Question Period Note: PHARMACARE

• In Budget 2019 and 2021, the 2020 Speech from the Throne and the Fall Economic Statement, the Government committed to implement national pharmacare, beginning with the creation of a Canadian Drug Agency, a national formulary and a national strategy for drugs for rare diseases.

KEY MESSAGES
• No Canadian should have to choose between paying for prescription drugs and putting food on the table.
• The Government of Canada is committed to working together with provinces, territories and stakeholders to build on the foundational elements of national universal pharmacare that are already in progress so that Canadians have the drug coverage they need.
• We have established a Canadian Drug Agency Transition Office and are taking steps to develop a national formulary, while moving forward with developing a national strategy for drugs for rare diseases in collaboration with provinces, territories, stakeholders and the public.
• In addition, we have signed a first agreement with the Government of Prince Edward Island to improve access to medications for Island residents and accelerate the implementation of national universal pharmacare.
IF PRESSED ON STATUS OF THE NATIONAL STRATEGY…
• We recognize that for many Canadians who require prescription drugs to treat rare diseases, the cost of these medications can be astronomically high.
• To help Canadians get better access to effective treatments, we are working with provinces, territories and other partners willing to move forward to develop a national strategy for drugs for rare diseases.
IF PRESSED ON THE AFFORDABILITY OF PRESCRIPTION MEDICATIONS…
• We have already taken action to improve accessibility and affordability of prescription drugs.
• For example, we modernized the way patented drug prices will be regulated in Canada, which will help Canadians afford the prescription medicines they need, improve the health of Canadians and better meet health care system needs.
IF PRESSED ON THE CANADIAN DRUG AGENCY TRANSITION OFFICE…
• The Canadian Drug Agency Transition Office is working closely with provinces and territories, partner organizations, patients, care providers, and stakeholders to develop an approach that addresses shared objectives for better health outcomes for patients and a more sustainable pharmaceuticals management system.

Private Member’s Bill on Pharmacare
On February 24, 2020, NDP MP Peter Julian tabled Private Member’s Bill C-213, An Act to Enact the Canada Pharmacare Act, in the House of Commons. This bill would provide for a legislative framework for a public single-payer drug coverage system in Canada. On February 24, 2021, Bill C-213 was defeated on second reading with a vote of 295 against and 32 for.
Opposition Motion on Pharmacare
On March 13, 2020, the House of Commons unanimously adopted a motion from NDP MP Don Davies (Vancouver Kingsway, BC) that called on the government to negotiate with the PTs to establish a dedicated fiscal transfer for universal, single-payer, public pharmacare. The motion was passed with the Government’s support.
Text of the motion:
(a) acknowledge the government’s intention to introduce and implement national pharmacare;
(b) call on the government to implement the full recommendations of the final report of the Hoskins Advisory Council on the Implementation of National Pharmacare, commencing with the immediate initiation of multilateral negotiations with the provinces and territories to establish a new, dedicated fiscal transfer to support universal, single-payer, public pharmacare that will be long term, predictable, fair and acceptable to provinces and territories;
(c) urge the government to reject the U.S.-style private patchwork approach to drug coverage, which protects the profits of big pharmaceutical and insurance companies, but costs more to Canadians; and
(d) recognize that investing in national pharmacare would help stimulate the economy while making life more affordable for everyone and strengthening our health care system.
Advisory Council on the Implementation of National Pharmacare
In Budget 2018, the Government announced the creation of the Advisory Council on the Implementation of National Pharmacare, chaired by Dr. Eric Hoskins. The Council engaged with Canadians, patients, provincial, territorial and Indigenous leaders, health care experts, and stakeholders through regional roundtables, town halls, an online questionnaire, and written submissions. On June 12, 2019, the Council’s final report was tabled in Parliament, recommending the implementation of national universal pharmacare over several years.

Budget 2019 Commitments
Guided by the recommendations of the Advisory Council, Budget 2019 announced federal investments to move forward on three foundational elements of national pharmacare:
o Creation of a Canadian Drug Agency to take a coordinated approach towards assessing effectiveness and negotiating drug prices;
o As part of the work of the Agency, development of a national formulary to promote more consistent coverage across the country; and,
o Creation of a national strategy for drugs for rare diseases to help Canadians get better access to the effective treatments they need.
Budget 2019 announced $35 million over four years, starting in 2019-20, to establish a Transition Office to support the creation of a Canada Drug Agency and national formulary. It also announced an investment of up to $1 billion over two years, starting in 2022-23, with up to $500 million per year ongoing, to help Canadians with rare diseases access the drugs they need.
These commitments were reiterated in the Speech from the Throne, Fall Economic Statement and Budget 2021.
Modernization of the Patented Medicines Regulations
On August 21, 2019, the Government modernized the Patented Medicines Regulations (‘Amendments’) to ensure the Patented Medicine Prices Review Board (PMPRB) has the tools and information to fulfill its mandate to protect consumers from excessive patented medicine prices. The Government has delayed the coming into force of the amendments three times in response to the increased demands and challenges on industry stakeholders due to COVID-19. The coming into force of the amendments is currently scheduled for January 1, 2022. It is estimated that the amendments will result in billions of savings for governments and private payers over the next 10 years. However, the brand-name pharmaceutical industry, and some patient groups, have expressed concerns that the amendments could result in reduced pharmaceutical investments and access to medicines.
The Amendments have been challenged in the Federal Court and Superior Court of Quebec by Innovative Medicines Canada (IMC) and sixteen subsidiaries of brand-name companies. On June 29, 2020, in the ruling of the case IMC v Canada, the Federal Court upheld most of the regulatory amendments, but struck down the collection of confidential rebate information. On December 18, 2020, a similar decision was issued by the Quebec Superior Court in Merck et al vs the Attorney General of Canada to uphold the constitutionality of the existing regime and regulatory amendments. Both these decisions are currently being appealed.

KEY FACTS
• In Budget 2018, the Government announced the creation of the Advisory Council on the Implementation of National Pharmacare, chaired by Dr. Eric Hoskins. On June 12, 2019, the Council’s final report was tabled, recommending the implementation of national universal pharmacare.
• Budget 2019 announced $35 million over four years, starting in 2019-20, to establish a Transition Office to support the creation of a Canada Drug Agency and national formulary. It also announced an investment of up to $1 billion over two years, starting in 2022-23, with up to $500 million per year ongoing, to help Canadians with rare diseases access the drugs they need.