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What's Happened and Where Are We Headed? Taking Stock on National Pharmacare


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For our last webinar of 2018, we hosted an engaging discussion on the updates in National Pharmacare with panelists Bill Dempster, CEO of 3Sixty Public Affairs and Louse Binder, Health Policy Consultant at Save Your Skin Foundation.

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What's Happened and Where Are We Headed? Taking Stock on National Pharmacare

  1. 1. What's Happened and Where Are We Headed? Taking Stock on National Pharmacare Canadian Cancer Survivor Network Webinar December 13, 2018 1:00 PM - 2:00 PM
  2. 2. Today’s speakers 2 Louise Binder Health Policy Consultant Save Your Skin Foundation Bill Dempster CEO 3Sixty Public Affairs
  3. 3. Pharmacare in Canada – a few facts • Majority of Canadians have access to drug insurance through private or public plans, or both (there is overlap) • All Canadians have access to some form of catastrophic drug coverage though the medicine must be on the provincial formulary to obtain reimbursement • Main issue in the national pharmacare discussion is who should provide “first dollar” or primary coverage, what does it cover (the formulary), who pays for the coverage, and what part of the coverage is the responsibility of the patient (deductibles, premiums, co-pays and sometimes a cap) • According to the Conference Board of Canada out of the 37 million Canadians: • More than 25.6 million are eligible for a public drug program • Nearly 22.5 million are enrolled in at least one private drug plan • Approx. 35.5 million Canadians are eligible for one form of insurance coverage
  4. 4. “Uninsured” Canadians all in Ontario and Newfoundland <25 25-64 65+ All ages 3.2% 0.0% 0.3% 1.8% Insurance Gap, Canada and Provinces 614,700 45,100 (4.4%) (8.5%) (% of population uninsured in orange) Proportion of Uninsured Population, by Age Group Note: Analysis is based on 2016 data. Results are estimated with the introduction of OHIP+ in Ontario on Jan. 1, 2018. Source: The Conference Board of Canada. Uninsured Canadians: 659,800
  5. 5. Of course, as it is often, cancer is different • Many cancer treatments are covered through hospital budgets or cancer agencies • But for some provinces, there is a bigger gap and discrepancy between infused drugs taken in hospitals and oral “take- home” drugs • Visit: for more information!
  6. 6. On March 21, 2018, the Standing Committee on Health adopted a report entitled Pharmacare Now: Prescription Medicine Coverage for all Canadians. Jan. 2018 Ontario Health Minister Eric Hoskins to chair newly created federal pharmacare committee Hoskins resigns as provincial health minister Feb 26, 2018 April 28, 2017 Free Prescription Medications for Children and Youth Through OHIP+ Government of Canada launches Advisory Council on the Implementation of National Pharmacare June 20, 2018 Ford Government Making OHIP+ More Cost-Effective June 30, 2018 National pharmacare gaining momentum… Feb. 2018 Mar. 2018 Apr. 2018 Jun. 2018 Jun. 2018 Mar. 2019Dec. 2018 Ford government’s changes to OHIP+ slated to be implemented On Dec. 10, 2018, the finance committee tabled its Pre-Budget Consultations Report in Advance of the 2019 Budget Recommendation 2 That the Government of Canada amend the Canada Health Act to include drugs prescribed by a licensed health care practitioner and dispensed outside of hospitals in accordance with a common voluntary national formulary, as part of the definition of an “insured health service” under the Act. Recommendation 63 Build on the existing drug coverage enjoyed by millions of Canadians and follow a close- the-gap approach to pharmacare to ensure that all Canadians have access to prescription drug coverage, in addition to examining ways to provide catastrophic drug coverage to Canadians.
  7. 7. …with Ottawa setting the stage for a 2019 election promise Changes to pan-Canadian Health Organizations Changes to PMPRB framework Health Minister’s Mandate • As Minister of Health… work with PTs to make prescription drugs more affordable… improve access to necessary prescription medications… join with PT gov’ts to buy drugs in bulk, reducing the cost Canadian governments pay for these drugs, making them more affordable for Canadians, and exploring the need for a national formulary…Ginette Petitpas Taylor Minister of Health Health Canada regulatory modernization
  8. 8. Provincial political dynamics have shifted AB election < May 31, 2019 BC election May 2021 (Possibly earlier!) SK election Nov 2, 2020 MB election Oct 6, 2020 NL election Oct 8, 2019 PEI election Oct 7, 2019 NB election Oct. 2022 (Possibly earlier!) NS election 2021 FED election Oct 21, 2019 ON election June 9, 2022 QC election Oct. 3, 2022NEXT ELECTION!
  9. 9. Advisory Council Members & Timeline Eric Hoskins Chair Mia Homsy Vice-Chair Dr. Nadine Caron Vincent Dumez Camille Orridge Diana Whalen John Wright Oct. 2019 Federal election Jun. 2019 Federal advisory council report Sep. 2018 Submissions to advisory council Jun. 2018 Creation of national pharmacare advisory council Advisory council’s cross-country consultations 2020-2021 Potential FPT discussions PHARMACARE TIMELINE Dec. 2018 Federal advisory council interim report
  10. 10. Two potential approaches for national pharmacare Single / first public payer Targeted approach Canadian Citizens NATIONAL PHARMACARE exp. xx/xx/xxxx
  11. 11. PROBLEMS BARRIERS REALITY Louise Binder Health Policy Consultant Save Your Skin Foundation
  12. 12. The 5 Es Equality EquitabilityElections Ease of AdministrationEconomics (past and forthcoming) 1 2 34 5
  13. 13. Questions 1. What are you hearing from patients? 2. What would you like to see the Advisory Council recommend? 3. What enhancements would you like public drug programs to make? 4. Are there links to other F/P/T initiatives that might impact what we see in a national pharmacare program?
  14. 14. Discussion
  15. 15. Canadian Cancer Survivor Network Contact Info Canadian Cancer Survivor Network 1750 Courtwood Crescent, Suite 210 Ottawa, ON K2C 2B5 Telephone / Téléphone : 613-898-1871 E-mail or Web site Instagram: @survivornet_ca Twitter: @survivornetca Facebook: Pinterest: