The document discusses issues around implementing a national pharmacare program in Canada. It summarizes that while some groups support national pharmacare, there are significant costs that would require tax increases. Previous programs in Ontario have experienced issues around oversight and accountability. Any national program would need to be carefully planned to avoid inefficiencies, control costs, and ensure value for the funding through proper auditing.

1. NATIONAL
PHARMACARE –
AFFORDABLE OR
NOT?
PaulYoung CPA CGA
June 12, 2019

2. PaulYoung - Bio
• CPA, CGA
• Financial Solutions
• SME – Business Process Changes
• SME – Risk Management
• SME – Close, Consolidate and Reporting
• SME – Public Policy
• SME – Financial Solutions
• SME – SupplyChain Management
• Academia – Advance Accounting, Public
Finance and Advanced Management Systems
Contact information:
Paul_Young_CGA@Hotmail.com

3. Agenda
■ What is national pharma care
■ Canada and Drug Costs
■ Top six reasons for high drug costs
■ Countries and Pharmacare
■ Healthcare Ranking
■ Pharmacare Blog
■ Pharmacare Blog
■ Summary

4. WHAT IS PHARMACARE?
Source - https://www.pharmacists.ca/advocacy/pharmacare-20/

5. DRUG COSTS / CANADA
Source - https://www.pharmacists.ca/advocacy/pharmacare-20/

6. Top Six Reasons for High Drug Costs
Source - https://www.businessinsider.com/ap-multiple-factors-cause-high-prescription-drug-prices-in-us-2015-9
1. Lack of proper price controls – Government have failed to negotiated proper drug pricing
2. Lengthy Patents - Patents last longer than in other countries, usually giving a drug's maker exclusivity that
prevents competition for 20 years from when the patent is issued. Because patents are filed while drugs are still in
testing, that clock starts ticking long before the drug goes on sale.
3. Limited Drug Protection - For many drugs, there isn't enough competition to hold down prices. Many older
generic drugs were priced too low to be profitable, so some drug makers stopped making them. Once only one
company or two companies make a drug, the price usually shoots up.
4. Small markets - Many new drugs are for rare conditions or cancer subtypes involving a particular genetic
mutation, so they might help just thousands or hundreds of patients.To recoup research and development costs,
drug makers set high prices, though they offer many patients financial assistance.
5. R&D and Development costs - Research is becoming increasingly expensive. Industry groups say it can take about
a decade and well over $1 billion to get a new drug approved, though that includes development costs for the
many drugs that don't work out.
6. Fewer generics - After a huge wave of patent expirations from 2011 through 2013 that brought generic versions of
drugs taken daily by millions of patients, the number of popular drugs going off patent has declined.

7. Healthcare
Ranking
Source -
https://www.bloomberg.com/news/articles/2018
-09-19/u-s-near-bottom-of-health-index-hong-
kong-and-singapore-at-top

8. Blog -
Pharmacare
Liberals are consistent that when there is bad news then rush out a
feel good policy before the policy has been properly vetted.
https://www.thepostmillennial.com/trudeau-government-attempts-
to-divert-public-outcry-for-resignation-with-pharmacare-
announcement/?fbclid=IwAR3oik_WiFkLqKQrWUpOFsBYSQnkRcUc
PZb4UYSjLdJ1UiSL1GLMbWjW8EU
Or
PBO
https://business.financialpost.com/pmn/business-pmn/if-canada-
wants-national-pharmacare-taxes-will-have-to-go-up-former-pbo-
warns
Auditor-General Ontario
https://globalnews.ca/news/4979855/ontario-pharmacy-fraud-
prescription-for-profit/ or
https://www.cbc.ca/news/canada/toronto/pcs-announce-changes-to-
ohip-1.4729873
I guess lessons were not learned by @DrEricHoskins from the poor
Ontario plan!

9. Eric HoskinsTrack Record
■ https://www.cbc.ca/news/politics/pharmacare-hoskins-recommendations-final-report-1.5171517
■ https://www.slideshare.net/paulyoungcga/2019-election-pharmacare-canada-june-2019 Libs also do not listen to AG reports and/or believe in
oversight!
■ @DrEricHoskins – Ford is fixing your bad Ontario plan - https://www.inhalton.com/province-announces-changes-to-prescription-drug-coverage-in-
ontario
■ Chretien did not move on the pharmacare due to the cost - https://nationalpost.com/news/john-ivison-national-pharmacare-report-bullish-on-
universal-program-but-offers-few-ideas-on-how-to-pay-for-it
■ Canada already has structural deficit of $18B. Canada has unaffordable government and yetTrudeau thinks there is more money to be spent, right?
https://www.slideshare.net/paulyoungcga/2019-election-fiscal-management-canada-june-2019
■ I am not surprised asTrudeau has people on his team that led to the train wreck in Ontario - https://www.slideshare.net/paulyoungcga/doug-ford-and-
ontario-pc-government
■ Drug prices are an issue, but there needs to be a proper path to fixed drug prices including working with big pharma - http://theconversation.com/why-
the-us-has-higher-drug-prices-than-other-countries-111256
■ Pharmacare / costing - https://www.cbc.ca/news/opinion/pharmacare-report-1.4852503
■ There are huge issues with delivering of healthcare dollars - https://globalnews.ca/news/5268965/canadian-health-care-stuck-in-the-60s/
■ This program is not well thought out as many people have private insurance. I believe there are things to be done via synergy with various
governments as well as existing programs. I am not about a new agency unless there are annual audits (value for money and performance
measurement)
■ You can bet this pharma care policy will be part of the Liberals platform as way to force the CPC into a corner.
■

10. Summary
■ A national pharma care has to be well thought out.The problem is whatever
government usually touches in terms of policy it tends to go south in a big hurry
– PBO - https://business.financialpost.com/pmn/business-pmn/if-canada-
wants-national-pharmacare-taxes-will-have-to-go-up-former-pbo-warns
■ Taxes have been growing steadily as such there is little wiggle room
to continue to increase taxes, especially if Canada wants to remain
competitive in terms of attracting people and FDI.
■ Ontario Auditor-General called out the Ontario Drug Benefit Program -
https://globalnews.ca/news/4979855/ontario-pharmacy-fraud-prescription-for-
profit/
■ National Pharmacists has been very outspoken there is a need to handle drugs for
10% of the population that is underserved in terms of drug coverage
– https://www.pharmacists.ca/advocacy/pharmacare-20/