Canada's health ministers met in Halifax September 27-28 to discuss the 2014 health accord, the recommendations coming out of the Council of the Federations' Innovation working group, and how to work together to improve health care without leadership from the federal government.
In July, the premiers announced that provinces would begin work on bulk purchasing two to three generic drugs. The advantage with bulk purchasing is that provinces and territories can often get a better deal with pharmaceutical manufacturers the more they buy. Currently, provinces and territories negotiate one-on-one with pharmaceutical companies and due to a non-disclosure clause they're often unaware of what the other provinces or territories paid for the same drug from the same manufacturer. Less populous provinces or territories are likely to purchase less of any drug and therefore they pay a higher price per pill.
Bulk purchasing is certainly a step in the right direction, but limiting bulk purchases to 2-3 generic drugs is a far cry from the national pharmacare program promised in the 2004 health accord.
The Ontario government had promised to look into bulk purchasing with their regional neighbours in hopes that they could bring down the cost of the drugs they use. However, every province and territory has a different drug formulary -- meaning they purchase different versions of drugs and the provincial plan covers different versions of different drugs. Negotiating which drugs should be included in the formulary and which shouldn't is rumoured to have been a nightmare and the provincial governments gave up on the idea of bulk purchasing all of their pharmaceuticals until the federal government was able to take leadership and help develop a national formulary.
Provincial/territorial premiers play tug-of-war with Stephen Harper
This summer when the premiers first announced their intentions to bulk purchase drugs, the Council of Canadians and many of our allies saw this an attempt from the provinces and territories to find solutions to the pharmacare crisis -- 1 in 10 Canadians are unable to afford their prescription medication -- regardless of the federal government's absence. We understood that the provinces and territories are in a tough position. They've been told that they'll lose $36 billion in health transfers in the next accord, more programs and services are being downloaded onto them by the federal government -- such as is the case with Manitoba and refugee health care -- and with many Canadians losing their full-time jobs, health benefits are also being lost. The premiers have a lot on their plate right now.
Due to the federal downloading of programs and services and the abdication of the federal government from their health-care responsibilities, the Council and our allies were expecting the implementation of programs like pharmacare to be a little slow. We encouraged and supported the premiers' calls for Harper to return to the 2014 negotiating table. But this Friday the federal government announced their intentions to join the premiers in bulk purchasing 2-3 generic drugs -- the federal government still purchases medicines for aboriginals, RCMP and prison inmates. Bulk purchasing would save the federal government some money and if the premiers are already doing most of the work, Ottawa can take a backseat in the negotiation process.
Having the federal and provincial governments work together to bulk purchase medicines will indeed save Canadians millions of dollars. However, if the governments fulfilled their promise of pharmacare in the 2004, we could be saving billions -- $10.7 billion -- each year! The federal government's announcement has simply turned into another abdication of responsibility. Instead of trying to negotiate a pan-Canadian pharmacare plan that would bulk purchase all medicines, change our current price comparator countries -- Canada artificially inflates the cost of drugs because we use the most expensive European comparator countries instead of the global or even OECD average -- and ensure that everyone in Canada has access to the best medication, the federal government is hopping on board with a less time-consuming program that will leave Canadians with cheaper access to only 2 or 3 medicines.
While we applaud the Council of the Federation for taking the first steps towards a national pharmacare plan, we are disappointed with the federal government's plan to continue rewarding big pharma with no plans to bulk purchase or change price comparator countries. The federal government is obviously on the side of big pharma -- they're even negotiating for a free trade agreement with the European Union that will extend patents for big pharma and cost Canadians $2.8 billion a year!
The health ministers are returning to their provinces this week to ask their premiers if the federal government is welcome to join the generic bulk purchasing plan. While we want Canadians to save money, we'd prefer that they save billions of dollars instead of just millions. But the only way for that to happen is for the premiers to insist that the federal government return to the 2014 negotiation table and lead talks on a pan-Canadian pharmacare plan.
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