Health Care Checkup: Pharma-Tabled!

It’s here!  

After years (decades) of discussion and debate on pharmacare, there is finally a stake in the ground on the federal government’s plan. Health Minister Mark Holland took an important first step towards a pharmacare framework on Thursday when he introduced Bill C-64.  

The legislation – a key plank of the Liberal and NDP supply-and-confidence agreement, builds the foundation for a national pharmacare program in the future and commits to cover the cost of contraceptives and diabetes medications for Canadians.  

The introduction of the legislation was not without controversy, with the federal government downplaying the commitment, the NDP claiming victory, and some provinces quickly dismissing the program.  

What’s included 

The federal government has committed to: 

• Provide universal access to birth control and diabetes medication for Canadians through a single-payer system. 
• Adhere to principles included in the Canada Health Act as well as the federal government’s Hoskin’s Report. 
• Establish a committee of experts to recommend options for the operation and funding of “national, universal, single-payer pharmacare” no later than 30 days after the bill passes. 
• Request the development of an essential medicines list within one year of the bill passing. 
• Request that the Canadian Drug Agency (formerly the Canadian Agency for Drugs and Technologies in Health) develop a national bulk purchasing strategy for prescription drugs. 

What isn’t included 

• Funding details: Despite reports estimating a full single-payer model could account for more than $15 billion in new spending, Minister Holland pegged the estimated price tag of the pharmacare program outlined at approximately $1.5 billion. However, the actual cost could change significantly dependently on buy-in from the provinces and territories and the implementation approach. Expect funding details to be outlined in the 2025-26 federal budget.  
• Full or universal: A commitment to a universal, single-payer, and national pharamcare system beyond contraceptives and diabetes medication, although the NDP maintains that the legislation creates the framework for further expansion.  
• Provincial Buy-In: Minister Holland indicated that individual agreements would need to be negotiated individually with each province and territory.  

What’s next?  

While it was a scramble to meet the March 1 deadline, reaching a deal and tabling legislation was the easy part. The federal government must now chart a path forward to pass the legislation and implement the program in the narrowing window before the next federal election. 

Once the legislation makes its way through what is anticipated to be a lively committee process this spring, it will merely act as a framework for implementation, and, ultimately, negotiations.  

Canadians will be left waiting to find out exactly when they may benefit from public access to free contraceptives or insulin.  

Whatever the next phase looks like, we can promise it won’t be boring. Expect the Liberals to make significant noise relating to universal access to contraceptives – a political wedge that they will use to contrast themselves with the Conservatives – and the NDP to continue to claim this legislation as a major political victory.