09/21/2017 14:43 EDT | Updated 10/02/2018 10:44 EDT

Don’t Let NAFTA 2.0 Stand In The Way Of Pharmacare

Canadians will pay — either with their pocket books or with their health.

Canada is closer today than ever before to achieving a public prescription drug plan for everyone. Provinces, cities, labour unions, businesses, doctors, nurses, health-care workers, economists and patient groups have come together to form one of the broadest coalitions in Canadian history — one in favour of a national pharmacare program. Nevertheless, NAFTA poses an existential threat to the dream of establishing such a program. After two rounds of NAFTA 2.0 negotiations, the Canadian Federation of Nurses Unions (CFNU) is calling on federal negotiators to defend Canada's interests and protect our country's pathway to pharmacare.


If the Trump administration has its way in NAFTA 2.0, Canada will be forced to lengthen lucrative monopolies to Big Pharma giants for costly and life-saving biologic medications. Billions could be added needlessly to yearly medication costs in Canada.

This wouldn't be the first time Canada has conceded to Big Pharma in a trade deal. Two years ago Canada made concessions on patent terms in the free trade agreement with the European Union. Some estimate this will raise prescription drug costs in Canada by nearly $1 billion per year when fully implemented. If NAFTA 2.0 generates yet another unnecessary spike in prescription drug prices, Canadians will pay — either with their pocket books or with their health. Adding salt to the wounds, rising costs could also dissuade the federal government from finally introducing a Canada-wide pharmacare plan.

The math isn't hard: spend $1 billion to save $8 billion!

Pharmacare is a common-sense solution to excessively high prescription drug costs and the financial barriers to accessing medicines.

As nurses, we know the lack of coverage and high prices continue to force millions of patients in Canada to reduce dosages or avoid taking prescriptions altogether. Patients become sicker, lives are threatened and, too often, avoidable tragedies occur. In fact, nearly one in four Canadian households report members not having the money to take prescription medicines as prescribed.

Pharmacare also holds the key to unlocking billions in health-care dollars currently being wasted by the inefficient multi-payer system. A recent CFNU-commissioned report, penned by economist Hugh Mackenzie, found that Canada wasted $62-billion health-care dollars between 2006 and 2015, because a pharmacare program wasn't in place.

Chris Wattie / Reuters
Canada's Foreign Minister Chrystia Freeland speaks to journalists on Parliament Hill in Ottawa, August 14, 2017, on the topic of NAFTA renegotiation.

Despite the broad consensus across civil society in favour of pharmacare, and the evidence base to support it, the federal government remains the last major holdout. Similar to most good policy ideas, the buck stops at the dollar sign. The federal government's reluctance seemingly stems from the (estimated) sum of $1 billion required to launch the program. However, peer-reviewed studies have found that pharmacare would save patients, businesses and, ultimately, governments upwards of $8 billion per year. For once, the math isn't hard: spend $1 billion to save $8 billion!

As Mackenzie put it: "Politically, [pharmacare] is a no-brainer — eliminate waste and deliver better services."

It's long past time for Canada to expand medicare to include public coverage for medications for everyone — let's not let NAFTA stand in our way!

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