people with diabetes who struggle to afford their medication have to ration their intake. Safer sex will also become a priority with the expansion of covered products. This story is still developing so it is important to continue to be informed and up-to-date on this brand new process.

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