Pharmacare plan will "cost less" for plan sponsors

CEO of RNAO says funding saved can be used to enhance current plans, while CPA VP says switching from private to public plans would be disruptive

Pharmacare plan will "cost less" for plan sponsors

Reactions to the federal government’s tabled pharmacare plan introduced last week continue to make headlines across the country, with many opposed and few who are praising it.

Those who are praising the plan say they have been advocating for a similar one for several years and are eager to see it to completion. Dr. Doris Grinspun, CEO of the Registered Nurses' Association of Ontario (RNAO), is one of those people.

“We are the only OECD country that has universal access to health care without the universal pharmacare,” says Grinspun. “It goes without saying that the nurses stand fully behind this. We also stand fully behind that there be a single payer system. Our end goal for nurses is that it be comprehensive.”

Grinspun says the RNAO is starting with the framework that will eventually lead to the universal single-payer system. The framework consists of two categories, Grinspun added, one for those with diabetes and the other is contraceptives.

“Both are very important,” she said. “Diabetes is a disease of people that are compromising social determinants of health. It has to do with nutrition, the capacity to exercise, having less stress in your life, all of which are people that are, for example, from equity seeking communities, have lack of equal access to work and for requests of access to health care … that's all to say that it is a critical start.”

“Contraceptive is also critical,” Grinspun added. “It is an issue now in in the U.S., big time in several states and I am afraid it may become an issue here. We believe that trans rights are human rights and women's rights are human rights. So, contraceptives are critically important for women. We are happy we are starting there, but we don't want to just end there, we want more of it.”

The key challenge with the pharmacare plan, Grinspun noted, is that it still needs to go through several readings before going to Royal Asset.

“We the nurses want this to be the first province that signs the agreement with the federal government for the universal, single payer pharmacare. Even if we are starting with these two categories, that's a start and it's leading us in the right direction.”

Vice-president of public and professional affairs at the Canadian Pharmacists Association, Joelle Walker, said there’s still a lot of work that needs to be done with all the provinces “in order to make any progress on this.”

“Our position has always been that Canadians would be best served by a mix of public and private coverage,” she says. “Historically, private insurance has provided a much broader range of drugs that patients are eligible for, which means that we don't want people to lose coverage, we want people to bring everybody up to a very high level.”

Walker added that switching millions of people from private plans to public plans would be very disruptive. “Think about a patient going into the pharmacy and finding out all of a sudden that their drug is no longer covered on a on a public plan and the pharmacist has to do all the switching potentially, and even contact a prescriber to say you need to issue a new prescription or we need to fill out some new forms.”

While there’s lots of other classes of medications that are cost prohibitive, Walker says, “we need to look at how we spend the total amount of public funding that we have to the best effect.”

Grinspun highlighted that employers who enrol in the government’s plan, rather than go through one that’s offered through an insurance company, pharmacare will “cost less for them.”

“They will save more on the pension plans for employees, or they will enhance their plan to include other aspects,” she said. “A national single payer system of pharmacare in any country that has been implemented, will start costing less, not more, to our taxpayers. That funding then, can be used for so many things that we're in dire need of, let alone human resources that are desperately needed.”

At the end of the day, Walker says there's still several drugs that are not included in the plan, like Ozempic, and plan sponsors will need to review what’s being offered.

“I would say that it's important for plan sponsors and ensures to keep that in mind that there are still some gaps and that they have a role to play, I think on completing that coverage.”