The Gazette endorses Dr. Marc-André Gagnon's position on universal Pharmacare

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23 May 2011

Canada needs a universal drug plan. Without one, Canadians are left in a medical limbo where life-and-death decisions are made on the basis of where a patient lives.

As The Gazette reported Friday, Alice Thepen and her husband Rudy, of Hudson, have paid $100,000 out of pocket for 14 months of treatment with Avastin for Alice Thepen's brain cancer. With the treatment, Thepen's tumour has shrunk significantly, but the couple's savings are depleted.

If the Thepens lived in British Columbia, the treatment cost would have been picked up by the province. Without a universal drug plan, this is what Canadians face: a postal-code lottery.

Health care, which is under provincial jurisdiction, is nonetheless one of the perennial themes during federal election campaigns. Long waiting lists, uneven coverage and crowded emergency rooms are all issues Canadians want to see addressed. And as far as they are concerned, if the provincial government won't do it, the federal government should.

But if Ottawa can't interfere in front-line health-care delivery, it could use its powers to negotiate with the provinces to set up a universal drug plan (along with a strict drug-assessment program). A universal national plan would ensure that when potentially life-saving drugs are approved by Canada's federal health authority, they are made available on an equitable basis, to all Canadians no matter where they live.

The country can't afford it? To that, experts say a universal drug plan would engender enormous savings. Last fall, the Canadian Centre for Policy Alternatives estimated that a universal plan could result in savings of more than $10 billion a year. The centre described Canada's current patchwork of private and public plans as inequitable and inefficient.

It is also unsustainable because Canada cannot control the cost of drugs. Canada is among the most expensive countries in the world for brand-name drugs, the centre said, 'because Canada deliberately inflates drug prices in order to attract pharmaceutical investment.'

'The cost of such policies far exceeds the benefits to Canadians from having a domestic pharmaceutical industry,' said the centre's Marc-André Gagnon, a professor of public policy at Carleton University in Ottawa.

Canada has as well one of the highest annual increases in drug costs among developed countries, Gagnon said, about 10 per cent a year. Even so, nearly one in four Canadians has no drug coverage.

A publicly administered universal plan would go a long way to bringing those costs down.

First, a single buyer like a federal government has real bargaining power with drug companies. For another thing, publicly run plans have proven to be less costly to administer. The centre estimated the administrative fees for public plans in Ontario and Quebec at two per cent, whereas private plans run to eight per cent, it found.

It's time to bring order to a system that has been allowed to grow topsy-turvy without any concern for how fair it is to the people in greatest need.