Deciding What Drugs Will Be Covered | National Pharmacare Online Consultation | Let's Talk Health

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Deciding What Drugs Will Be Covered

about 2 months ago

Pharmacare is a system of health insurance that provides people with access to necessary prescription drugs. The scope of drugs eligible for coverage through a pharmacare plan can vary.

One approach would be to limit coverage to those prescription drugs for which there is good evidence of both effectiveness and value-for-money. This approach would result in a less costly plan, but provide fewer options for some patients. 

Another approach would be to expand the list of covered drugs to include those for which there is less evidence of value-for-money, e.g., to include higher-cost drugs that may have little clinical evidence supporting how well they work. This approach would result in a more costly plan, but provide more options for some patients.

How extensive a selection of drugs should be covered under a national pharmacare program? Share your thoughts below:

Thank you for your interest in this consultation with the Advisory Council on the Implementation of National Pharmacare.

The online consultation is now closed, and written submissions are no longer being accepted. You can still keep in touch with us via email at pharmacare-assurancemedicaments@canada.ca.

Please stay tuned for the consultation report, which will be posted here and on the following website: www.canada.ca/pharmacare.

Sincerely,

Advisory Council on the Implementation of National Pharmacare

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  • AnonKingston 17 days ago
    The question of when a drug has demonstrated utility is a challenge. Drs now can prescribe drugs off of the approved use. This leeway allows professional judgment to enter into the equation. However, many drugs not approved because there usefulness has been marginal or of short duration are also very costly. I think the standard to apply is still open to discussion. In reality, most treatments are fairly standard. The decision to go beyond that standard array of treatments should probably rest on a professional entity NOT SUBJECT TO INFLUENCE BY BIG PHARMA. Note that this happened with the decision to reduce annual physical examinations. Some people take exception to this despite the evidence. Further, it is not clear to me what counter steps exist to make sure people keep in touch with their medical practitioners over the years. I may seem to be off topic, but it is significant to the discussion because it highlights the complexity of such decisions. One thing to keep in mind is the possibility of national manufacturing of medications arising out of public investment in research, thus controlling the profiteering motive from exaggerating the cost of new medications.
  • Christiebelle 21 days ago
    The drugs that need to be covered are the ones ordered by the doctors. Why can’t I get continuous glucose monitors covered for my type 1 diabetic son? They are proven to save lives. I pay out of pocket everymonth for something to keep him alive.
    Hide replies (2)
    • Peter 18 days ago
      Absolutely right - if my doctor prescribes it, it should be covered - PERIOD!Bureaucrats cannot be trusted to second-guess a doctor's decision.There are many examples of nonsensical rules these so called experts have dreamed up. Invariably, the only outcome is less expense for the province, while the patient is left in a lurch, which is precisely what we want to avoid.
      • StudyBuffalo 17 days ago
        Prescribers (e.g. physicians, nurse practitioners, pharmacists) are not infallible, nor do they always know the most up-to-date information on every medication (there are easily over 4000 drug therapies). A proper drug review can be done by health professionals that select therapies for which there is evidence to support its use, which ensures that patients are not getting therapies that do not work (or work less effectively) than the alternatives. When all other things are equal, we could then start making decisions based on cost (such as when a class of medications is anticipated to have identical effects, such as ACE inhibitors). This can be a very valuable resource for prescribers who literally cannot keep up with every new study published, especially for those in a general practice. An example to this point: Alberta Health Services was able to de-list a stool softener, provide better patient care, and probably even save money for the health care system and patients (who are no longer being prescribed a medication that doesn't work). Here is the presentation to CADTH: https://www.cadth.ca/sites/default/files/symp-2016/presentations/april12-2016/Concurrent-Session-D5-Darren-Pasay.pdf
  • pharmacaremama 17 days ago
    One thing I'd like to see, among the other factors taken into consideration, is equity based on gender, ethnicity (e.g. insofar as certain conditions are more prevalent in certain populations), or gender identity. It all needs to be looked at through that lens, along with the questions of clinical efficacy and so on. No covering drugs for erectile dysfunction while not covering them for birth control or post-partum depression or hormones for transgender people. Overall I'd like to see the approach to coverage be taken similar to how we do it for health care overall, based on a holistic notion of the patient, and regardless of where the care happens (hospital, community, etc.).
  • Piccolino 17 days ago
    National Pharmacare should cover a comprehensive, evidence-based formulary of drug products These are the principles of comprehensiveness and appropriateness for National Pharmacare, in alignment with the Canada Health Act. Specifically, National Pharmacare should provide universal, public coverage of the safest and most effective medicines based on the best independent evidence of positive health impacts and value for money. The CADTH’s common drug review reports provide an example of how an evidence-based formulary may be developed.
  • Sunflower52 19 days ago
    We already have a very robust drug evaluation process in Canada – CADTH. CADTH is moving from a health technology assessment process to a health technology management process, which is a good thing. This means that CADTH will be not only evaluating the performance and value for money of drugs based on the clinical trial data but could begin to evaluate new drugs compared to older drugs not included in the trial, and possibly even recommending sequencing and further approve any off indication use of drugs. This health technology management process is currently being done by the Canadian Association of Provincial Cancer Agencies for cancer drugs and I think it would be a good idea if something like this were also implemented for non-cancer drugs. CADTH could also, if it were mandated to do so, expand its review process to look at how drugs perform outside of the clinical trials in the real world. (called real world evidence) I believe we have a very good process in Canada to make recommendations as to which drugs should be covered. We should let CADTH expand their review processes and then accept their recommendations as to which drugs should be covered. Three additional points I want to make. You indicate a trade-off approach between ‘those prescription drugs for which there is good evidence of both effectiveness and value-for-money’ and ‘those for which there is less evidence of value-for-money, e.g., higher-cost drugs that may have little clinical evidence supporting how well they work.’ First, we should never want to pay for a drug for which there is little clinical evidence, regardless of the price, (though I would concede on this one point when we are talking about new innovative drugs for very rare conditions for which it is not possible to do extensive clinical trials). Second the trade-off should have nothing to do with evidence, but only how much more it costs. Evidence is evidence, and if drug A performs better than drug B, and the evidence is irrefutable then we have the answer. Drug A is just better. But when we are talking value for money, well that is not about the evidence, but as the name suggests, how we value the evidence. Decisions will have to be made regarding Drug A if, for example, it performs better than B but the difference is not significant enough to warrant the additional cost OR, even if it far out performs B, but it is still too expensive. I think we all understand that point, and likely since it is a value judgement alone (it really is), we will all disagree with how much we will pay for that additional evidence. I just don’t like confusing the issue by suggesting, as this question has suggested, that somehow the trade off is higher cost drugs for which there is little evidence. It is misleading of this question to link higher cost and little evidence, as you have done. There are low cost drugs which don’t perform well (by evidence) and we still pay for them. Why, I don’t know, but we do. There are also high cost drugs that have significant, irrefutable clinical benefits, and some we pay for but others we don’t. Usually we want to have those drugs, but we cannot afford them. Thus, it is. The third point I want to make concerns precision medicine, so it a little off topic. This is a new field of medicine, and we are all waiting for it to come of age. I wish CADTH or someone would start doing an analysis of cost savings that could be achieved just by knowing precisely if a drug would work, or not, before it was given to someone. I wish we could work collaboratively with Pharma so that we don’t have to pay extra money for drugs every time an old drug is found to be useful for a new indication (Pharma has to go through the entire approval process again and that extra cost I am sure is built into the price increase.) The point is, that using old drugs for new indications is the start of precision medicine. It means we know that the same drug works on different disease types because there is some similar metabolic or molecular process common to both disease types, but we just don’t know precisely what that is yet.
  • Appraiser 19 days ago
    The selection should be expanded to cover medications that are required for some conditions even if they are more expensive. Those medications are even less affordable for lower income people who really need them
  • Damn technology 19 days ago
    Take the latter approach.
  • NickelCity 19 days ago
    In 2018, Canadians need a comprehensive Pharmacare program that is flexible and expandable. If, as a nation, are going to become serious about an all national pharmacare plan, we need to include those drugs that are on the cutting edge of innovation. Orkambi, for those with Cystic Fibrosis, for example, is one such drug. This drug has extended the life of numerous CF sufferers, yet the CADTH has rejected any proof of it's effectiveness. Sadly, these people are only interested in numbers and not listening to patients. As a result of their tunnel vision, Manitoba Health is still dragging it's legs on approving it for use in Manitoba. Again, it's all based on numbers. A bulk purchasing system that is nation- wide would alleviate much of the concern regarding the cost of higher costing drugs that have so-called " less evidence" that they work.
  • health53 19 days ago
    Are we seeking to create a Toyota model or Cadillac model? Let's see how affordable a Toyota model is before we go looking for a Cadillac. That said, some people may need to try a relatively unproven drug if they have tried everything else to no avail. I think the system should account for that in these special circumstances.
  • donbuck 19 days ago
    The drugs that are now covered by Pharmacare should be updated, to make sure what is already covered are still needed to help out the people. Any newer drugs that come out that do cover and work for people who need them, have to be done as a free drug clinical test trial and given to the ones who need it now. And once they have been proven to work, then they can be covered by Pharmacare to cover any cost for the ones who need it.
  • tyghbn 20 days ago
    The scope needs to be more than the limited number of drugs covered under any provincial formulary as at best that covers only about a third of the drugs available. There are older drugs that still work well and newer and yet to come drugs that will be more effective than existing solutions and should be there for long term cost effectiveness. There are many duplicates in the system that probably do not need to all be there. The formulary should be based on effectiveness, value for money and future new drugs that will have a greater overall impact on effectiveness than existing solutions. Thus it needs to living and dynamic. The fact is that a national program needs to provide health protection and effectiveness to maintain or return to health a population. If it is not going to work if the solution is not covered to get the results. The cost control comes from the design and integration of all types of program participants out there now - from employers and insurers to governments and supportive programs to the pharmaceutical industry itself. Currently they all pay towards an un-coordinated approach that is failing us.
  • Hd_pharma 20 days ago
    This is the element of the national pharmacare initiative that worries me the most. The upside of the program seems clear for established drugs used by many people, but the example of New Zealand shows that their approach results is large lag times for the approval and funding of new drug treatments - lag times that people with terminal diseases (such as metastatic cancer) can’t afford to wait. So while now people without private insurance can’t get these drugs in Canada, some private insurances do cover them. If we move to a national program, will this mean no one will get them?
  • Beekay 21 days ago
    All physician prescribed classes of therapeutic drugs should be covered. Substitution with generic or brand of drug that has a negotiated price should be mandatory unless medically contra indicated.
  • Goddess 21 days ago
    All medications prescribed by a healthcare provider ( or a suitable substitute) should be covered. Physicians should not be able to deny the government the right to make a suitable substitute, to prevent Big Pharma from tipping the scales in their favour.
  • Birdman about 1 month ago
    A universal Pharmaceutical Plan for all Canadians sounds great. Unfortunately it will be very costly. How and/ or who will pay for this plan? Canada has many people who have great ideas on how to spend taxpayers money. There are citizens that want free housing, subsidies on rent, free transportation, free school University tuition and a minimum guaranteed income for individuals to rise above the poverty line to name a few. Let us not forget that some First Nations still do not have clean drinking water. Taxpayers ratio to Retirees in Canada as of July-20181960 -5 workers per retiree2000 -3 1/2 workers per retiree 2018 - 2 1/2 workers per retireeHow much more can be taken from working taxpayers? We have a federal government who is already running a $18 Billion deficit in a good economy. We need to find the funding from what governments already receive. Remember healthcare costs continue to rise annually without adding more costs from new plans. We need everyone to pay as their is no free anything in this world. People who have catastrophic medical issues/expenses (drugs/ equipment/specialized treatments etc.) need to have our assistance. Should we as a society help citizens who choose a risky lifestyle ( drugs, alcoholism for example) have access to this extraordinary extra medical option? As the Baby Boomers Age and retire over the next few years, healthcare costs will skyrocket. Oh Canada 🇨🇦
    Hide replies (6)
    • hollymackerel about 1 month ago
      Birdman. So true! I hear you, man. Who can afford to pay for all the health mistakes people make willingly and happily destroying the only real gift God gave them - their body?The need for complementary medical arts is greater today than ever in the history of humanity.Toxic environment, big pharma propaganda, lack of health education in schools (medical schools too!) has to be addressed before we decide to provide toxic drugs to all Canadians.I agree with catastrophic medical issues need help, but it's already done and we are already paying for that - it's called hospital care.
      • snoopy 75 22 days ago
        Regular exercise is as a example of a complementary medical art when we are properly instructed by a trained person. I have exercised all my life and my friends are amazed that I need only a lowest dose blood pressure medication compared to their catalogue of pills. The government should allow gym fees to a limit of say $500 per annum plus fees paid to a registered exercise trainer to a maximum of $750 per annum to be deducted from income tax. My experience is that after a trainer creates a program for you it only needs to be up dated/revised annually to provide constant benefits to your health. Regular exercise can reduce our health costs and improve our enjoyment of life.
    • Mia about 1 month ago
      Removed by moderator.
    • fieryfee about 1 month ago
      I genuinely question why there's this insistence that disease is somehow deserved. Nobody deserves to be sick. Everyone is the same. Human. The issue is not cost when implemented but cost that will be saved. When Canada is in the top 3 nations for costs to big pharma (ask yourself why only the Swiss and Americans pay more for pharma -- because Canada is willing to pay it. ), there is a need to regain some control. This is a market issue as much as a healthcare one. I notice many here fear that pharmacare will cost MORE. How can cheaper meds and a healthy population cost MORE over the long run?
      • Birdman 30 days ago
        I agree no one deserves to get sick. Our healthcare right now is stretched thin. The long waiting lists for medical surgery tells the story. As the boomers ( that’s me included) age our costs to the healthcare system will skyrocket. When I retire I will pay very little if any income tax. Should I now insist that someone else pays for my healthcare including all my medications? That is why those costs should be covered for those with catastrophic medical problems ( cancer, invalids, heart disease to name a few). If you believe governments are good stewards of spending tax dollars then that is where I would disagree. All the best.
    • maxwelldm 25 days ago
      Actually, this is considerably simpler than it may appear: the savings brought about by economy of scale and standardisation of supplier more than offset the cost. It would actually cost less to provide universal coverage, although the drug companies would suffer.
  • snoopy 75 22 days ago
    Drugs covered should be those that Health Canada has determined on the basis of scientific evidence that work for their intended purpose even if they are costly. We (our doctors) should have the flexibility to prescribe the drugs they think are best for their patients and this requires that a wide choice be available to them.
  • drugsforK 23 days ago
    My kid has JIA. I got really excited when Ontario implemented free RX for children under 21. I had no idea there was a catch- the criteria. A drug that my insurance company would have paid for is now not covered by the Ontario pharmacare for children and neither by the insurance company, because if Ontario has a criteria- now the insurance company will institute the same one. Her disease could go into remission with a very expensive drug- leading to less healthcare costs over time for the Province. I believe we need to review the whole system and overhaul it! The principle of health care for all should apply to all areas- including pharmaceuticals.Furthermore Insurance companies should be regulated. We pay good money yearly to have coverage. Their criteria sems to change on a monthly basis on what will and will not be covered. Standards please!!!
  • bcjcw1 24 days ago
    Easy enough to start with the obvious ones, the ones that support people with our highest rates of illness - insulin for Type 1 diabetes, meds for Type 2, standard heart meds, etc. For rarely accessed meds, use a case by case submission by a doctor.
  • Jonilase 24 days ago
    Can the cost for Truvada (an HIV prophylaxis) be lowered? I am currently a student and do not have an income, however I am worried about catching HIV. I would need to pay 100$ each month for the medication, and this medication is the closest medication to HIV vaccinations available.
  • waterlooregion about 1 month ago
    We should be expanding the drugs available. This is not just about cost savings, it is about doing the best for Canadians in terms of the health care. Limiting the list is not what should be planned
    Hide replies (2)
    • hollymackerel about 1 month ago
      DRUG CARE is not HEALTHCARE. Dont mix them. Drugs are not without sidefects, they prolong state of disease by masking symptoms temporarily. More drugs as history and stats show never equalled better health.It is a wrong approach to healthcare. And we should not pay for this big Pharma moneygrab.
      • Cronic Crohnie 25 days ago
        Drug care and Healthcare may not be the same, but they go hand in and to cure people of diseases, and allow people with chronic diseases to live a happy productive life until a cure is found ( which by the way is cured by "big Pharma" Drugs)
  • maxwelldm 25 days ago
    We already have systems of "approved" drugs, in the form of provincial formularies listing drugs covered under specific groups like welfare recipients and seniors. This generally works well, and acts to curb abuse by health care providers. But there is an additional layer interposed which I think it is critical to maintain: the existence of a readily accessible expert consultant pharmacist, (not a clerk with a script), with the power to over-rule the official list, based on individual circumstances. With this caveat, I think it is absolutely essential that the drugs covered be circumscribed and controlled. The majority of my fellow physicians have demonstrated their inability to resist the blandishments of Big Pharma, and choose therapies rationally. Placing control in the hands of a small number of "experts" is obviously fraught with equal hazards, but, with the addition of an independent "appeal" layer, (which must be structured in a manner that it is able to respond contemporaneously), it probably represents the best balance of clinical autonomy and evidence-based control.
  • Dhhe 26 days ago
    We need medication for DEVASTATING illnesses like Myalgic Encephalomyelitis. Physicians are ignorant of the disease are 20 years behind the research. We need off label medications to be tried in these instances.
  • Shoemaker 27 days ago
    I agree with the inclusion of drugs for which there is good evidence of both effectiveness and value-for-money. In cases in which the patient wants a higher-cost drug with little evidence of efficacy, they should be allowed to pay the difference. It is possible that with a big enough group using that same drug, sufficient evidence might prove it to be of both effectiveness and value-for-money.
  • Sickboy about 1 month ago
    Drug companies spend mega bucks on lunch and learns with doctors, advisory committees etc to push the newest most expensive options. This practice should stop altogether. All lobby to medical people should be regulated and doctors should have to publish what they get from drug reps and companies. Coverage should be decided on levels of evidence and pharmacies should be more involved in that process. They are the drug experts and go to university for 5 years to gain that knowledge. Doctors should diagnose the disease and pharmacists should choose the appropriate medicine in concert with doctors and lab work. A collaboration should be in place.
    Hide reply (1)
    • fieryfee 30 days ago
      I agree with everything you say. I have MS and rely on my pharmacist to manage the use of drugs, interactions, whether something will actually work. Just because I walk away with a prescription doesn't mean that I take it without serious consultation with my pharmacist, who I know by name. I came from 17 years in UK/Ireland and am seriously appalled. Out there doctors don't push drugs like they do here! I am sometimes utterly blindsided or desperate and untangling yourself from excess medication is complicated business. If the government could limit the influence of big pharma, I think we'd see a very different population. Pfizer sold depression to North America and everyone bought it.
  • Tamayaka about 2 months ago
    Train both NDs and MDs to be able to effectively prescribe homeopathic remedies and then cover this type of medicine. Allow herbal medicines and detoxification protocols to be covered, not just medicines that can likely be patented. To decrease the likelihood of illness and the need for drugs, provide access to preventative screening such as micronutrient status/deficiency, body burden of toxins, and capacity to detoxify.
    Hide replies (5)
    • Dinah about 1 month ago
      NO to homeopathy!! It is not scientifically validated and is only a placebo effect. There is no such thing as toxification products--your liver and kidneys are for that.
      • hollymackerel about 1 month ago
        Dinah, you are wrong. Homeopathy is closer to today's use of drugs that you think. It is scientifically validated but not by FDA. There are medical systems that are validated by 5 thousand years of practice like Ayurveda (medicine of India) like TCM (Traditional Chinese Medicine) practiced as long if not longer and still in practice today on millions people with great success! Get informed about them. You'll understand that health is not lack of drugs in your system. And lack of symptoms now is not a sign of health neither. Open your horizons Dinah!
        • Dinah about 1 month ago
          Sorry, you will never get me to agree about homeopathy. The effects are nothing but placebo effect, powerful as that can be.
        • fieryfee 30 days ago
          We really need to stay focussed on those who are truly ill -- diseases of morbidity are very costly to control. The roll out will need to be progressive and slow and the priority is not alternative medicine.
    • hollymackerel about 1 month ago
      Right Tamayaka!
  • let's talk health 30 days ago
    limit coverage to those prescription drugs for which there is good evidence of both effectiveness and value-for-money
  • Old Guy about 1 month ago
    All medications prescribed by a doctor or registered prescriber should be fully covered. We trust doctors to be the gatekeeper for access to hospitals, why not for access to prescription drugs?
  • Bubbie1947 about 2 months ago
    I am a strong supporter of a National Pharmacare Program, but it also has to cover things such as vision, dental , hearing and physical disabilities to include health aids.
    Hide replies (19)
    • Grannie about 2 months ago
      I agree with this comment. My family immigrated to Canada from Germany when I was very young but I had an opportunity to visit and work there before I became a Canadian citizen. While there I had access to free dental and medical.I realize that if you have money or are lucky enough to have some of these costs covered by private insurance you may not know how difficult it can be to just make ends meet without having to worry about emergency health expenses.If these costs are taken care of we would all have a healthier workforce and that is a more productive workforce. Which in turn reduces cost to employers and the government in turn.
      • Bubbie1947 about 2 months ago
        For all the naysayers for a National Pharmacare program, if we do not have good primary health care services like a family doctor, able to see a dietician, ophthalmologists, physiotherapists, audiologists, and mental heath specialists, helping to keep people healthy, it causes people to use ER services and clogging the system for people who need medical attention for more dire needs like heart attacks. People who do not have access to primary care services use ERs for prescription refills and other minor ailments that could be resolved through a pharmacare program, instead of using expensive hospital services. Most naysayers have no idea what the costs of ER services compared to a program like National Pharmacare coverage. Most are financially secure or very strong business people who do not care about people who are not as fortunate to have the option of paying out of pocket for their health care. They probably do not pay attention about reports out of the US where their medical system have bankrupted millionaires in dire need of life saving medical care. No, it is selfish and a sign of being uneducated for the well heeled to not want to contribute to a system that would benefit the unfortunate and save billions of health care dollars while freeing up ERs across the country. They also think a national health care system is a waste of taxpayer dollars. They just don't care period!
        • hollymackerel about 1 month ago
          Hi Bubbie 1947. Are you ever confused or ill informed. Drug program has nothing to do with health program. Its a moneygrab from public purse by Big Pharma that has hard time to meet its financial targets and needs to expand the market for their toxic ineffective drugs. Healthcare Program would give Canadians access to complementary medicine that is effective, natural and has no side effects! And the choice to be cured from chronic, degenerative and autoimmune diseases. That is needed not more DRUGS!
          • Bubbie1947 about 1 month ago
            Did you even read what I wrote? If people were to have access to basic primary care; vision, hearing, physiotherapy, mental health, dieticians, dental, podiatry, and minor surgeries like mole and wart removal, we would save billions on not only ER services but prescription drugs as well. However if we are to get a national pharmacare program they might as well include all of the things included in private health care plans from drugs to basic primary care. The fear I have is that if a National Health Care Plan is created and if the report I read where all private health care plans is to be covered under the umbrella of the national program, I do not want to lose the coverage of all of the other basic primary care I have mentioned. Access to basic primary health care is what keeps everyone mobile, especially the elderly.
        • Mia about 1 month ago
          Actually, I still think for most of us, Canada is a country where we take care of each other. I NEVER want become a little USA. Shame on anyone who is selfish and callous enough to want us to be like the disaster the USA is in terms of healthcare. In the US, you have to be afraid to get old or sick.
      • hollymackerel about 1 month ago
        Another believer in national Poison Program. If you emigrated from Germany you certainly know that Germany has much wider health system than just drugs. Are you familiar with Hheilpraktiker scope of healthcare? You should be! These doctors heal people not drug them indefinitely. National DRUG plan is not a solution - it will be a calamity both health wise and financial for all Canadians.
      • Mia about 1 month ago
        A healthy population is a stronger country.
    • keithmnop77 about 2 months ago
      I totally agree. Pharmacare first. Wheelchairs and hearing aids ($2,000+ per year, yikes) next. Then vision and dental.Canada's coverage is great compared to the USA. Only when compared to the USA.Every other developed country tops us.
      • Del about 1 month ago
        Agree, Pharmacare 100 % but little steps will not adequately fix our health care system. For instance, dental care is vital for overall health. Poor or inadequate dental care will lead to major health concerns which in turn will result in other diseases and treatments requiring prescription drug treatments. Circular problem, need holistic Pharmacare which includes dental services (check-ups, cleanings, fillings, extractions, root canals, crowns, dentures, & orthodontics, etc), vision care (routine visit, eyeglasses, contact lenses, refractive surgery or surgical procedures to correct common vision problems to restore and/or reduce your dependence on prescription eyeglasses and/or contact lenses), prescription drugs, medical supplies and equipment, medical travel (meals, accommodation &ambulance services). Pharmacare is a symptom requiring a solution with no boundaries, to finally get it 99% right.
      • hollymackerel about 1 month ago
        Are you sure we can afford that? I can't! I"m retired and on a limited income. You want more taxes? You'll be paying for this. For this guy who chose to take toxic drug that cost him hearing, for that woman who chose to eat junk food till she developed Arthritis, for the kid whose dumb parents vaccinated him with 26 toxic vaccines before the age of 2 till he turned autistic or cancerous, for the demented elderly high on glyphosate curtesy of Monsanto crackers who are on 34 different meds that do not cure them from anything? Good luck to you. But if you think your idea will help anybody to get well, think again.
      • Mia about 1 month ago
        Exactly!
    • Dinah about 1 month ago
      Just not sure that we could bring in all that at this point in time. Would be better to stick to our primary target.
      • Bubbie1947 about 1 month ago
        The report I heard in the media was, the idea of making prescription drugs cheaper, in trying to create a National Pharmacare Program, it would mean all private medical programs would be done away with by melding all the private medical insurances, Sunlife, Blue Cross, Great West Life, etc. under the umbrella of the National Pharmacare Program. It is not clear what coverage the National Pharmacare Program would provide. Unless the other things I had mentioned are included I would lose the benefits of health aides, vision care, physiotherapy, podiatric care, psychiatric care, hearing aides, chiropractic care, and dental care from my private health care provider. I know many people who suffer from simple foot ailments such as corns and calluses that are causing them to become disabled because they cannot afford to receive the services of a podiatrist that my health insurance covers. Many people who have more coverage than just prescription drugs covered by private medical insurance providers would be losing far more than what a National Pharmacare Program would provide. It would be devastating to many aging retirees who have complete medical health coverage.
        • Dinah about 1 month ago
          You make an interesting point, if what you say is true. I think most of us on here expect the companies to stay in the business of providing all the extended health care coverages that are not medications. Since they can include things like massages, there is definitely a business model still there.
      • hollymackerel about 1 month ago
        Hi Dinah. Absolutely. Primary target is health not disease. Seeking health does not involve drugging people. It involves education in...health. Doctors have to be educated in health not the disease. People have to be educated in health and in what their body is made of. And it's not made of ... drugs! It's made of minerals, vitamins and amino acids, good water & good fats. Why nobody in our government is proposing national healthcare only national drug care or disease care? Germans can why not us, Canadians?
        • Dinah about 1 month ago
          I have no problem with health promotion. But don't forget that what your body is made of is molecules when you drill all the way down. Minerals, vitamins, amino acids, water and fats are all elements or molecules made up from them. All drugs are molecules, too, and they are taken in by the body to address a shortage or to interact with molecules that our bodies are already making.
    • Suzieque about 1 month ago
      Bubbie1947, I agree that ideally comprehensive benefits such as dental, assistive devices, etc should be included in National Pharmacare, but who decides what come first. It's taken a half-century for a serious political discussion on Universal Pharmacare, so another 50 years for each Health Aid will be centuries away. Rather than no coverage in some provinces and some coverage in others, the Canada Health Act should require equal provincial coverage for all the uninsured poor/low-income (not just for social assistance) or at least low-cost health clinics. European countries such as Germany and even the U.K. have some degree of private health coverage allowing more funding for better and more comprehensive public healthcare, a far better solution, in my opinion, than waiting decades to centuries for Universal everything. There are circumstances where a prescribed medical/assistive device is more important to an individual than a prescription medicine.
      • Bubbie1947 about 1 month ago
        Glad you mentioned the Canada Health Act. I am not so sure that apples anymore and is ineffective as we have been without a National Health Accord for sometime now. One of Trudeau's campaign promises was to have a new National Health Accord but talks broke down between the provinces paving the way for bilateral agreements with Ottawa and coverage for medical care varies between the provinces and is no longer universal. The last round of negotiations between Ottawa and Nova Scotia saw lost funding totalling a billion dollars over ten years or a hundred million per year. I believe every other provinces lost funding as well with their agreements. The electorate do not seem to realize what jeopardy our supposedly National Health Care is really in. In my province of Nova Scotia I am in fear our health care system will be privatized as the latest announcement of $280,000,000 for the next ten years or roughly a quarter of the net loss in the last round of negotiations is not nearly enough to sustain our provincial health care system. Canada, as a country, can afford both a National Health Care System along side of National Pharmacare Program but the governments of all stripes and colours lacks the willingness to do so. They throw money, as if there is no tomorrow, at pipelines and other frivolous spending while our health care system is rotting.
    • hollymackerel about 1 month ago
      We don't want to pay for this! You pay for your mistakes in your own health, why to force the public to pay for your own stupidity? Drugs prescribed indiscriminately are the cause of disease not a cure! There is no Safe dentistry. Hearing loss is in most cases today induced by taking drugs prescribed by your doctor, not by age! People on drugs have no mind of their own they are zombies doomed to perpetual disease state. Just go to hospitals and see for yourself. Then you'll form another opinion, healthy one I suppose? If you think drug program is a solution you'll think twice after your visit to a hospital.
  • Hudson about 2 months ago
    Leave mainstream drug coverage to the provinces. Provide coverage only for those extraordinary drugs that are likely to provide help to those, especially children, who would not be covered by provincial programs.
    Hide replies (17)
    • MattP about 2 months ago
      Exactly - other than expanding coverage to those who fall through the cracks, a public system will reduce coverage for the vast majority of the working population, and likely at greater expense.
      • hollymackerel about 1 month ago
        Well, what is really happening is that Big Pharma is aiming at market (a lucrative)niche selling their statins, blood thinners, beta blockers, psychotropics, bisphosphonates, and steroids to the uneducated, uninformed and poor masses of Canadians. And on top of it they want us, Canadians to pay for it! How it's been working in the USA? Financial disaster in a big rich country like USA is a calamity in a much smaller and not richer country like Canada. And the effects? Anybody is showing any rates of CURE????Think about it!
      • middleman about 1 month ago
        Well, Hudson and MattP, you seem to think that we can distinguish between the deserving and the undeserving based on some some accidental characteristic such as age. Further, you seem to think that narrowing the population covered will somehow reduce overall costs. How, then, did it happen that the Canada Health Act increased medical coverage for the vast majority of the working population at lower expense? How does public auto insurance increase coverage and reduce expense for the vast majority of the driving population? It is useful to put aside misconceptions about how insurance works and focus on how to pay for benefits when the pool includes 100% of the population.
    • armynorb about 2 months ago
      EXACTLY, Hudson!!! However, the provincial programs would cover those drugs needed, especially children. Fedaral government involvement is nothing more than a cynical tax grab, anything the government touches gets fouled up... just look at Phoenix, and it is nothing more than attempting to steal the progtram from provincisl jurisdiction!
      • middleman about 1 month ago
        As soon as you introduce any descriptor, such as "especially children," you make it possible for any decision maker (for example an unthoughtful person who insists that the majority rules no matter what) to exclude you from coverage. For example, the decision maker could say, "No coverage for people whose screen names begin with a."
    • Suzieque about 2 months ago
      Hudson: Problem with Provincial coverage is that it depends on the province you live in and the provincial "government of the day". Maybe okay if one lives in a more generous province such as Ontario. I live in B.C. where recently pharmacare co-payments for low-income reduced and coverage of insulin pumps expanded, but these changes could be eliminated with next prov. election and change of government. Ontario also has an allowance for assistive devices; not so in B.C. I don't have a problem with provincial coverage as long as there are federal guidelines so that coverage is EQUAL in all provinces. B.C. also charges MSP premiums, at one time 5% of after-tax income for a family earning $30,000 plus $1.00 and the same amount but an infinitesimal percentage of a family earning $300,000. Personally, I am okay with private coverage but I still need the income tax deduction for over 3% and some folks do need the B.C. Fair Pharmacare coverage that comes into effect once a maximum has been spent on prescription medicines.
      • Dinah about 1 month ago
        There is no pharmacare in Ontario unless you are already on an Ontario government program, or over 65.
        • Suzieque about 1 month ago
          Dinah, I was thinking of the Trillium drug program for those under 65 who spend 3-4% or more of their after-tax income. In B.C. there is Fair Pharmacare, also based on income and exceptions only for seniors born 1939 or earlier. Any medicine not included under B.C. Pharmacare is not covered at all. Regardless, neither of these programs is adequate. I believe Ontario has an Assistive Devices Program whereas B.C. offers nothing in this regard. There are exceptions in BC for Drugs and Comprehensive benefits for Social Assistance.
          • Dinah about 1 month ago
            Sounds like you know more about coverage in Ontario than I do!
        • hollymackerel about 1 month ago
          And this is already too much! No drug ever cured simple GERD or acid reflux, no drug is good for Canadians. What we need is not DRUG CARE is HEALTHCARE! Allow us to seek and choose modalities of health care that are effective like herbal medicine, access to education serving us not Big Pharma. Do not grab our, public money to propagate ineffective medicine imposed by financial interests of five Pharma companies lobbying our government.
    • keithmnop77 about 2 months ago
      Hudson, from what I've read, my province of Manitoba is the only province doing a good job on this. The other provinces either don't have anything, or they only have pharmacare for the elderly and children.It is heartless that other provinces follow the US system of covering children and the elderly, while leaving the parents of young children uncovered.
      • phamde about 1 month ago
        "The other provinces either don't have anything, or they only have pharmacare for the elderly and children".Quebec has a Pharmacare program which work for everybody since more than 20 years !!!No need to reinvent the wheel. Use this model or others available to fill the gap.
      • hollymackerel about 1 month ago
        Well, it looks like Manitobans like to be poisoned by ineffective drugs, not only their children and elderly who do not know any better. Before the WWII all people went to the fiels gathered herbs and brew them and got well.Now with drugs nobody gets well, only Pharma companies make billions and trillions of profit!
        • Dinah about 1 month ago
          Are you aware that a number of the drugs are actually molecules that have been isolated from those herbs, etc. that people used to grow and gather? The active molecule has just been isolated in order to be given more conveniently and without side-effects from other molecules that the plant may make. Drug companies actually send workers out into exotic locales these days to gather plants to be analyzed for potential medicines, and local people's wisdom is used to know where to start. The statin molecule was originally isolated from a mushroom.
      • Mia about 1 month ago
        It is heartless to leave ANYONE uncovered. Do YOU want to be one of those who are not covered? Not me. That fine line cut off can cut like a knife for many.
    • hollymackerel about 1 month ago
      Drugs have their place in the emergency settings only where they may (!) provide temporary intervention into natural body processes and solve an acute problem.No chronic, degenerative, autoimmune disease was or is ever cured with a synthetized drug. It's a fallacy of our times. It is wrong to impose on our society Big Pharma desire to sell their toxic drugs as "cure" for anything. And now they want us to pay for it? NOOOOOO!
      • Dinah about 1 month ago
        Chronic diseases are often not curable, but the use of drugs sure can make them much more controllable! And greatly extend the lifespans of those who take them!
  • resaw about 1 month ago
    I have had kidney disease since the 1980s and was on dialysis for two years earlier this decade, but most of the required drugs were of relatively modest cost. On top of that, both my wife and I had benefits from work so they were easily covered. Two years ago, I had a life-changing kidney transplant, which has been wonderful for me. We have continued to have drug coverage from work, but if I were to change or lose my job or retire, I would lose that coverage, and then, here in Ontario (I've lived in BC and Manitoba as well), a substantial portion of the cost would fall to me. Mine is not the only situation where medical intervention can extend productive life for many years, of course, and it just seems irrational to me that we as a society go through the effort of healing someone, which we pay for collectively through our taxes, and then don't provide the necessary additional financial resources (by means of "pharmacare") to help them maintain their health. It's like building infrastructure but then not budgeting to maintain it once built. I strongly support the introduction of a pharmacare program.
    Hide replies (3)
    • phamde about 1 month ago
      I agree with you, BUT we should not duplicate a private regime which is already working when it is available. Limit the program to those who have no private access and for high cost/catastrophic drugs for all Canadians.
      • middleman about 1 month ago
        Consider the rank stupidity (and cost!) of unsatisfied judgement funds in provinces that still have private auto insurance.
      • Mia about 1 month ago
        The health of Canadians should not be a business opportunity that private companies are loath to loose. I have 'private insurance'; it is NOT 'working'; 3 years of paying a lot monthly from my meagre retirement income and and I have yet to be covered for ANY drugs by this company because the deductible is so high, and they expect the Ontario government seniors program to pay first. Unless I get VERY sick; I get nothing and they get paid for NOTHING EVERY month by me.
  • Mia about 1 month ago
    Limiting coverage to those prescription drugs for which there is good evidence of both effectiveness and value-for-money is reasonable. This, at least, is far better than means testing who gets covered, or not covering at all. We all deserve coverage as part of our medicare plan. Anything else is just not right. We will ALL pay for this; cover ALL of us.
  • Fay Kname about 2 months ago
    Living in BC, the MOST EXPENSIVE province in Canada, we pay more for everything !We are drowned with provincial programs such as ICBC and MSP. No choice, rammed down our throats and consistently losing money, so increasing the fees yearly. We could really use a break in Pharmacare or any other federal program.Our gas, real estate and food is also ridiculously priced so please help us out.
    Hide replies (8)
    • Dinah about 2 months ago
      A lot of Ontarians would like to take a look at your auto insurance! And our real estate in TO is a huge problem too. That said, those of us supporting Pharmacare are hoping that it will keep medication costs down in the aggregate when all is said and done, so that should help you.
      • Fay Kname about 2 months ago
        Hi thereBelieve me , you don’t want our antiquated ICBC, mandatory insurance. The BC gov bungled it’s handling of the insurance company and it is debt for billions of dollars. As a result they are going to raise our already ridiculously high rates 5 % percentage ( is the rumoured amount) each year for the next 5 yrs! All to cover their mishandling error. Private and competitive insurance is the way to go.Also, we are the only province still paying monthly for our medical coverage. It was $75 monthly but is now reduced to $35. It should be 0 like all of the other provinces and paid for on a sliding scale. A middle income person pays exactly the same as a billionaire . How the heck is that fair?
        • Dinah about 1 month ago
          Hi Fay, I checked with my son who works in the car insurance industry here in Ontario. He is sure that your ICBC premiums are still way better than what we pay here. In Ontario the government's hands are also deep into it as each company has to set their rates for each year and get them approved by the provincial government. They then cannot compete by changing them till they take a look at their results and try their best guess for the next year. For this reason, we have to go through the trouble of checking a number of companies each year to try to get the best rates.
        • Dinah about 1 month ago
          I also agree that you should not be paying any premiums for health coverage!
      • hollymackerel about 1 month ago
        Dinah, the facts are clear - meds are costly for a good reason: Big Pharma producing them is very greedy. And if you want ot pay to make them more wealthy, go ahead. But understand that meds do not bring health, never did and never will. It is the biggest scam of our times.You'll have to be stricken sick with some chronic, autoimmune disease and survive the treatment provided by allopathic medicine to wake up to that reality. We live in a Matrix where the truth is so suppressed, so hidden from our public view that we are made believe that some chemical derived from crude oil can "save a life". That there is a Pill for every ill! This is a lie. There are no such things. Our children are unable to recognize what is real food for our bodies and what is made-believe to be food. Unless we wake up and get interested in our daily road to HEALTH we are doomed to disease invented for profit by Big Pharma that is educating our doctors to be pill pushers.
        • Dinah about 1 month ago
          OK, as a former health professional, attitudes like yours drive me nuts. Meds absolutely do return people to health. Antibiotics anyone?? You are quite right that we are better to keep our immune systems strong by eating right, but when you have an infected scrape such as my elderly father is dealing with right now, modern medicine is wonderful to have! People used to die at much younger ages than they do now, but most of us have forgotten how it used to be when each family could expect to see a couple of their kids not make it adulthood!
    • armynorb about 2 months ago
      Pharmacare won't give you any break, Fay!! You will STILL pay for it... and most of the drugs will go to the illegal border crossers!
      • Dinah about 1 month ago
        I think Pharmacare will be limited to Canadians and properly landed immigrants. There is a separate Federal health system for refugees. I don't know about drugs, but where I worked we spent a lot of time asking for timely coverage for expectant refugee mothers!
  • Marnie about 2 months ago
    There should be more than one approach. Yes, the basic level should limit coverage to those prescription drugs for which there is good evidence of both effectiveness and value-for-money. This should be able to be easily and inexpensively administered and handled with little proof or questioning needed. However, this should then be able to be expanded to, for example, cover other drugs. This should be handled, keeping two points front and center. Firstly, people in crisis, especially health crisis, should not be put through further hell any more than is absolutely necessary. Secondly, it is NOT cost-beneficial for anyone to take too many people and too much time to make decisions. And it would be best if the decision makers were to be volunteers, NOT paid people. Have medical people volunteer to put in volunteer work on decision-making panels. There should be a lot of volunteers signed up, so that no one have to put in too much volunteer work each year. The person making an application for coverage should firstly be assigned a medical representative to help, represent, and work with him, documenting what is being asked for, for whom, why, and so on. The medical representative can be someone of the applicant's own choosing who has agreed to help him or can be someone who has volunteered for such a position just as the panelists have volunteered. The person and the medical representative should then make a presentation with documentation having been given out the week before to a panel of, say, three medical people with their being able to ask questions of the person, who can be helped with the answers by the medical representative. The three medical panel people can then meet again one week later to discuss what they think. If unanimously for or against, then that is the decision. If not unanimous, then they should try to get some more information and then meet again. If still not unanimous, then two out of three should carry the day. If unanimous, then the applicant has no further recourse. If not unanimous, then the applicant can request a second panel, with the second panel consisting of, say, five people instead of three. After that second panel, there is no further recourse. The goal should be for the process to proceed quickly. The panel people should work quickly. The only slowdown should be on the applicant side; the applicant should be allowed to have virtually as much time as he wants to prepare his case. But once he is ready to make his presentation and request, the volunteer panelists should be Johnny-on-the-spot. They should go through the documentation provided, meet with the applicant with the medical representative, give serious and sincere thought to the situation, meeting and discussing the case with the fellow panelists, and come up with a decision. There should be enough volunteer panelists and representatives that presentations can be made on a weekly basis, if necessary. With volunteer panelists and representatives, this program should be inexpensive. There will of course be some administration, but the cost of that should be trivial really - accepting applications, recruiting and managing volunteers, sending documentation out to the panelists, providing meeting spaces, … Dragging decisions out is costly and is NOT cost-beneficial. If an applicant is unsuccessful, he is probably better off these days to try to crowdfund or raise money some other way. It is never going to be possible to help everyone to the extent that everyone wants. Let us make decisions and move on, helping as many as we can.
    Hide replies (4)
    • MattP about 2 months ago
      I, for one, don't want decisions on my life to be made by a "people's committee" of volunteers. Sounds like one heck of an onerous and time consuming process that sick people may not wish to devote their energy to.
      • Marnie about 2 months ago
        MattP, I would rather have medical people who actually care make the decisions than, for example, politicians who care diddly squat about me or people being paid megabucks who are going to decide against spending any money on me because it might adversely affect the money that they are pocketing themselves.. And do have any idea of what sick people who want special coverage now have to go through?!?!? What I am suggesting would put them through far less with far more control than what is currently the case. If what you are saying is that you want anything and everything to be simply be paid for for anyone and everyone, well, surely you know that that is not possible, much less likely.
        • Dinah about 1 month ago
          The committee members must largely have medical/pharmaceutical credentials. Perhaps 1 in 10 could be general public members. But I think decisions could be made quickly by a group who use a discussion panel such as this and get it done in time for efficacious use in the patient. We could look into the model of how out-of-country testing is approved for genetic testing in Ontario.
    • middleman about 1 month ago
      Many of your concerns about price suggest that you have not considered that there may be something wrong with the way we allow the private market to assign drug prices. Many economists would employ their specialized vocabulary to say that the inability of the drug suppliers to satisfy all demand for drugs at satisfactory prices is a clear example of market failure. We could make a start in Canada by revamping our intellectual property laws and creating more public benefit.
  • Rene3h about 1 month ago
    All drugs approved by Health Canada should be covered but consider limiting access to the program to those who have no private/employer coverage and for high cost/catastrophic drug treatments for all Canadians.
    Hide reply (1)
    • middleman about 1 month ago
      Rene3h: What good would be done by retaining "private/employer coverage" when we know it is more expensive than universal coverage? Consider that an expensive component of "private/employer coverage" is profit, which, along with amazing administrative costs, would be eliminated by a universal pharmacare program. Another way to think of it would be to observe that now we have a public/private system which disguises the true costs. Only a universal program funded by a progressive income tax gets around the problems posed by a patchwork.
  • adespicableuntruth about 1 month ago
    A cohesive and comprehensive pharmacare strategy is essential to maintaining the society we live in. As the nation ages and climate change and technology present new health challenges, we will become more dependant on medication. However, wages are stagnant and underemployment for young people is rampant. As more people retire, the tax burden will fall on these younger people. If we wish to maintain order in society, we have to create a better safety net so that underemployed young people aren’t crippled by illness and unable to pay into the system that everyone benefits from.Creating cohesive and comprehensive pharmacare strategy is essential to achieving this.Cohesive and comprehensive then means, the strategy must cover as many drugs as possible, with no gaps from sea to sea to sea. An Inuit man in Nunavut should get heart medicine just as easily as a child in Toronto or an old woman in St Johns.As to paying for a strategy, simply raise corporate tax rates and close offshore loopholes. If that is unpalatable, then nationalize the entire pharmaceutical industry. No should profit off of people's health anyway.
    Hide replies (2)
    • hollymackerel about 1 month ago
      Removed by moderator.
      Hide reply (1)
      • adespicableuntruth about 1 month ago
        Removed by moderator.
  • Odessa about 1 month ago
    I think make an extensive number of medications available, however with more expensive drugs, if for off lable use, or to determine doseage they should be dispensed in such a way to limit waste. (Depending on when effects should be observed)
    Hide replies (2)
    • hollymackerel about 1 month ago
      Odessa, Again misinformation induced by TV Big Pharma propaganda. No drug ever cured anybody from anything. We are born with self healing system within us. The belief in drugs is just a belief not a scientific fact. The drug industry wants us to believe it. And they put a big money into it so we do.Only if you get sick and ... get drugged you'll see that is not a cure! We should not pay for this. Health is not a deficiency of any particular drug or a combination of drugs. Start thinking.
      • Odessa about 1 month ago
        Most illnesses and disease require "treatment" or "management". I am not suggesting that medication from a pharmacy is the only answer. I am not a medical doctor and the topic I am responding to is 'which drugs to cover'. I stated an opinion and it seems your opinion is that no drugs should be covered. That is a valid opinion.I have an autoimmune condition that I personally manage with diet, exercise, supplements and steroids when I am experiencing a flare. The steroids will never cure me. Nothing will.However they help manage my condition and are an important part of my treatment plan.I hope this helps clarify my position that pharmaceuticals should be covered and not specifically limited.
  • middleman about 2 months ago
    There is a prior question that should be considered which may be beyond the mandate of the industry-dominated committee. Our intellectual property laws place many drugs beyond the reach of the "laws" of supply and demand. Neither the size of the order nor the importance of the customer affect the price, particularly where patent laws create a limited monopoly.The notion of an "extensive" but "selective" pharmacopoeia must inevitably draw its boundaries using a price criterion, obviating the principles of universality and accessibility enshrined in the Canada Health Act.
    Hide replies (4)
    • DRED about 1 month ago
      The costs of approval of various products in Canada (and other countries) … and the inability for Canada to accept approval in another country … may limit access to some products except on experimental/special use conditions because the market simply isn't there to recoup the investment. A high percentage of products in the development pipeline fail to come to market as testing proceeds … but this investment must be recovered from the sales of successful products. There is a need for the patent protection for some period of time to ensure sustainability of the system.
      • middleman about 1 month ago
        Most of your reasoning is unassailable, particularly when our authorities refuse to accept tests that seem to offer remedies that Canadians could use. But, but, but... The apparently rigorous American protocols are not always observed, and we have sometimes had approval granted on the flimsiest of pretexts. Methotroxate, for example was approved for a whole lot of bad reasons and may be doing more harm than good in Canada.Second, where is it written that the market should decide anything? The market has no brains and no powers of reason. People make decisions based on greed: "That drug will cost more to test than our investors will tolerate."Third, any reference to the development pipeline cries out for costs to be apportioned between public and private funds. Many of us insist that every nickel spent in public labs and universities on drug development is well spent but hardly ever rewarded by the proprietary drug companies. Big pharma chafes under regulation of any sort. Tough.
        • adespicableuntruth about 1 month ago
          This is a good point. Markets don't care about people's actual health. In fact, they generally profit from peoples unhealthiness. I say we nationalize the entire pharma industry so it can be used for no other purpose than to help people. Why should the rich profit off the illnesses of the poor?
        • hollymackerel about 1 month ago
          Well put. Hmm. Methotrexate is prescribed for: ectopic pregnancy, RA, cancer, psoriasis and more. May I ask with what effectiveness? Is it curing any of these conditions? No! Why? Because it is a toxic substance that our body has to use its own ressources to eliminate it. It did not and does not cure anything. Why to prescribe it in the first place? Who really benefits from its prescription? Not a patient indeed. Because the patient is made believe that psoriasis is not curable. What a nonsense! Just google it and you'll get rid of this and more with green veggies, good fats, and herbals. Simple effective and done! No need for toxic drugs that stuff the pockets of the Big Pharma investors - the doctors who prescribe the drug that cure nobody!
  • Anthony041 about 1 month ago
    I could live with a system that resembles the UK system used by N.I.C.E. One problem with evidence-based economical analysis is that evidence from a placebo-controlled RCT doesn't easily address the benefit/harms of "standard" therapy as a reference point; thus the "evidence" from a RCT may under-estimate the benefit, while over-estimating the apparent cost and thus lead to exclusion of a new drug from the formulary. Provinces tend to negotiate a defensive position by imposing conditions under which a new drug may be used - and by-and-large this has worked quite well in Ontario. Hopefully a national pharmacare plan would have even more clout to negotiate these conditions, and the costs of the drug (and hopefully with NO reference to the US equivalent costs)
    Hide reply (1)
    • hollymackerel about 1 month ago
      National Toxic Drug program is not an answer for us, Canadians. We cannot afford to pay Big Pharma for their toxic drugs prescribed indiscriminately to all vulnerable, uneducated, uninformed segments of society blindly trusting doctors who are educated by and in service to Big Pharma. When given only a hammer every problem looks like a nail. That's is the state of Disease care in Canada now. All complementary therapies that work like for example phytotherapy are removed from doctors' education since 1968. Our body is designed 2 million years ago and it responds to natural therapies not drugs made form petrol.
  • Open Minded about 1 month ago
    I think we should cover all drugs that our doctors prescribe and are approved by Health Canada. Let doctors decide what is best for patients not based cost/value.
    Hide replies (2)
    • Lifeline about 1 month ago
      Agree. Medicines keep people out of the most expensive doorways in healthcare. If we want to keep healthcare sustainable and people living at home we must rely on medicines and trust our physicians to prescribe them appropriately.
      • hollymackerel about 1 month ago
        The drugs are not helping anybody who is sick. Our health is not a deficiency of a drug or a cocktail of drugs. Drugs paid from public purse are not a solution, they are a depopulation program. Canadians wake up Big Pharma is aiming to get into your pockets to propagate their depopulation program! More than 100 000 people die in USA yearly from dully taken doctor prescribed drugs. Ask for the real Health Care not a DISEASE CARE program!
  • VictoriaZ about 1 month ago
    My husband was on 8 medications to address his health condition. There is no cure for his condition. Working with his Physician he has changed his diet, exercise plan and started to eliminate the prescribed medications. He now has one medication, medical marijuana. The cost through the federally regulated providers is costly. Previously we had coverage for the 8 prescribed medications, but his quality of life was not as good and some medications were not sustainable for the long term. We would be in favour for all prescribed medications to be covered by Health Canada.
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    • hollymackerel about 1 month ago
      There are no incurable diseases. There are doctors who do not know how to cure anything anymore. Access to marihuana was and is denied to Canadians. We know well who has the vested interest to deny us health and push us into permanent disease state with no end to prescription drugs. Anyone who wants to be drugged to death should be allowed to do it at his own expense or better at the expense of the drug companies that are poisoning us.
  • hollymackerel about 1 month ago
    No drugs that are toxic to humans should be covered under national drugcare program and therefore encouraged to be taken by Canadians.We don't want it! We want health not prolongation of disease state.
  • L'acadien about 1 month ago
    A very wide selection of drugs and vaccines. Those prescribed by physicians for treatment or prevention of diseases or medical conditions and those meant to improve the quality of life for those dying of chronic diseases.
  • rhkary57 about 1 month ago
    Basing drug coverage on lower price alone is a big mistake.This practice leave patients with little options for treatment if standard medications do not work. In the long run COSTING patient more for drugs than provincial plans cover now. Forcing lower generic prices will, and have already, thank to the Pan Canadian Drug Initiative, create drug shortages and put patient health at risk.
  • Can't afford my meds about 1 month ago
    Definitely, as a minimum, proven medications should be immediately approved, no question. There should be a fast and easy process whereby physicians, nurse-practitioners and pharmacists can electronically generate requests for medications not on the "approved" list to be applied for, reviewed and given a fair ruling for the patient, then receive an electronic response in a timely manner.
  • keithmnop77 about 2 months ago
    Remember that private group health insurance usually limits annual drug coverage to between $1,000 and $3,000 per year. With some diseases you can completely blow through $3,000 in your first month. Private group health insurance is nothing without some kind of government run pharmacare backing it up in case of disaster. // At an absolute minimum we need pharmacare for catastrophic out-of-hospital drug expenses. // So let us stay focused on the topic of this section. //That topic is what drugs should be covered. // "No drugs" is not an answer. // "No drugs" would mean no coverage after you hit your $1,000 to $3,500 a year limit your group coverage provides. And that is IF you are lucky enough to have a job or retirement package that includes group health. // That topic is what drugs should be covered.
    Hide replies (12)
    • Suzieque about 2 months ago
      keithmnop77: I don't know what health insurance you have, but not all Plans have limits, as stated in the Pharmacare Now Commons report under "Private Plans: In 2013, 86% of plans had no lifetime or annual maximums of the amount an individual could claim for drug coverage."
      • SeniorLG about 2 months ago
        Here is what I found on page 56 of Pharmacare Now: <<<>> Thus private plans are having difficulty controlling costs.
        • SeniorLG about 2 months ago
          Somehow some text got deleted??Some witnesses told the Committee that private plans are passing off the costs of prescription pharmaceuticals onto employers and employees in the form of rising premiums, deductibles and co-payments, rather than improving the management of these programs.174 For example, witnesses pointed to a study by Express Scripts Canada that found that private plans provided $5.1 billion in reimbursements for drugs that offered no therapeutic benefit.175
          • Suzieque about 2 months ago
            Yes, Senior LG, you are correct, however considering the big Labour group that made that comment, who are generally considered to have very generous benefit plans, they need to manage their insurance plans better. I certainly am not in favour of them passing on their costs to the general public, then using the savings to enhance their own supplementary benefits as noted on P.80 of the Pharmacare Now report.
            • SeniorLG about 1 month ago
              I agree that most benefit plans need better management and controls. This is needed to control rising costs due to the increasing number of very costly drugs that must be taken for years at a time. The current system is not sustainable and EVERYONE is paying more than they should
              • Suzieque about 1 month ago
                Almost half of Employers are satisfied with their current Private Plans. However, I would agree that there are and will continue to be rising costs and it is necessary to control them. In the meantime pCPA have obtained considerable discounts/savings, however I heard that 75% of the savings is going to distributors.
                • SeniorLG about 1 month ago
                  Hi Suzieque. Yes, the pCPA has negotiated considerable savings but I understand those prices are primarily available to the provinces (for use, eg, in hospitals) and do not apply to the drugs we purchase at pharamacies. I know that my employer is not particularly satisfied with the plan and our contributions to that plan have increased. Further I have friends who have lost benefits because their employer cancelled the plan. And private plans do not cover everyone. In my view they are an inefficient way to provide drugs.
                  • Suzieque about 1 month ago
                    Thanks SeniorLG: I appreciate your info re use primarily in hospitals; that explains why there's been no consumer reduction. Yes, I agree that there are problems with Private plans, however, there are certainly limitations with Provincial plans (depending on the province). Certainly I consider our Provincial Plan to be lacking in generosity to the poor/low income with the exception of Social Assistance, thus I'm equally suspicious of any proposed Pharmacare plan to help the poor. I have known too many poor who are simply left our, not only due to co-payments, but more often because the Formulary doesn't cover their prescription.
                    • SeniorLG about 1 month ago
                      Hi suzieque: I believe that a key aim of a 'national' pharmacare program is to improve the provincial plans and one way to do so is to put coverage for drugs under the Canada Health Act. This would lead to improvements in the provincial plans and to efficiencies in the system as a whole. A national plan would ensure that persons with low incomes would get the same coverage as persons with higher incomes. And there does not need to be co-pays. What province are you in? Good point about restricted formularies meaning that prescriptions will not be paid for - so we need something broad enough to cover some options. (Note that national means federal and provincial govts working together. )
          • Dinah about 1 month ago
            My plan (extended health and dental care) went up over 20% this year. I was informed that it is entirely premium funded, so we may have more of this.
            • Dinah about 1 month ago
              Also, the administrative company was changed about a year prior, so it would appear that my employer was not happy with their private plan.
      • Dinah about 1 month ago
        I don't believe my plan has limits, thank goodness!
  • HealthProgress about 1 month ago
    The selection of drugs covered under a national pharmacare program should be broad, but the key criteria for their inclusion should be efficacy demonstrated in clinical trials/large observational studies and comparative cost effectiveness compared to similar drugs. Too often a new drug is approved for sale, with a much higher price tag than current medications and only a marginal improvement in efficacy. In these cases, the government should negotiate strongly with manufacturers, or consider not routinely covering the drug.
  • hk about 2 months ago
    Limit to life saving drugs
    Hide replies (5)
    • charrion about 2 months ago
      And who decides which drugs are life saving? Who decides which lives are worth saving if the cost is high?
    • Christine0912 about 2 months ago
      the problem with this is that if a person doesn't take meds that prevent disease because they can't afford it it would cost more down the road to treat a person who needs their life saved
      • Del about 2 months ago
        Yes, poverty, homelessness are major factors in health care. Life saving drugs are not to be limited because then only the wealthy or those with government type health care have access to reasonable health care. We have to stop thinking how to keep people down and more to how to raise everyone to equitable health care where no one is left behind.
        • keithmnop77 about 2 months ago
          I totally agree that we need to be more equitable and ensure that no one is left behind, no group is left behind.Most, maybe all provinces already have pharmacare for the very poor. Homelessness is still a big deal for life expectancy in Canada. So is living far from a city, like in the far north.But poverty on its own is not the big killer here that it is in the USA. What we do suffer from is a widespread reduced life expectancy that affects the entire middle-class. We rank in the 30s from the top of life expectancy, partly because our health care coverage for the working poor and middle classes is deficient. Our country needs to lift up its working people, including tradespeople, professionals, labourers, etc. Our whole country is suffering compared to the rest of the developed world.In health care we're great compared to the USA, we rank in the 30s and they rank in the 40s. They have the highest spending, we have the eighth highest spendind.Do we want a medal for that? I think you'll agree it is not much of an accomplishment. Del, I'm a conservative and I think a lot of conservatives will agree with you on this.
          • Suzieque about 1 month ago
            keithmnop77: I agree that we need to be more equitable and ensure no one is left behind, but all provinces do not have pharmacare for the very poor or working poor or seniors. In my province it's limited to social assistance; seniors' discounts start at age 79 if one is still alive then; everyone pays until a deductible is reached; even though it's based on income the bar is set far too high, taking food off the table.
  • Buffy70 about 2 months ago
    I agree with expanding the list of covered drugs to include those for which there may not be value-for-money, e.g., Catastrophic drugs need to be covered as an option for those who can not afford them.Also who will determine the value for money what criteria will be used to evaluate this? Not everyone can use generic drugs due to allergies or side effects so there should be alternatives and or options for those that need name brands as opposed to generic drugs.
    Hide replies (2)
    • Dinah about 1 month ago
      I had a doctor who had so many problems with his patients using generics that he stopped prescribing them altogether. I would not recommend his approach either.
    • SeniorLG about 1 month ago
      Buffy - it may well be that the catastrophic drugs will provide benefits for the cost. Just because a drug is expensive does not mean it won't be covered. The cost-benefit calculations will be important but as much to say which of a number of similar drugs are most beneficial and most cost-effective.
  • Think Big about 2 months ago
    We do not need a National Program, this will be another boondoggle that will go miles over budget. Life saving drugs should be covered for those under the poverty line. For all others it should be a tax deduction or they should get private coverage.
    Hide replies (8)
    • Dinah about 2 months ago
      If it is a tax deduction we are paying for it in that the rest of us have to make up for that portion of tax not paid. Same thing in the end.
      • Think Big about 2 months ago
        No it's not the same thing, people need to spend there own money and get a deduction same as the deductions we get now which don't cover the total cost but only a rebate based on their tax rates.
        • SeniorLG about 2 months ago
          What happens to the 20% of the population that either has no coverage, or very limited coverage and/or very limited incomes. Many low income people including seniors and persons with disabilities have to choose between medication or food as they cannot afford the $400 per month for medications. Furthermore, there are very few people (or drug plans) that can afford to pay $100,000 per year for some of the high cost drugs. And while some drugs are very costly, if they are cost-effective, then they would be covered.
          • Suzieque about 1 month ago
            SeniorLG: the 20% that has no coverage, limited coverage and/or limited income is exactly the population that should be targeted. Provincial doesn't currently cover everything and there is no assurance Federal will either. If there's to be National pharmacare for everyone, then there needs to be secondary insurance for those drugs not covered, with a "means option" for those with limited incomes. Ideally insurance should include basic dental and assistive devices. Just as there are those who are horrified re patients not obtaining drugs they need, I have seen too many poor folks who need assistive devices (often seniors who can't work) whose medical condition deteriorates rapidly due to lack of a prescribed essential medical device. At least, there should be mandatory low cost Health Clinics, a "last resort" would be better than nothing.
        • middleman about 2 months ago
          It's termed a tax expenditure, and it is the equivalent of the economist's observation that there is no such thing as a free lunch: somebody is paying for it. A rule of the sort that you propose assumes that all Canadians have enough cash on hand to pay for the drug in the first instance, no matter its cost, which is clearly not true. Your rule not only would make the rest of us pay to make up for your tax deduction, it would put many drugs out of reach for many.
    • armynorb about 2 months ago
      I CATEGORICALLY agree with you, Think Big!!!
    • survey about 2 months ago
      Why aren't the options of "thumbs up or thumbs down" available to Thank Big's statement?
      • Christine0912 about 2 months ago
        They turn grey once clicked so that one cannot keep clicking the like of dislike thumb
  • freedomrider1983 about 1 month ago
    I think the first option would be best.
  • lilli.depoil about 2 months ago
    Obviously the list of covered drugs should be limited to those which actually work and are the lowest cost generic product. This is already available on affordable private plans - what’s the point of a government one? The same people who have money for postpaid cell phones, alcoholic beverages and cable tv will complain they lack drug coverage - what the government really needs to do is educate people on financial priorities and then help the few remaining people who aren’t covered. People can afford the things that make a priority for, Trudeau obviously could use some of this finacial priority help himself!
    Hide replies (2)
    • keithmnop77 about 2 months ago
      You're paying for a government plan for other people and a private plan for yourself.And if you're self-employed or working on contract you probably don't have access to a private plan that covers your existing illness.I don't expect middle class people and young parents to cough up $60,000 a year for a drug that lets them keep on working. And I don't think it would be fair to put them out of work and perhaps even orphan their children.It was Tory PM John Diefenbaker who commissioned the study that started Canada's medicare system. It is the Tory way to be conservative and cautious and to protect Canadians.
      • Dinah about 1 month ago
        It is also the Tory way to do things in as efficient way as possible. That is why former Tory senator Hugh Segal is championing Universal Basic Income, as it would be much simpler than the long list of income supports we have now.
  • ?Rosco? about 2 months ago
    I believe that every drug available should be included in the program.
    Hide replies (4)
    • qpwoeiruty12345 about 2 months ago
      So we should cover stuff like Viagra? That stuff is EXPENSIVE. What a good way of spending tax dollars. Think.............
    • keithmnop77 about 2 months ago
      Not lifestyle drugs like Viagra. Not cosmetic drugs like for hair loss or long eyelashes. I can see covering Accutane if someone has really severe acne with abscesses and scarring -- but then it is preventing infection, not just cosmetic. // But otherwise, Rosco, I agree with you.
    • SeniorLG about 2 months ago
      Rosco, the recent trend in pharmaceuticals is to make a very minor change to an existing effective drug and remarket the 'new improved' formula at a much higher cost. In fact there may be little difference, if any, in effectiveness, but the costs go up enormously. There are drugs out there that are not very effective and there needs to be a place to assess them to ensure they are worthwhile.
      • Dinah about 1 month ago
        Our committee of savvy pharmacologists should be able to see right through that type of scam and demand that the new drug be available at the old price or we aren't buying. They only do that anyways because "new" drugs are protected for what is it, 8 years?
  • dlhealth about 2 months ago
    If pharmacare is going to be effective it must be universal, just as is health care. There should be no "restrictions" on the range of drugs covered. The more the better as that will allow bulk buying by the government and reduce costs for everyone.
    Hide replies (12)
    • mrsmg about 2 months ago
      I do think that there must be a restriction on drugs simply because many of them are not effective and the current MD's in clinical practise have such a poor knowledge of them/pharmacology together with the fact they are constantly being sold/exposed to Big Pharma misleading sales data
      • Worldtraveller about 2 months ago
        Canada has a very effective system to ensure appropriate drug marketing. I strongly believe this respondent to be misinformed. Evidence on inappropriate drug marketing needs to be made more public if (indeed) I am the one misinformed.
        • mrsmg about 2 months ago
          My clinical experience has shown me that most doctors have very little knowledge and and understanding together with a total failure to appreciate side effects and interactions. Precisely because they rely on big pharma and big pharma taught thecourses during their training. There is no independence of thought/training/example within the existing system.
          • Dinah about 1 month ago
            I think it would be very useful to have a committee of pharmacists and pharmacologists to look at drug interactions. In these days of computers there ought to be something like an app at the doctor's office or at least at the pharmacy that could pop up a warning when a new drug is added for someone that is known to interact with something the person is already taking. Also, we may want to think about funding genetic testing which can show who will benefit most from a certain drug.
            • mrsmg about 1 month ago
              Sadly in the processes of getting a patent for a drug it is not obligatory for Pharma to test interactions with other drugs and substances. Often any information is also considered proprietary and therefore not in the public domain. It is usually in the 10 years following the release of a drug that 'red' flag events are reported and independent researchers look at interactions. The whole issue of genetic testing is a red herring. Only around 1-2% of serious disease is genetically caused. Our primary health issues are due to chronic disease caused by lifestyle including nicotine and alcohol and probably in the next 10 years consumption of cannabis. Some presumptions can be made on the known method of action of a drug such as excretion of cancer drugs through specific liver pathways so that obvious contraindicated drugs can be avoided but most MD's and pharmacists do not have that knowledge or have kept up to date. They rely on printed materials which inevitably are 2-3 years out of date.
    • Dinah about 2 months ago
      Yes, it may be possible that by buying a huge lot of a frequently used drug (eg a statin) we may be able to bargain down the price of the expensive rarely used drugs made by the same company.
      • Christine0912 about 2 months ago
        good idea
      • Worldtraveller about 2 months ago
        Not at all how it works in real world. The government does not buy drugs but reimburses drugs purchased by independent pharmacies.
        • keithmnop77 about 2 months ago
          In some other countries the government negotiates the price paid by pharmacies. The UK does this on expensive drugs and they don't claim it is a revolutionary idea.
          • mrsmg about 2 months ago
            By and large the NICE system works and is effective. There are always exceptions but equally you cannot successfully treat all conditions and all people with or without drugs.
          • Dinah about 1 month ago
            New Zealand too.
        • SeniorLG about 2 months ago
          A key feature of pharmacare is that the government will negotiate the lowest possible price as is done in many other developed countries around the world. Canadians pay the third highest drug costs in the world after the United States and Switzerland. Our goal as commentators is to provide input to the Advisory Council which has been set up to develop an implementation plan for Canada.
  • leslea_kate about 2 months ago
    Don't put money over people's lives. Cover meds. period. And don't let the companies gouge people in the process. It's really that damn simple.Stop looking for excuses to deny coverage.
    Hide replies (14)
    • MattP about 2 months ago
      Healthcare decisions always involve money - the whole system involves tradeoffs. The question is, is National Pharmacare at a cost of $15-20 B the right tool for the job? Are there alternatives that will work at a greatly reduced cost? What, in fact, is the issue that National Pharmacare is trying to resolve? This hasn't been clearly articulated yet, with defensible facts.
      • SeniorLG about 2 months ago
        Matt have you read the House of Commons report on Pharmacare? The idea of a national plan is that it will save Canadians 4 to 10 billion dollars and provide access to everyone. Canadians collectively are already paying well over $20 billion for our drugs.
        • Ultra Conserv about 2 months ago
          Government estimates, especially the liberals are always 10 time too low, look at the long gun reg, 100 million to over a billion, truedope jr said he’d run a deficit of 8 billion, now it’s over 50 billion,, keep the govt out of it, they should make policy not run programs, govt have to hire over paid union workers, who through the union get most of their healthcare as well, keep the money in the hands of the people, they can spend way more wisely
          • keithmnop77 about 2 months ago
            We taxpayers already paying for these drugs now. We're paying for our own drugs directly or through out private health plans, and we're also paying for the drugs plans of MPs, federal government employees (including members of our armed forces), welfare recipients, and indigenous people living on reserves. So this is not some new expense that taxpayers are not already shelling out money for.I see the idea as that:1. We'd reduce the overhead like we did for physicians appointments, by having a single payer that would negotiate lower prices (as the large HMOs and health insurance companies in the USA already do). As currently with physicians and labs, the pharmacies would remain independent providers/independent companies, but the insurance would be provided by the government as a single payer in each province.2. Taxpayers would get closer to the full pharmacare coverage our tax dollars already fund for special groups.Why should people pay for something and then be excluded from receiving it? As a fellow conservative, that doesn't seem very conservative to me at all. We're already paying for others to get it, we shouldn't be deprived of it just because we work in private industry or are business owners.
            • Ultra Conserv about 2 months ago
              That would be great if only conservative govt could stay in power to administer it, but liberal promises continue to buy votes from voters who don’t remember all the broken promises so it’s the liberals who will almost certainly mess it up and corrupt it
            • Suzieque about 2 months ago
              keithmnop77: Re "We're already paying for others to get it". The Public will pay for free drugs for government unionized employees and they'll use the savings to enhance their supplementary benefits. P.80 of Pharmacare Now: "Employers could use the savings that they obtain from creation of a national pharmacare program to enhance other services such as mental health, vision care, dental care, hearing care and physiotherapy". No wonder Unions are the prime pharmacare advocates; they stand to benefit the most. I'm not very enthusiastic about general taxpayers providing private plans with free drugs so they can enhance their supplementary benefits while the working poor and seniors in poverty have no supplementary benefits and are unlikely to get any with the increased public cost of pharmacare.
            • Dinah about 1 month ago
              Pharmacists may also appreciate the dependability of their recompense, as the doctors did in the 1960s.
        • Suzieque about 2 months ago
          SeniorLG: The figure in the Commons Report is 4.3 billion after co-payments unless you've concluded that the suggestion of changing some prescriptions to over-the-counter status will be implemented saving billion(s) of dollars (at a higher cost to consumer of course); something I'm not keen on since there are seniors in poverty I know of that can't even afford a bottle of Tylenol. Regardless, the Parliamentary Budget Officer estimated an ADDITIONAL cost of 7.3 billion dollars to the public for a national pharmacare program.
      • Lincoln about 2 months ago
        "What, in fact, is the issue that National Pharmacare is trying to resolve?" Is that not obvious?
    • armynorb about 2 months ago
      It is very simple.. we do NOT need a national pharmacare program, rather, we need control over what companies charge! That is sall! The provinces are quite capable of dealing with the issues and there is no reason for the feds to create something which will only suck MORE tax dollars out ouf our pockets, with no benefit!
      • SeniorLG about 2 months ago
        Amynorb, by having a single payer to negotiate, Canadians will receive the best value for money. Why should each province have to have a separate process to assess which drugs are effective and provide good value for money? And the smaller provinces have very limited negotiating power with the large pharmaceutical companies whose main goal is to provide dividends to their stockholders.
        • Ultra Conserv about 2 months ago
          Shareholders are Canadians investing their money to support them in retirement, that’s keeping the money in the people hands,,It also costs a lot of money to develop new drugs, if Canadians paid less taxes, there’d have money for their medications, I pay 65 dollars a month for blue cross my drug costs are over 3000 a month, I think the province is doing a great job handling it, we don’t need another level of government doing what’s good enough already,
          • keithmnop77 about 2 months ago
            I hear you UC, but the drug companies don't refuse taxpayer funding when it comes to subsidizing their research. When it comes to subsidies and the benefits of government funded research, pharmaceutical companies are amongst the leading socialists. A lot of research dollars come from taxpayers though university researchers and the Canadian Medical Research Council.And once the research is done, drug companies pay more for marketing than they do for research. And for expensive drugs, like the new biologics, the cost of research and the cost of production are negligible compared to the price.Why should shareholders be denied the pharmacare coverage that they're funding for MPs, federal employees, welfare recipients and indigenous peoples?
      • Ultra Conserv about 2 months ago
        Exactly we’ll said!
  • gophers about 2 months ago
    I am a strong supporter of a program that covers nothing because it doesn't exist.The majority of healthcare spending in life occurs when you are old. Maybe we should force people to save to deal with these costs than continuing to raise taxes for the working population of this country, making it a worse place to invest and do business. Pharmacare, just another tax grab to encourage business to move south of the border, Asia, really any place that doesn't have to put up with funding this sort of junk.
    Hide replies (4)
    • Christine0912 about 2 months ago
      As Canadians most of us live well enough. I have no problem paying taxes for programs such as this. What I do have a problem with is Government waste-exorbitant expense accounts etc. We live in a time where people who are academically inclined can make a lot of money but the high paying manufacturing jobs were replaced with agencies paying minimum wage. We need a pharma care program where people pay based on earnings. We should not allow anyone to go bankrupt because they can't pay for medications.
      • gophers about 2 months ago
        Most medical expenditures happen at the end of life Christine0912. These are expenditures that should be saved for over the course of your entire life. The idea of doing that isn't particularly novel. Canada is a wealthy enough country that not saving is a choice. Statistically, approximately 0.3% (yes you read that right) of Canadians go bankrupt annually and only approximately 15% of those bankruptcies are medically related, which is more likely due to lost wages. I have no problem with helping people in a genuinely bad situation, but given the minuscule size of that issue, to put another program like this in place is basically using a bazooka to kill a fly; it might get the job done, but it's horribly inefficient and want to cause a rather large amount of collateral damage.
        • Christine0912 about 2 months ago
          health care is a basic necessity and is a Human Rights issue. 15% of bankruptcy due to medical costs is 15% too much. Many people can only get minimum wage work and there is no possible way for them to save enough to pay for medications. I know some people whose treatment costs up to $50,000 per year. Are you saying that this person failed to save that type of money? People making low wages live pay to pay. There is absolutely nothing I can say that will change your mind so I will not respond further.
          • Dinah about 1 month ago
            I will just respond further to ask gophers: Shall we kick all those over 60 out of Medicare too, so they can't even go to the doctor or hospital? That would go with what you are saying. Leaving it the way you want goes back to the old problem of having people leave the doctor's or hospital with a prescription they can't fill, so those visits were primarily a waste, weren't they? That is what follows from your thinking.
  • 204!Hibbing about 2 months ago
    We need to be very cautious about expecting the government to pay for all of this. It seems that whatever the government touches, there is opportunity for graft and corruption. Things never seem to turn out as rosy as it sounds. Look at Venezuela. We don't want to end up like that by the government spending too much of our money. Therefore, I am not in favor of national pharmacare program.Personally, I feel that we need to get away from all these drugs by allowing other very effective treatments that the government could support: naturopathy, osteopathy, and other alternative treatments - that are much cheaper, and in some cases more effective. Why such a push to prescribe/take more drugs?
    Hide replies (5)
    • SeniorLG about 2 months ago
      The government is already spending money on drugs through purchases for hospitals and in many cases for low income people and seniors, and so forth. Corruption and graft also happen in the private sector. Other health services can also help to reduce drug costs, but we are not there yet as a society, unfortunately. Also by monitoring usage, pharmacare can also provide the evidence to get people off of drugs they do not need.
    • Christine0912 about 2 months ago
      Venezuela's problems were not caused by National Pharma Care. That Government is incompetent & does not understand economics. Part of their problem is because the Government ordered prices of items, eg(, toilet paper), to be lowered significantly thinking that everyone will be able to afford it. As a result, suppliers can't cover costs of manufacturing and distributing and stopped supplying. Instead of lowering prices, Venezuela should have given money or lowered taxes for people who made less money.Giving them the money to buy such items would have been a better option.
      • gophers about 2 months ago
        As an economist, their best option would have been to get the government out of the process altogether. Government price controls do not work. Time and time again we have seen this proven.
        • middleman about 2 months ago
          Government mandated public auto insurance works. The insurance that is cheapest for everyone is the insurance that covers everyone, whether a crown corporation or not. Consider, for example, how successful life insurance started.
    • Dinah about 1 month ago
      NO to naturopathy!! It is not scientifically validated and is simply the placebo effect. More physiotherapy might help. What we should do is encourage healthier lifestyles, but that is not for discussion here. I think the level of corruption in Canada is among the lowest in the world and wouldn't affect this initiative significantly. We are also excellent at rooting it out.
  • keithmnop77 about 2 months ago
    Manitoba has a pretty good pharmacare system in place already. It has some deficiencies, but overall I think it would be a good pattern for a federal pharmacare system to follow:1. Generic drugs are generally covered according to a formulary (list of drugs) very very similar to the formularies of the other 10 provinces.2. It does cover brand name drugs for thyroid hormone, because for this particular medication, thyroxine, dosage must be precise and dosage varies according to filler. (Thyroxine might be the only standard exception to the generic medicine requirement.)3. It doesn't cover lifestyle drugs, like viagra, or cosmetic drugs.4. It doesn't cover vaccines not in Health Canada's recommended list for the patient's age and occupation. (It doesn't cover travel vaccines.)Maybe travel vaccinations should be covered, since most people will no longer have private medicare.5. It does cover off-label uses of drugs when the off-label use is not for lifestyle or cosmetic purposes.So "cancer drugs" used for transplant patients and for autoimmune disease patients (rheumatoid arthritis, lupus, etc.) are covered. "Antidepressants" used for fibromyalgia are covered. 6. Experimental drugs are not covered. * Why should government fund experiments when there is a pharmaceutical company that is going to make money if the experiments succeed? * If the Government of Canada funds an experiment with a drug, then Canadian taxpayers should get a share of patent ownership.* However, as I posted separately so it can be discussed separately, it may make sense to pay for experimental treatments for truly rare "orphan" diseases where there is no commercial market.7. It has an Exception Drug System to cover drugs where the common drug doesn't work. a. Generally the MD faxes off a request for coverage explaining what was tried and didn't work, and the pharmacy technician at EDS faxes back an approval. (The pharmacy technician can see on the computer records that the patient had had prescriptions filled for the drugs that failed.)b. In some cases the MD sends a request for approval to committee of specialists in the disease concerned, and they give the yes or no. I think this is more for complex and expensive situations like rare off-label uses of drugs. 8. The biggest thing to change from Manitoba Pharmacare is the deductible. This should be funded by income tax, which has progressive taxation. As such the wealthy are already paying extra for it.It is a total bureaucratic waste of money to "means test" a benefit funded by progressive taxation. The wealthy are paying more than their fair share for it, so why spend money sorting everyone out to ensure the wealthy don't get what they're paying for? (I'm below middle class (due to illness) and even I think means tests for things funded by progressive taxation are stupid.)So have zero deductible for members of families with incomes less than $20,000 per person.And then have a $200 annual deductible for each member of all other families.8. No "per prescription fee", since per prescription fees:a. Are "socially regressive" b. They discriminate against the sickest amongst us.c. $10 or $20 per prescription fees will cost more to collect than the amount of the fee. <<=== !!!---------This is how the deductible is calculated in Manitoba. As I say, this is the one bad part of it.The Pharmacare deductible for the 2018/2019 benefit year is calculated as follows:a. The total income is determined from line 150* of your 2016 Canada Revenue Agency (CRA) Notice of Assessment.b. The applicant's total income is added to the total income of a spouse (if applicable).*If you and your spouse elected to split pension income, the line 150 amount is reduced by the split pension amount indicated on line 210 to ensure the pension income transferred is not included twice in a family's total income.c. $3,000.00 is subtracted from the total income for a spouse and each dependant under the age of 18 years. This amount equals to the Adjusted Total Family Income.d. The Adjusted Total Family Income is multiplied by the corresponding percentage rate in the chart below to determine the Pharmacare deductible. Adjusted Total Family IncomePharmacare Deductible Rate$0 - $15,000 = 3.09 %$15,001 - $21,000 = 4.38%$21,001 - $22,000 = 4.42%$22,001 - $23,000 = 4.50%$23,001 - $24,000 = 4.56%$24,001 - $25,000 = 4.60%$25,001 - $26,000 = 4.67%$26,001 - $27,000 = 4.72%$27,001 - $28,000 = 4.78%$28,001 - $29,000 = 4.82%$29,001 - $40,000 = 4.85%$40,001 - $42,500 = 5.26%$42,501 - $45,000 = 5.39%$45,001 - $47,500 = 5.50%$47,501 - $75,000 = 5.57%$75,001 and greater = 6.98%-----Not mentioned there, but if your income will be more than 10% lower in 2018 than it was in 2016 you can get your deductible re-calculated with your estimated 2018 income.
    Hide replies (3)
    • Christine0912 about 2 months ago
      I don't think any sick person should be burdened with deductibles. It was mentioned that people making under $20000 should not pay a deductible and that higher earner should pay $200 yearly but really, a person making $30000 a year is struggling and should not have to pay a deductible. I also don't believe that the wealthy pay their fair share. They pay more because they have more. Paying more does not equate to fair share. People become rich on the backs of others. Example, charging more for a product than necessary. Or like the Ontario CEO of Hydro, no one EARNS 6 million dollars a year. He might have been given that much but he certainly didn't earn it. As a result, he took money out of the tax payers pocket. His greed makes other people suffer. I know, it's not just him. Other people are greedy too and if he didn't jump at the job it would have went to someone else.
    • middleman about 2 months ago
      Your generally clear thinking thinking is sullied by the concept of "fair" taxation. Almost everyone thinks they are unfairly taxed, so welcome to the club! Progressive income tax is the closest proxy we have to taxation based on additions to wealth, which would produce fairness over time, so, for now, just tax.
    • Dinah about 1 month ago
      A couple of comments: 1)Perhaps we should look at the cost of travel vaccinations compared to the cost of treating people (and possibly others who pick up the contagion) when they come home with some disease. 2) Using a previous taxable income to determine deductibles looks to be fraught with problems, especially as someone's income could go down precipitously in the year they are diagnosed with eg. Cancer.
  • DRED about 2 months ago
    Physician prescriptions are based on a standard of care that requires as much knowledge as possible about the patient, the condition, anticipated outcomes, available treatments etc. That means that primary focus needs to be on those prescription drugs for which there is good evidence of both effectiveness and value-for-money. The discussion on other drugs requires a tremendous amount of thought and consideration of how all players would participate … and a very tough and deep discussion on how to balance public money in the high risk investment for those products with little clinical evidence.To me, the only way that national pharmacare can be of benefit is to be collaborative with the provinces who have responsibility for health delivery … some of which is managed by agreements around funding assistance from the federal government. In today's collaborative world, the other player in the delivery of pharmacare needs to be the industry and health care professionals (physicians, nurse practitioners, pharmacists, pharmaceutical industry, etc.). On some level, these groups all participate now … the trick is to build the collaboration to enable a national pharmacare.As some note in other discussions, great care will need to be taken that a national pharmacare actually saves money … and is sustainable. Driving prices down can also drive out investment and research, both of which are essential in sustainability. It is in my view a very tricky balance.
    Hide reply (1)
    • middleman about 2 months ago
      Let's not overlook the Canada Health Act which is a very effective work-around for the jurisdictional difficulties caused by the division of powers between the federal government and the provinces, a result of the 1867 world view.
  • Jmor about 2 months ago
    There are people who need expensive drugs that have little evidence of clinical effect, however the evidence may be restricted because the medical conditions are rare and such evidence is not provided easily as drug companies do not research such conditions that are rare. I feel these individuals affected should have access to the drugs, especially if they are young. So perhaps coverage should be age related......not applicable to individuals over 60?
    Hide reply (1)
    • middleman about 2 months ago
      Or how about not applicable to individuals who are female, for example, or black? Just switch the categories and you see how exclusions are always harmful.
  • Banana about 2 months ago
    Deciding which drugs to cover often drives doctors to write those prescriptions, when they may not be the best drug. Sometimes people are not able to tolerate or it is less effective for that person, but if it is not on the list, it's not covered
  • Darcy09 about 2 months ago
    Using current Blue Cross drug list w/out expansion seems reasonable. An appeal process could be put in place for extenuating need.
  • adanaC2018 about 2 months ago
    The national pharmacare program is a step in the right direction . It will enable the government to purchase medicines from the drug companies at a lower price . drugs like metformin etc .The drug formularies of each province could be coordinated and drugs proved through double blind testing reported in prestigious should be acquired.The cost of generic drugs will also come down once the federal pharmacare invites bids for the drugs . In case the older drugs fail a step up approach to stronger meds may be resorted .The drug plan payments should be made on ability to pay and not restricted to disease. For those who have the means they will end up subsidizing the drugs for those who cannot as in the case of income tax.Wastage in the drug industry should be managed . My mother is prescribed an antibiotic drop for her eyes . She needs only 16 drops from the pack each month . The leaflet says to toss the remaining drug away causing unnecessary expense. Each month this cycle is repeated after the procedure causing waste of money and time at the pharmacies. Can the pack not be made smaller or the life extended to prevent the waste !
  • Cannon about 2 months ago
    People with illnesses shouldn't have to pay extensive amounts of money to stay alive, especially if they are low income families. Any drug prescribed ,should be on the list of drugs that are taken care of by the catastrophic drug or genetic plan.
  • justintime about 2 months ago
    Many doctors are influenced by advertising ( if it did not work they would not do it.) By practicing evidence based medicine and going to regular refresher courses these influences are mitigated however these are not always possible. Saying this there are good organizations such as NICE in the UK. pCODr in Canada that look at evidence and help make good informed decisions to list or not. It is difficult however as the measurement of success is different in different areas of medicine. A statin will lower your cholesterol but how much does that translate into improving overall survival which is how they measure how effective a cancer drug is. We need to invest time and money into creating bodies of health care professionals that work in the real world and are given time and resources to help create the list of best drugs. These resource will need a large infrastructure of data collection so that we have good outcomes. It might be easier to start with a having a national Pharmacare strategy for something like cancer as they have some of these created already and then if that works expand to other areas
  • Bransom about 2 months ago
    I would like to believe this would also cover the cost of medical Cannabis as this would help eliminate the addictions to Opiate based drugs.
    Hide reply (1)
    • Christine0912 about 2 months ago
      medical Cannabis should be covered but it fails to treat pain in many people. For me, it made me have pain throughout my body. I think this when this happens, it is hyperalgesia. People who require opioids to treat pain long term have less than a 1% chance of addiction. This has been confirmed in several different studies analyzing more than 1/2 million charts. Please see this document written by the World Health organization using info from the United Nations-International Narcotic Control Board. http://apps.who.int/iris/bitstream/handle/10665/44519/9789241564175_eng.pdf?sequence=1
  • keithmnop77 about 2 months ago
    Coverage should be based on need and effectiveness, not on disease popularity, and not on lobbying by disease lobbies. In Manitoba we had coverage for 100% of diabetes medication and supplies. I have type 2 diabetes, the cost is not much. And the meters are free from the manufacturers anyways -- so why was the province paying good money for what was being given away by manufacturers in other provinces? This year diabetes supplies were reclassified as regular medications subject to the normal deductible based on income. Cancer chemotherapy drugs also have no deductible here, even when taken at home. The same methotrexate, Cellcept, or whatever, when taken for cancer has no deductible, but when taken for rheumatoid arthritis, another autoimmune condition, or for any illness but cancer, then the income based deductible applies.Why? Because the cancer lobby is strong.Coverage should be based on social justice and what is morally right, NOT popularity and lobbying.
    Hide reply (1)
    • Christine0912 about 2 months ago
      I agree.
  • SustainabilityFirst about 2 months ago
    The focus should solely be on covering drugs where there is robust evidence of efficacy, as well as cost-effectiveness. Mechanisms can be put in place to allow for more costly drugs when proven alternatives have tried and failed. There are far too many drugs that over-prescribed because they are over-marketed to prescribers. If proceeding with national pharmacare, we must eliminate marketing hype, and target increased utilization of medications that are tried, tested and true. A good-hard look at revising the Canada Food Guide and reducing intake of processed foods may also curb the increase of chronic diseases requiring medication.
    Hide replies (6)
    • Christine0912 about 2 months ago
      a 'fail first' policy will result in unnecessary suffering for some people and is a waste of money if the more expensive drug should have been prescribed in the first place
      • SustainabilityFirst about 2 months ago
        it is not a "fail first" policy. It is rational prescribing. Far too often, people are prescribed expensive treatments first line that are less effective and less safe.
        • Christine0912 about 2 months ago
          semantics aside, a fail first policy is not rational prescribing if it can be reasonably determined that the time taken to go through the first drugs will result in disability, death or prolonged suffering
          • SeniorLG about 2 months ago
            Do you have an example of the situation you describe?
            • Christine0912 about 2 months ago
              SeniorLG, That's a fair question, I will need to get back to you on this. I will have to ask on Twitter and a Lupus forum. I believe that the problems I read about came from people in the US. The insurance companies often used a fail first policy when it sometimes was inappropriate. As a result, people were left to suffer through cheaper less effective options before being permitted to get the treatment that the doctor believed they should have started with.
    • keithmnop77 about 2 months ago
      SF, I accidentally downvoted you. The old drug usually worked, which is why it is the old drug!The new drug sometimes works when the old drug doesn't. That does not mean it always works. Also the old drug has the benefit that doctors know what its side effects are and how to handle them.The new drug might not have the side effects of the old drug, but it might have new side effects. Like the painkillers from a few years ago that didn't upset stomachs, but after a few years of use they found that they sometimes stopped hearts.So yeah, doctors should have to try existing drugs that are proven to work first, and only move on to new drugs when the existing drugs fail.The only exception would be where the patient had a known inability to handle the existing drug. Then the current drug could be skipped.
  • justmelogan about 2 months ago
    All medications should be covered. A friend of mine died because Pharmacare stopped covering her brand of insulin and insisted on giving her a cheaper alternative. She complained all the time about having trouble maintaining her sugar levels with the alternate. She told her doctor and her pharmacist. Pharmacare wouldn't budge.
  • Ultra Conserv about 2 months ago
    How about a crowd funding to help pay, and a tax right off for those who donate
    Hide replies (7)
    • charrion about 2 months ago
      You know what other countries call crowd funded care? Health insurance. I'd rather not entrust my life to the whims of others.
      • Dinah about 2 months ago
        That is exactly what health insurance means. Everyone pays into it on a scale related to ability to pay, and any member can get what they need to pay for a prescription.
        • Ultra Conserv about 2 months ago
          Giving money to the government is like throwing it into the wind, it’s always over administered and pays high paid union workers, the common working person has it hard enough to make ends meet, get rid of all income tax, for individuals making under 100,000 per year and totally get rid of business taxes, govt needs to learn to live within its means, make health insurance private like the United States is, put a sales tax higher on imported items and lower for Canadian made goods also a special low tax on goods made with environmentally friendly processes. Canada can not afford any more taxes we are one step away from communism, might as well make everyone work for low wage food stamps and assigned housing and public transport
          • SeniorLG about 2 months ago
            Are you saying you would prefer the US system of extremely high cost medical care with some of the worst health outcomes in the developed world?
            • Ultra Conserv about 2 months ago
              It’s not higher, if you take all the taxes we pay to the govt for healthcare our holy cow, I have some American friends they pay for their healthcare through their jobs from the outside it looks like it cost more, but they get great healthcare in a timely manner, look at all the Canadians heading down south to get surgery done much faster, if we have 2 tier healthcare in Canada those Canadians heading south would spend that money here in Canada, but nooooo we can’t have that we don’t wNt the rich to get special treatment, which in fact they are by heading south, it makes no sense at all
              • keithmnop77 about 2 months ago
                International calculations of health care costs include taxes and insurance fees.They're sums of costs, not sums of bills.
              • SeniorLG about 2 months ago
                Regardless of taxes, the cost of the US system is several thousand dollars higher per person in the population than in Canada. And many poorer US residents have no medical coverage. As as result life expectancy is lower in the US and infant mortality is higher.
  • PensivePharmacist about 2 months ago
    Copy the existing NIHB framework. The research already has been done.
    Hide replies (3)
    • SeniorLG about 2 months ago
      What is NIHB? Is it a US based agency?
      • PensivePharmacist about 2 months ago
        NIHB is the Canadian federal program deciding drug coverage for all Canadian aboriginal peoples and transferred freely across provinces. It stands for Non-Insured Health Benefits. If we expanded it to include all Canadians then it's simpler
        • SeniorLG about 2 months ago
          Thank you.
  • Wendy Watson about 2 months ago
    Drugs should include those with proven effectiveness, and also include those proven effective for less common diseases. Nobody should have to mortgage their house to deal with an illness.
  • Norman7m01 about 2 months ago
    Any drug prescribed by a doctor should be covered.
    Hide reply (1)
    • qpwoeiruty12345 about 2 months ago
      Removed by moderator.
  • keithmnop77 about 2 months ago
    I am 63 and I've got a serious degenerative illness. And I've got some other diseases due to premature aging due to the drugs I take for my degenerative illness (I'd have been dead 10 years ago without them). I get through a lot of drugs in a year. // My drug coverage makes my continued life possible. My drug coverage consists of: // 1. Standard group health insurance including drugs. // 2. Enhanced group health insurance including drugs. // 3. Manitoba Pharmacare that covers all Manitobans once they reach a very high deductible. // My experience has been that, once I reach my Manitoba Pharmacare deductible it covers everything I get to keep me alive and walking around. // The only thing Manitoba Pharmacare has not covered has been Shingles vaccine and Viagra (back when I could take Viagra). Those were covered by my Enhanced group health insurance. //This is what national pharmacare should ensure. That all Canadians have coverage at least equivalent to current standard group health insurance.//Either national pharmacare will be provided by the federal government, or it will be like medicare, where the federal government sets minimum standards that the provinces must follow in order to get federal assistance in funding. // Those who are saying we'll have less coverage, they do not know what they're talking about because that is still to be decided. What we should be demanding is EVERY CANADIAN, self-employed, young parent, contract worker, doing 3 part-time jobs, have coverage like most of us here have. // Standard drug coverage should not be something limited to those on welfare, government payrolls, or aboriginals. Standard drug coverage should not only be for those working for big companies. Standard drug coverage should be for all Canadians. // Standard drug coverage should be funded by progressive taxation and cover all Canadians regardless of wealth. // Standard drug coverage means coverage for all prescribed drugs other than lifestyle and cosmetic drugs. // Standard drug coverage assumes that generally doctors will try standard effective medicines with long track records of performance first, before trying expensive newly developed drugs that lack track records. //Standard drug coverage includes coverage for off-label uses of approved drugs for unapproved uses, provided that those uses are not lifestyle or cosmetic. // Standard coverage does not include experimental drugs because drug companies who stand to profit from experiments working should fund those experiments themselves. //I'd like to see Canada's minimum standards for pharmacare be even a little bit better than than private industry standard coverage. // 1. I'd like to see experimental drugs covered for very rare diseases for which there is no commercial market. // 2. I'd like to see travel vaccinations and occupational vaccinations covered. //
  • qpwoeiruty12345 about 2 months ago
    For those of you in support of National Pharmacare, fell free to pay 50% of your income to the government. Is there an option of opt-out of this nonsense?
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    • armynorb about 2 months ago
      I TOTALLY agree with you, qowoeiruty!!!
    • keithmnop77 about 2 months ago
      Most of my life I did. But that is beside the point. What will change is that I won't be paying for a private drug plan, and parents of young children in less fortunate provinces will be able to get coverage their provinces currently reserve for us older folks.If you pay taxes in Canada, you're already paying for other people's pharmacare. Just most of you are not getting the benefits of it.
      • qpwoeiruty12345 about 2 months ago
        I don't know what income bracket you are in to pay FIFTY% of your income to tax...but really it sounds like you just don't want to pay for your private drug plan anymore and you want the young ones to pay for you. Yes, I am already paying for some people's pharmacare but I don't want to pay for MORE people's pharmacare. I rather pay less tax and pay for my own drugs out of pocket then pay more tax to "benefit" everyone.
        • lilli.depoil about 2 months ago
          Obviously, no Canadian could possibly have enough work ethic to pay for their own drugs... earn enough of a living to take care of your own family, what a hopelessly neo conservative idea! What we need are entitlement programs to give us the theft we need from the productive members of society while pretending it’s our civic right, that’ll work better and result in lower guilt levels for stealing from the productive people. Like even bats know better, when a vampire bat takes blood from the rest of its group without sharing, it will be starved eventually by the group, in Canada we just offer free stuff to anyone who doesn’t feel like working or who figured they’d get a subsidized degree in basket weaving. I think a lot of people and companies are going to move to the states if this goes through.
  • Canadian Gal about 2 months ago
    All medications prescribed by qualified physicians should be covered, including opiates, which some people genuinely need for pain. I know so many people (including myself) with comorbidities, allergies, rare illnesses, drug interactions, and experience of severe side effects - we sometimes need a newer or more expensive medication, or off-label prescriptions. If people are concerned about the opiate crisis on the streets, or pharmaceutical companies influencing doctors, then this is the wrong end to start fixing those issues. Denying medications to people who need them but cannot afford them is not going to impact those problems, it's just cruel and inhumane. I see a lot of people talking about private drug plans - please know that those of us who need a lot of meds often cannot work (or are elderly and retired) and are living in poverty as a result. We don't have access to any non-government coverage and sometimes have to choose between buying medication and buying food.
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    • MattP about 2 months ago
      Great points. The elderly, the retired, and those on social assistance can fall back on their provincial program which, unfortunately, generally doesn't cover anywhere near as many drugs as the private system does. This is what National Pharmacare is proposing - that private insurance be scrapped in order to reduce coverage to a common, low, denominator. I can't imagine that coverage will improve, regardless of the panacea that is being proposed. It is a shame, but a reality, that the government can't afford all medications, and this is why some people are forced to pay out of pocket. I would like to see the National Pharmacare debate address the issue of helping those who require these medications but are unable to pay for them, rather than paying for all medications for all people and eliminating a system that works, for the most part, quite well for the working population.
      • keithmnop77 about 2 months ago
        I think that is a strawman argument. Nobody in the LPC or NDP has proposed banning private pharmacare.What is generally being talked about, and there might be some fringe talking about something else, is something as good as standard private health insurance.I have both Manitoba Pharmacare (as do all Manitobans of every age and income) and once I meet my deductible the only thing it does not cover 100% has been shingles vaccination and Viagra (back when I could still use it).I'm a sick 63 y/o person. I get through a lot of drugs. If Shoppers Drugmart had a "Admirals Club Lounge" I'd be eligible. Our provincial pharmacare covers every medication my standard Desjardins group health covers.My Enhanced Desjardins group health covered my shingles vaccine.
  • Truenorth about 2 months ago
    Health care is a managed by provinces and I am not sure why Federal government gets involved, specially when election is just around the corner! Who is paying for this program? When we are running MASSIVE deficits, is it prudent to keep spending!! Generally, we are taxed to the point of burden with little return in services. Another program as such will call for another billions of dollar in spending.
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    • Dinah about 2 months ago
      We are currently paying for drugs one way or another, and also for hospital treatments for those who can't get drugs they need, which is very expensive!!
    • MattP about 2 months ago
      Has there ever been a private program that improved service and reduced overall expenditures once it has been taken over by the government? The cost will be exorbitant, and the expected savings will not materialize. And who, from any level of government, would ever want to give up their private insurance in favour of the one that they'd get from a truly public system? Not a good way to go.
      • armynorb about 2 months ago
        I agree, MattP
      • keithmnop77 about 2 months ago
        Yes Matt, there was Canadian medicare. Other countries have their own examples too.
    • armynorb about 2 months ago
      EXACTLY RIGHT, Truenorth!!! It is nothing more than a tax grab and stealing control over a program which is the jurisdiction of the provinces!
  • Momtokids2 about 2 months ago
    Health is a provincial jurisdiction, and I would like to see subsidiarity so decision making can be made on a city level, with group coop buys for bigger ticket items. One thing j am certain we don't need is any federal tinkering at all. Corrupt, inept, greedy and marvelous fools.
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    • Think Big about 2 months ago
      Exactly correct, the last thing we need is federal involvement.
    • keithmnop77 about 2 months ago
      I expect that in the end it will be like medicare and the Canada Health Act. A federal standard for health insurance that provinces provide.Like with the Canada Health Act, federal assistance for funding would depend on the province providing at least the minimum coverage the federal act called for. The difference being that Canadian medicare is provincial health insurance for only hospital stays and physicians appointments, and the new Canadian pharmacare would be provincial health insurance that cover most prescription drugs. (Doctors, blood test labs, x-ray labs, pharmacies, outside of hospitals would remain private enterprise. Medicare and pharmacare are government health insurance, not as Americans think, health care providers.)
  • steinley69 about 2 months ago
    Concern is that under this pharmacare program, limitation on drugs available and thus as in our own case where we already have retirement benefits that cover many drugs, it gets more expensive with having to contribute to a gov drug program as well as maintaining our private drug plan under our retirement benefits to ensure that we can access the variety of drugs we may require now and in future. Why not just provide an enhanced tax benefit versus starting an expensive new program which will cost in administration etc.
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    • keithmnop77 about 2 months ago
      I don't plan on continuing my current private coverage if government coverage replaces it.What I expect will happen is that my private plan will be radically changed, as it must have been when medicare came in in the 1960s. The premiums will be radically reduced since they will only be covering dental, vision, ambulance, and travel.I'll expect I'll be saving $85 a month out of my current $130.
  • hk about 2 months ago
    Limit to essential drugs only
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    • charrion about 2 months ago
      Care to define what fits into your "essential drugs" box?
    • Ultra Conserv about 2 months ago
      And force all children to be vaccinated
    • keithmnop77 about 2 months ago
      Do you mean the UN Essentials Drugs List: The "popular" drugs for people with "popular" diseases. I read that too, during Ontario's last election, some Ontario doctor came out with this proposal to cover the UN EDL (probably thinking it could be the thin wedge to get pharmacare in). But read some of the other comments and I think 90% of us are past that now.Canada is not some third world country. We can afford to cover what Germany, Japan, Italy Poland, and France cover.I gather even communist China covers more than the UN Essentials Drug List.- OR -If by essential drugs you meant non-cosmetic non-lifestyle drugs, then yes, I totally agree with you that they are what should be covered.
  • Blue about 2 months ago
    Expand the list of drugs. Coverage amount should be tiered based on family income.Families living below a poverty threshold and indexed to cost of living adjustments would pay nothing.
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    • keithmnop77 about 2 months ago
      I agree with a generous list of drugs. And normal I'd agree with indexing, but in this case there is a cheaper solution that is even more socially just.Pay for pharmacare from progressive taxation, like income tax, and don't waste money on means tests and variable deductibles.The wealthy pay more income tax, the upper middle class pay more income tax -- that is where the fairness comes from. We don't need a bureaucracy doing a double redundant set of income adjustments on payouts when the income adjustments have already been made in the funding end.
  • Lincoln about 2 months ago
    In my experience, the current Ontario approach to deciding what drugs are covered (e.g. for those on social assistance and seniors is flawed. Newer, typically more expensive drugs for some conditions are only covered when it is proven that older drugs for the same condition have been tried and failed to work (in the opinion of those making the jusdgment) which can take a long time). That is a waste of time, - especially when, typically, the newer drug has fewer side effects and thus reduce the medical/hospital costs of addressing those side effects.
    Hide reply (1)
    • keithmnop77 about 2 months ago
      Typically newer drugs are riskier. The older drugs have track records. Physicians know what side effects to expect and how to handle them. Newer drugs don't have track records.The newer drugs may work in cases where the older drugs didn't work, which is why they're approved. And sometimes newer drugs are expected to have fewer side effects of the type that the current drug has -- but then they newer drug may turn out to have new side effects the old drug did not have. Like the cardiac arrhythmias some new painkillers turned out to have. They didn't cause stomach upset, but they sometimes stopped your heart. Newer doesn't actually equal better. If they're lucky, after 5-10 years of use, maybe they'll find the newer drug is better.So I fully agree that in 90% of cases doctors should have to try the current medications before trying something that is new. The remaining 10% where the new drug should be approved would be cases where the patient is known to be intolerant to the family of existing drug being skipped. (I say this based on my experience as a patient with a rare disease who has done a lot of reading. I'm not a medical professional.)
  • SeniorLG about 2 months ago
    There needs to be a balance. Definitely cover the costs of generic drugs which have proven cost-effectiveness. Have a process in place for exceptions. And if someone wants to pay the extra costs for a non-generic formulation or a drug with little clinical evidence then they can pay for it themselves (or through the extended health care benefit plans, should they still exist).
    Hide replies (2)
    • Lincoln about 2 months ago
      But have an "effective" process in place - the current process in Ontario is not as effective as it could be
    • keithmnop77 about 2 months ago
      The process for this here in Manitoba seems pretty effective. So it can be done.
  • keithmnop77 about 2 months ago
    It is important that rare diseases be covered, and physicians have told me it is impossible to test drugs for rare diseases to the normal level because:1. There is not enough money2. There are not enough patients eligible for testingA. So typically drugs used for similar disease are used "off-label" for rare diseases. Drugs used in this way should be covered.B. Sometimes a drug will be proposed for a rare disease that does not have prior approval for another disease. In this case the drug is experimental.My leaning is that generally experimental drugs should not be covered. I feel this strongly for drugs for common diseases where if the experiments are successful the drug can be commercially marketed.I am a little more open to maybe perhaps paying for experimental drugs for rare / orphan diseases.
  • Mags about 2 months ago
    This is a bad idea. Stop spending money that we don’t have. Everyone will suffer. Just stop it!
    Hide reply (1)
    • SeniorLG about 2 months ago
      HI Mags. We are spending the money already - it is actually a case where we can spend less money more wisely and improve the overall health of our population.
  • GoodCitizen about 2 months ago
    I think this question must be addressed carefully. I have two points to make.1) These prescriptions are ordered by Medical Professionals who have been accredited by government. It is assumed that they prescribe the medication that will be effective in treating the patient regardless of cost or proof of effectiveness.2) There are some "expensive" drugs whose use can postpone the need for surgery and therefore have a money saving effect for the healthcare system as a whole.The decision on which drugs to cover cannot be based only on how much it costs or how effective it is thought be.
  • DaveP about 2 months ago
    The plan should have the basics covered that are cost effective and value proven. Individual and employer plans can choose to top up after that but covering all drugs is not sustainable.Many people are not aware that there are drugs with "weird" non-sensical pricing. There night be 25mg, 50mg and 100 mg dosages and all are priced at the same price, regardless of dosage. As a result, covering the 100 mg dose and having pills split in half or quarters can dramatically reduce costs. Many pharmacists do this no charge as a service to clients.Wise choices during the listing process can save dramatically, while still meeting the desired outcome.
    Hide replies (5)
    • Christine0912 about 2 months ago
      agree to some of your points but "value proven" can be an issue. If a drug is sure to be more effective but costs $40000 a year and would greatly improve the life of a person the cost may not be considered good value for the money. I don't believe that pharma coverage should be black and white
      • armynorb about 2 months ago
        We do not need a "national pharmacare program, the provinces can handle that quite well and it IS their jurisdiction! I do NOT want to hand over sbsolute power to the feds!
        • SeniorLG about 2 months ago
          What I understand is that national pharmacare will provide for consistent access to drugs in all provinces with the advantage that prices will be negotiated by one body (probably a federal-provincial group) with the pharmaceutical companies to obtain drugs at much lower costs. A national approach will also reduce time lags and duplication in the drug approval systems since drugs will be evaluated for cost-effectiveness once and not 13 times over. But for the average Canadian it will look like a provincial program - as with other health care services - provinces may decide to tailor some parts to meet the needs of their population.
        • Ultra Conserv about 2 months ago
          Exactly!! Armynorb
    • Worldtraveller about 2 months ago
      Why would we encourage manufacturers to price differently? It is ethical for manufacturers to price flat across dosages ( same price for patients even if they unfortunately require a higher dose) but cost-saving recommendations for pill splitting (which are not approved by regulators by the way) will result in forcing manufacturers to linear pricing. How is that a win?
  • lilli.depoil about 2 months ago
    I don’t think any drugs should be covered. We have adequate provincial coverage for low income people, and it’s not in the governments perogative to continue adding social programs given the already huge deficits. It’s nice to take care of each other, however that’s limited by being able to run responsible finances.
  • hutchb about 2 months ago
    Cover prescription drugs for which there is solid evidence of effectiveness and value-for-money
  • ayzhar77 about 2 months ago
    I am a parent of a child who, without warning developed Type 1 diabetes, or juvenile diabetes. I have been immersed in her treatment for the last 6 years and am shocked at the costs and diversity of Pharmacare options available province to province. A national plan would assist parents facing the astronomical costs of daily management, as there is no cure for this disease yet. We are lucky, in that we provide an extended health plan to our employees, through our company. Without this extended health plan, our child would be using the oldest, and cheapest, available treatment plans. These treatment plans require a substantial amount of planning, measuring and calculating to acquire the correct algorithm that correctly measures insulin to carbohydrate needs. Without this work these children face side effects, such as kidney failure, blindness and amputations from the high blood glucose. The latest technology provides easier insulin delivery but comes at a huge cost that most cannot afford and yet the complications later in life, from the side effects of poor blood glucose management, will cost our medical system far more as these T1d's age.
  • healthy about 2 months ago
    Generally limit coverage to drugs of proven effectiveness and lowest cost. The needs to be a process for exceptions if proven need. There needs to be an enforcement program to counter pharmaceutical companies who charge exorbitant prices for drugs of are conditions.
  • Spinnaker175 about 2 months ago
    I don't believe that the government can be all things to all people. I would limit the drugs covered under pharmacare to cover commonly used drugs of proven effectiveness. I would like to see a process where individuals in great need of special drugs can apply for coverage outside of regular pharmacare.
  • Universal 100% Public Pharmacare Now about 2 months ago
    Cover Everything Generic. Make All High Quality Generics. No Conditions. Do Publicly Funded Research on Generics to See What Does and Doesn't Work. Read Dr. Susan Rosenthal's "Sick and Sicker: Essays on Class, Health and Health Care," https://www.susanrosenthal.com/sick-and-sicker. It's free online there. Dr. Rosenthal says "Solidarity is the Best Medicine".Especially relevant is Chapter 5, "The US and Canada: Different Forms of Medical Rationing," https://www.susanrosenthal.com/articles/the-us-and-canada-different-forms-of-medical-rationing
  • Human Rights Advocate about 2 months ago
    I believe the first of the approaches described in the introductory text at the top of this page makes more rational sense.
  • Linus about 2 months ago
    Interesting. I just read in the Veterinary News that Canada plans on charging a service fee, aka TAX, on all human and veterinary drugs. Of course the vets are concerned about the rise in prices for their drugs, and then I found this survey. I believe weather we get a plan or not we will be taxed by the government for our drugs. I understand this survey to be a red herring to get us away from what they are really doing.
  • canadiannapoleon about 2 months ago
    All drugs, with no restrictions!
  • Worldtraveller about 2 months ago
    This question may be misleading (I am certain unintentionally so) because it may not be imagining the future of drug innovation in orphan and personal medicine. Many genetically-targeted drugs will be developed in near future and will be extremely effective for a few individuals. Because the evidence is built on an extremely small population, our normal evidence standards do not fit. The Europeans recognize this and suggest other evidence methods such as adaptive trials etc. It is usually not possible to prove ‘statistical significance’ on small numbers; nevertheless, it will be obvious to patients (and to taxpayers) that the product(s) probably work. Pressure will be enormous to fund...even if the small numbers do not fit old models of current clinical trials involving hundreds if not thousands of patients. Because populations are small ( even if effects dramatic), prices will be high. Is it realistic to expect taxpayers will allow Government to ignore personalized medicine? I believe it will be a politically unavoidable problem. Anyone reading this who has not seen ‘Dallas Buyers club’ (Matthew McConaughey) definitely needs to download that movie. It reminds us that when faced with catastrophic consequences, evidence standards need to adapt.
    Hide replies (2)
    • armynorb about 2 months ago
      We do NOT need a national pharmacare program created, implemented and controlled by the feds!!! They cannot get ANYTHING right, they do NOT care about the people,it is a tax grab, and it infringes on the jurisdiction of the provinces!
      • Think Big about 2 months ago
        Exactly correct armynorb. The feds get involved spend bags of money and it is worse in the end.
  • let's talk health about 2 months ago
    limit to evidence based
  • Pax about 2 months ago
    limit coverage to those based on good evidence of effectiveness
  • Veronica about 2 months ago
    Definitely an expanded list. There are many Canadians with life-threatening illnesses that need access to drugs that they can't afford, and many times more options than are available currently.
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    • Dinah about 2 months ago
      I most definitely agree. If we are not going to fund new drugs when they are developed, why don't we just shut down a lot of the medical and pharmaceutical research that we have going? I'm just mad because I spent 7 years of my life helping to find the gene for Cystic Fibrosis and I find that most countries won't fund Orkambi for little kids that could be really helped by it. Why did we do that then?!?
    • armynorb about 2 months ago
      The federal government does not have a magic wand to fix anything! They louse things up at best! Everything tey touch gets fouled up! Just look at the paysystem clled "PHOENIX This is the jurisdiction of the provinces and the feds should BUTT OUT"!!!
  • Jarviedean about 2 months ago
    To be of any use it must cover all drugs on the provincial and territorial schedules.
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    • armynorb about 2 months ago
      It is of no use, rather I see it as a tax grab! The provinces are quite capable of doing their own thing!
  • armynorb about 2 months ago
    We do NOT need a national pharmacare program!! The proovinces do it quite well already and a national program is nothing more than another tax-grab and power grab by the federal government! Medical issues are the jurisdiction of the provincial governments, NOT the federal government! It seems the federal government wants to control all aspects of Canada and that is not right! We do not need a dictatorship!
  • Bdg145 about 2 months ago
    Hi there, from my perspective most of the drugs that people use regularly could actually be eliminated because a) they don’t actually work S well as people think they do b) they do not correct the cause of the problem c) the actual cause could largely be corrected via lifestyle changes
  • Jlatrace about 2 months ago
    Cover all drugs commonly used and accepted. Not experimental.
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    • Del about 2 months ago
      Yes, all drugs used globally. Experimental drug research need to be fully funded up to meet the needs of patients and their families. Need more than long term generational solution, tic tock !
  • Del about 2 months ago
    All drugs need to be covered across Canada.Health Canada needs to ensure that all Canadians have equitable access to safe and effective drugs and health products based upon global research, no duplication, more google speed in solutions.Fast track new drugs in a more speedy current consumer / present day patient need. Diseases are too often a generational solution when in 2018 we need to minimize the health risk factors of current patients. The patient needs to have significant authority to say yes or no to higher-cost drugs. Everything monitored and evidence collection of data.
  • EclecticPony about 2 months ago
    Any drugs or supplies (like needles for diabetics or bandages for people on home care) approved by Health Canada and prescribed by a person licensed to prescribe should be covered. Any other option will undoubtedly leave some people who desperately need a particular drug still unable to afford it.
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    • EclecticPony about 2 months ago
      I do think Health Canada needs to listen less to the corrupt FDA, CDC & pharmaceutical industries when deciding to approve a drug and try harder to get independent studies or studies from other countries.
  • MattP about 2 months ago
    It should be based on what is covered on provincial formularies for those who fall through the cracks of the provincial system. A separate private system should remain. A full-blown national pharmacare program that provides the same level of coverage as what is currently provided by the private system was calculated by the government itself to cost at least $17 B, and this money has to come from somewhere. While this discussion provides great fodder for an election, it is not practical. If people knew what they were championing when it came to National Pharmacare, very few working age people would ever choose this option because the government formulary would be very limited, and expanding drug coverage to all drugs would be like killing a fly with a bazooka - totally the wrong tool to get the job done.
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    • Christine0912 about 2 months ago
      Not all drugs would be covered. Private systems don't cover all drugs either. No one should have to suffer due to needing prescription meds and the current Ontario system is very limited and not always based on good quality evidence
  • Concern about 2 months ago
    The choice of what needs to be covered needs to have leway. Example - i was needing special asthma product. The one perscribed was not covered by our company (costing 2x the other accepted one) but the one on the drug plan took 4x as much for LESS result. Tell me how this made sense. Cost them twice as much and needed another over the counter medication as well to breath
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    • Christine0912 about 2 months ago
      I agree. I just posted a comment that sheds light on some of the problems with a 'fail first treatment'. Although you are not talking about a fail first treatment this is an example of a 'value for money' issue
  • ronneebee about 2 months ago
    Absolutely no narcotic drugs....if the government pays for it guaranteed the person acquiring it will resell it
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    • EclecticPony about 2 months ago
      You clearly don't understand that there are literally millions of chronic pain patients who need these drugs just to have even faint hint of functioning like a normal person. You are clearly completely lacking in any empathy or understanding whatsoever that you think it's acceptable to cause harm to people who live in endless pain and already aren't getting the treatment they need because of this ridiculous and misguided "war on opioids" which is actually a war on pain patients. Do you have any idea how many chronic pain patients have killed themselves to escape the pain because of this kind of stupidity? Apparently you're perfectly willing to sacrifice chronic pain patients' lives in a misguided attempt to keep some people from abusing drugs.
    • Christine0912 about 2 months ago
      what you are advocating is human rights discrimination. People suffering from pain ahve a right to have their pain treated.
  • Bean about 2 months ago
    Drugs for which there is strong, independently reviewed evidence, ie, evidence not controlled by Big Pharma, should be covered. Pharmacare, (and actually all health care) should be managed federally, not provincially.
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    • EclecticPony about 2 months ago
      The only problem with this suggestion is that very few independent studies have been done on entire classes of drugs, much less individual drugs.
  • Christine0912 about 2 months ago
    Neither approach alone is acceptable to me. I would like to see the first approach however I also would like to see some of the second approach as well. Value for money needs to be defined. example-if drugs cost $40000 per year but is effective, is that considered poor value for money because of the cost? When appropriate, I am for trying tried and true medications first. The problem with this is that some physicians may believe that patients might first have to use drugs that fail until they are able to try a drug that is more costly but works. This approach may lead some patients to suffer unnecessarily when it may have been appropriate to jump right to the more expensive medication from the start. There are some medications that are very expensive that it might be appropriate to have a doctor either apply to have patient covered or consult with a specialist first. The problem with this is that bureaucracy can impede treatment.
  • paarm1 about 2 months ago
    Limit to drugs that have been proven to be effective for condition they are required
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    • Dinah about 2 months ago
      I would really like to know why there are any drugs approved by Health Canada that AREN"T effective for the condition they are labelled for. Not forgetting that different people metabolise different drugs and formulations differently, or can't use certain drugs because of pre-existing conditions.
    • MattP about 2 months ago
      Drugs react differently among different people. What works for you may not work for me. They are all approved by Health Canada, based on proven safety and efficacy, so this decision has already been made. The question becomes "cost-effectiveness", and the only drug that truly is cost-effective is the one that works, and this will vary from person to person. Cost-effectiveness analysis looks at broad populations - who will decide what the threshold is? Would you like the only drug that may work for you to be deemed "not cost-effective"? This is the problem with a government formulary and why the private system currently provides much greater access than any public system ever will. Be careful what you wish for.
  • momeister about 2 months ago
    How would the list of drugs that are 'effective and value for money' be established ? Would compiling this list spawn another branch of bureaucracy the cost of which would soon negate the savings that result from such a list? Also, If we are to rule out high cost drugs with low evidence of effectiveness there must also be a method by which those drugs can be covered when the professional care-giver is of the opinion that there is no viable alternative in a specific situation.
  • charrion about 2 months ago
    It really depends on how and who makes those decisions. I am currently prescribed three different medications that BC Pharmacare has decided not to cover for entirely arbitrary reasons. My depression is managed with Cymbalta (Duloxetine) which is not covered because there are allegedly cheaper alternatives and Cymbalta is primarily marketed as a treatment for nerve pain. However, due to the fact that I have no lower intestine as a result of ulcerative colitis, those cheaper options are not absorbed effectively.Decisions regarding efficacy invariably end up narrowed in scope or simply fail to consider every situation. Those decisions need to be made not by actuarial tables or accountants but by care givers.
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    • Dinah about 2 months ago
      There should also be a committee or something where situations like yours could go for compassionate review with a view to coverage in such exceptional situations, especially for a drug which is going to be taken continuously due to a chronic condition.
      • MattP about 2 months ago
        Great - more bureaucracy, more wait times, and let's bypass the health professional and leave the decision to a committee! No thanks.
  • Mags about 2 months ago
    If you are going to provide pharmacare then you must include all drugs prescribed by the physician. You cannot exclude some drugs because they are expensive when the patient can’t even afford them.
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    • Dinah about 2 months ago
      You are right. It's the expensive drugs that people are least likely to be able to afford. However, we do have to use the cheapest version available until we find out that the patient needs a better version. And we can completely do without pharmaceutical salespeople dropping in on doctors.
  • kf1977 about 2 months ago
    The ideal scenario is that ALL drugs are covered but if that isn't the reality (at least at first), I'd like to see coverage for medications that prevent disease or transmission. So, for example vaccinations for HPV, Hepatitis A & B. Or pre-exposure and post-exposure prophylaxis.
  • peaceologist about 2 months ago
    All drugs should be covered.