Universal Pharmacare in Canada

The federal Standing Committee on Health is recommending a single-payer, universal prescription drug plan for Canada. The recommendation came in its report Pharmacare Now: Prescription Medicine Coverage for all Canadians (in PDF), tabled in the House of Commons on April 18, 2018.

What is the issue?

Currently, Canada’s universal health care program does not include a universal prescription drug plan. Coverage in Canada vastly differs depending on where you live. And, it’s estimated about 700,000 Canadians skip purchases of food to pay for prescription medications and upwards of 240,000 skimp on heat to pay for drugs, said Dr. Danyaal Raza, chair of Canadian Doctors for Medicare in Toronto.

According to a recent federal report, pharmaceuticals cost Canadians an estimated $28.5 billion in 2015. Public insurance and private insurance paid for the bulk with the rest borne by individuals out-of-pocket.

In addition, the World Health Organization has declared that all nations are obligated to ensure equitable access to necessary medicines through pharmaceutical policies that work in conjunction with broader systems of universal health coverage. To that end, every developed country with a universal health care system provides universal coverage of prescription drugs—except Canada.

According to the federal government, pharmacare is the best system to solve the issue stated above across Canada, and for achieving

  • universal access to necessary medicines
  • fair distribution of prescription drug costs
  • safe and appropriate prescribing, and
  • maximum health benefits per dollar spent.

To this end, the federal Standing Committee on Health was mandated to study the development of a national pharmacare program.

Nearly 100 expert witnesses presented to the Committee, with the majority arguing that Canada needs universal, comprehensive and publicly administered prescription drug coverage.

What is the Standing Committee on Health recommending?

The recommendations found in the report include:

  • That the federal government work in partnership with the provinces and territories to replace Canada’s current private and public patchwork coverage for prescription drugs with a single payer, universal pharmacare program under the Canada Health Act.
  • That the federal government immediately commence negotiations with the provinces and territories to implement a pan-Canadian, single-payer, universal pharmacare program.
  • That the federal government assume up to 50 percent of the overall cost of a pan-Canadian single-payer, universal pharmacare system.
  • That the federal government, in partnership with the provinces and territories, develop a comprehensive, evidence-based national formulary managed by an agency that is arm’s length from government, and free of industry influence and political interference.
  • That there be no co-payments for formulary-covered pharmaceuticals as there is very strong evidence that even very small co-payments can prevent patients from filling their prescriptions.

The report also indicated that on February 27, 2018, the federal government announced that it will create an “advisory group” to launch yet further analysis and consultations on pharmacare. According to the Committee, Canadians “can’t afford to wait for universal pharmacare. They need action from their federal government. They need national leadership.” In addition, “Canadians don’t need another study on universal pharmacare. Decades of deferral have harmed the health of Canadians and resulted in billions of dollars in waste. Further delays are unjustified and unacceptable.”

That said, what do other people think: Here are some thoughts

Andrew Jackson is adjunct research professor in the Institute of Political Economy at Carleton University, and senior policy adviser to the Broadbent Institute stated in a Globe and Mail piece that

“The central recommendation of the health committee does move us forward, but the statement of the Conservative members falls well short of an endorsement and clearly envisages a continued role for private insurers and a diversity of provincial approaches to coverage. In short, there is still no all-party consensus on the main issue of whether we retain a mixed system or move to a public single-payer system.”

Accompass (a leading independent benefits, investment and compensation firm) President Sarah Beech also stated that she supports the principle behind providing drug coverage in Canada for those who are currently without, however, she is worried the recommended course of action will have consequences that may outweigh the overall objectives.

“I agree, there is a need for a form of coverage that will help those who are currently uninsured. The last thing a family should have to worry about is how they’ll afford costly prescription drugs when faced with a health issue.”

“However, “We already have elements of a strong foundation within the private and public systems. Starting from the ground up may not be the best solution. What would that rebuild look like for taxpayers?”

We will keep you updated on new developments because the implementation of a single-payer, universal prescription drug plan for Canada will impact the costs or offerings for an employer provided group insurance benefit plan. As the report hints, a national pharmacare program could be funded in part by employer and perhaps employee premiums to help offset the additional fiscal cost.


  1. This is a good idea in principle. I hope the government develops a realistic plan to pay for it.