You will know well from history that real change won't happen by providing more federal money with unconditional transfers.Real change will require helping provinces to shift the focus of our health system away from those who are relatively well resourced to new areas of care, such as essential pharmaceuticals and homecare.
The glaring gaps in drug coverage for Canadian children are made stranger by the economic dimensions of the issue. Children's health care represents a drop in the ocean of health care budgets -- extending universal drug coverage to children would constitute a small fraction of total pharmaceutical spending.
Cities have to spend this money, taken from local taxpayers, because Canada's medicare system is the only universal, public health care system among developed countries that does not include universal coverage of prescription drugs. It is not wrong for cities to care for their employees. But leaving these costs to the cities makes about as much sense as requiring every homeowner to maintain the roads and infrastructure surrounding their property. Here's why.
A new study in the Canadian Medical Association Journal with health economist Steve Morgan as lead author argues a national universal care drug program would not result in substantial tax increases. It seems the time is ripe to finally complete our universal system of public healthcare coverage by adding a national public drug plan. If anything, these cautions should serve as guideposts to make sure a new national drug plan is not only effective but also designed in a fiscally sustainable manner.
The federal government plays a vital role in pharmaceutical drug regulation. We have many reasons to be proud of the systems for drug safety already in place in Canada. Yet there's room for significant improvement. Canadians deserve safe, effective, accessible and reliable pharmaceutical drugs when they need them. The only way to do this is through perpetually improved systems framed by transparency and openness.
Employers want their drug plans to be as competitive as those offered by other employers. So what happens when the norm is to cover all new drugs at any cost, even if the drugs do not provide additional therapeutic value? Well, the end result is that everyone buys "generous" plans instead of increasing employee compensation. Everyone we spoke with agrees about the need to educate employees and employers alike. And in fact, everyone agrees (even insurers) that exorbitant drug costs are a big issue for Canadians.
Last week in Berlin more than 15 countries pledged over US$7.5 billion to buy vaccines for the children of the world's poorest countries for the next five years. While this is great news for the millions of children living in the 73 countries supported by Gavi, there were other big winners: the pharmaceutical companies that benefit from the soaring vaccine prices they charge for vaccines worldwide.
Although advertising of prescription medicines to the public is generally banned in Canada on public health grounds, shifts in administrative policy have allowed two types of ads since late 2000: "reminder" ads that mention a brand name, but make no health claims; and "help-seeking" ads that mention a condition, but do not state a brand or company name. We have identified six main weaknesses in how Health Canada regulates this advertising.
The Liberal government of New Brunswick appears to be stepping back from the brink of mandatory prescription drug insurance. And so they should. The drug plan chosen by the Conservatives was designed on a false premise: that the private sector can better manage things than government can. In many sectors, that might be true. But not in health care.
Better pharmacare for all Canadians will be difficult to achieve without the federal government at the table. The government of Canada could lead on this issue in a way that no single province or territory can do, by supporting the development of a single national list of drugs to be covered for all Canadians and by harnessing the purchasing power of the whole nation to get the best possible bang for our buck.
Back in 2012, things looked grim for Canada's Big Pharma industry. A significant number of the industry's high-earning products were about to lose their patent protection, and face replacement by low-margin generics. But Canada's pharma industry, the eighth largest in the world, maintained its levels of innovation as well as formulating an innovative and successful business strategy.
How do you strike a balance when treating children with drugs in the absence of such evidence? Most people might be surprised to learn that much of the medications given to children in Canada have never been adequately studied or even formally approved for the conditions they are commonly prescribed to treat.
The Trans-Pacific Partnership (TPP) Agreement is being negotiated in secret, but leaked documents from the negotiations have revealed that the United States is pushing hard for strict intellectual property rules that would protect the profits of pharmaceutical companies at the expense of patients. These rules would extend patent monopolies and delay the introduction of cheaper generic drugs, allowing the big brand-name drug companies to maintain their high prices for longer periods of time. This would put lifesaving medicines out of reach for millions of poor people around the world. It could also lead to higher drug prices here at home.
And as nations are just starting to get their heads around how to solve the obesity crisis, surely we shouldn't dump everything out of our toolbox before the real work has even started. We need to keep our public policy options open, to make room for initiatives to clean up a food environment that is literally killing us.
Focusing only on the cost increases associated with stronger (but still lagging) intellectual property protection for pharmaceutical innovators is simplistic and wrong. It is the balance of these costs and benefits that are the ultimate determinant of whether or not Canadians are better off, not just the post-2023 increase in drug costs to provincial governments, patients, and insurers.
There are academic pharmaceutical researchers still publishing independent, peer-reviewed articles, just as there are still farmers who have small farms with the kinds of smiling animals one sees in children's books. But more and more pharmaceutical research is done factory farm-style, with organized precision and efficiency, all paid for by drug companies. Welcome to new science.