When I had lymphoma 12 years ago, I needed to take the drug pegfilgrastim (Neulasta) to get my white blood cell count high enough that I could take my next chemotherapy treatment on time. Before prescribing it, my oncologist asked if I had insurance. I did. And so, I took the drug, which at that time cost well over $2,000 per syringe.
Just two months before the 2019 federal election, Dr. Eric Hoskins, chair of the Advisory Council on the Implementation of National Pharmacare, released A Prescription for Canada: Achieving Pharmacare for All, which recommended a universal pharmacare program.
Today, private and public spending on drugs is almost equal to what Canadians pay for physician services. But in the late 1950s and early 1960s, Canadians spent more than three times as much on doctors than they did on prescription drugs. As a result, physician services seemed more urgent.
The Hall Commission also expressed concern about the high price of drugs in Canada. Canadian drug prices were skyrocketing as new drugs were developed. But the industry was also highly profitable. Drug companies were spending more and more on advertising and promotion. Other countries that had included drugs in their public health systems, including New Zealand, Norway and the United Kingdom, were struggling to control costs.
By the late 1990s, after years of cuts, Canadians were worried about the health-care system. In 1997, the National Forum on Health, an advisory body established by the prime minister, recommended national pharmacare. The Liberals included pharmacare in their platform that year.
In 2004 at a meeting of the Council of the Federation (a gathering of the 13 provincial and territorial leaders), the premiers recommended a national pharmacare plan. But support for the plan was weak. The 2004 Health Accord, which promised substantial new funds to the provinces for health care, only agreed to cost-out options for catastrophic drug coverage.
Liberals need to negotiate with provinces
Will we finally get pharmacare with this just-elected minority government? It was a minority government under Lester B. Pearson that delivered medicare. The NDP have made it clear that pharmacare is a priority.
But the Liberals will need to negotiate with the provinces, and the mostly Conservative premiers are unlikely to make that easy. The insurance industry also has a lot to lose.
The Canadian public, the vast majority of whom have access to drug benefits through their workplace, will be sensitive to any tax increases that might result.
This is a corrected version of a story originally published Oct. 31, 2019. The earlier story misidentified the name and the cost of the drug the author used to raise her white blood cell count.