FAQ 1. Who should participate in this consultation?
This consultation is
open to all Canadians, and we invite you to join the discussions and share your
thoughts on national pharmacare.
FAQ 2. How can I participate?
The Council is inviting Canadians to share their ideas and views about national pharmacare by:
The input gathered will help inform the Council’s advice to the Government on how to best implement national pharmacare.
The deadline for written submissions, discussion forums and the online questionnaire is September 28, 2018.
FAQ 3. What is pharmacare?
Pharmacare is a system of health insurance coverage that provides people with access to necessary prescription drugs. This can be accomplished in different ways.
In most industrialized countries, pharmacare is part of a universal health care system. Prescription drugs are included as part of insured health services along with hospital care, medical care and a range of other health services.
Most Canadians have some form of prescription drug coverage—often through their employer—but the terms of coverage vary considerably, leaving some households without adequate coverage to meet their health care needs.As Canada considers how to move forward on a national approach to this issue, it has many options available. No decisions on a particular model or approach have yet been made. Understanding what will work for Canadians is essential to enabling the Government to make an informed decision.
FAQ 4. How many Canadians have insufficient drug coverage?
A recent study suggests that 95% of Canadians (more than 34 million) are eligible for some form of public or private prescription drug coverage. But even those with drug coverage can face significant out-of-pocket costs, either in the form of deductibles or co-payments, or if their expenses exceed the annual maximum for their drug plan. These costs can make affording drugs a challenge.
Nearly two million Canadians reported not being able to afford one or more drugs in the past year, leading to poorer health and increased doctor visits and hospital admissions.Another recent report estimates that hundreds of premature deaths occur each year among working age Canadians unable to afford their prescription medicines (Canadian Federation of Nurses Unions, 2018).
FAQ 5. How was the Council chosen?
The Council members were selected to reflect the regional, gender, linguistic and demographic diversity of Canada, as well as several perspectives that are key to shaping the pharmacare debate. These perspectives include health policy, finance and fiscal policy, intergovernmental relations, business and labour, and the patient experience.The Minister of Health and the Minister of Finance invited their counterparts to propose potential members for the Council. Suggestions were also received from a number of stakeholders.
FAQ 6. What are the timelines for the Council?
The Council was officially launched on June 20, 2018. Consultations, both in-person and online, began immediately following the launch and will continue throughout the summer and fall.The Council will provide the Minister of Health and the Minister of Finance with a final report in Spring 2019.
FAQ 7. Who will the Council consult?
In the coming months, the Council will engage with provincial and territorial governments, and Indigenous governments and representative organizations. It will also engage with representatives and experts in relevant fields, including health care providers, private insurers, businesses, labour representatives, patients, the pharmaceutical industry and other Canadians.This online consultation platform has also been launched to provide a starting point for the Council’s dialogue with Canadians about the implementation of national pharmacare. This platform gives all Canadians the opportunity to have their say and to help shape national pharmacare for the future.
FAQ 8. What is the Council asking Canadians?
To support a focused dialogue around the benefits and trade-offs of various models of pharmacare, the Council will be asking Canadians questions on the following key issues:
A system of health insurance that provides people with access to necessary prescription drugs. Its design can be determined by a number of factors, including which population groups are targeted, which types of drugs are covered, and how it is financed.
After any applicable
deductible limit has been reached, the amount paid out-of-pocket by the drug
insurance plan member each time a prescription is filled, with the remainder of
the cost paid by the insurance plan. This can either be a percentage amount
(e.g. 20% of total prescription cost) or a fixed payment per prescription (e.g.
$5 per prescription). See also ‘deductible.’
The amount that a
plan member must pay out-of-pocket on drugs within a certain period of time
(e.g., annually) before the drug insurance plan will begin to pay for eligible
prescription drug costs. See also ‘co-payment.’
Extended health insurance
plans that reimburse the cost of health care services, such as vision care,
dental care, physiotherapy, and prescription drugs that are not covered by
government health insurance. Also known as supplemental health insurance.
A list of drugs whose
costs are eligible for reimbursement through a drug insurance plan. The
formulary also lists any conditions under which a drug may be available to drug
insurance plan members, e.g., the cost of a drug will only be reimbursed for
plan members who meet certain clinical criteria and/or receive prior approval
from the drug plan.
prescription with a generic version of a drug rather than the brand name
funded health insurance system which covers the costs of basic physician and
hospital care for Canadian citizens and permanent residents. The majority of
Canadians also have additional extended health care insurance provided by
employers to reimburse the costs of health care services not covered by
medicare, such as vision care, dental care, physiotherapy, and prescription
The portion of drug costs paid by a drug insurance
plan member, or the amount paid by an individual without drug insurance.
A member of a drug
insurance plan who is eligible for coverage under the plan. The plan member’s
dependents may also be eligible for insurance coverage under the plan.
A fixed amount (often
paid annually) that an individual must pay to enrol in a drug insurance plan.
This amount is payable whether or not the individual uses his or her benefits
under the plan.
A drug that can be obtained only by means of a physician's prescription. Different types of prescription drugs include:
Private drug insurance plans
Drug insurance plans
that are sponsored by public and private sector employers for their employees,
and by unions and professional associations for their members. Also drug insurance
plans that are purchased by individuals.
Public drug insurance plans
Drug insurance plans that
are funded by government to serve as a social safety net for citizens, e.g, seniors or those
with low incomes. Also known as
Universal drug insurance plans
A drug insurance plan
that covers the whole population.
The personal information you provide is protected in
accordance with the Privacy Act and collected under the authority of the
Department of Health Act and the Public Health Agency of Canada Act. Your
personal information will be collected to help inform the Council’s advice to
the Government on how to best implement national pharmacare. You have the right
to request access to and correction of your personal information. You also have
the right to file a complaint with the Privacy Commissioner of Canada if you
think your personal information has been handled improperly. For more
information about the handling of your personal information, please contact the
Privacy Management Division at 613-948-3179 or firstname.lastname@example.org.