44th Parl. 1st Sess.
May 30, 2024 10:00AM
Madam Speaker, I am thankful for the opportunity to speak to a very important piece of legislation, Bill C-64, which deals with pharmacare and develops a framework for it. This bill, along with other investments made by our government, would help millions of Canadians who are struggling to pay for their prescription drugs. We had a very healthy process at HESA, the Standing Committee on Health. I want to thank all witnesses who appeared before the committee and those who sent written testimony because it really helped us understand the positive impact of this legislation.
This bill is a priority for our government. It establishes the fundamental principles for implementing a national pharmacare program in Canada. It also sets out our plan to work with the provinces and territories who so desire to propose universal single-payer coverage for a certain number of contraceptives and diabetes medications.
Since this bill was introduced, we have heard many facts about access to and affordability of prescription drugs within Canada. Statistics Canada's data from 2021 indicates that one in five Canadians has reported not having enough insurance to cover the cost of prescription medication in the previous 12 months. We know that having no prescription insurance coverage is associated with higher non-adherence to prescriptions because of cost. We also know that this results in some Canadians having to choose between paying for these medications and paying for other basic necessities, like food and housing.
This is why our government has consistently made commitments toward national pharmacare. Bill C-64 recognizes the critical importance of working with provinces and territories, which are responsible for the administration of health care. It also outlines our intent to work with these partners to provide universal single-payer coverage for a number of contraception and diabetes medications.
This legislation is an important step forward to improve health equity, affordability and outcomes and has the potential of long-term savings for the health care system. In budget 2024, we announced $1.5 billion over five years to support the launch of national pharmacare and coverage for contraception and diabetes medications. I would like to highlight the potential impact that these two drug classes, for which we are seeking to provide coverage under this legislation, would have on Canadians.
We have heard stories of people, or know someone, in our constituencies struggling to access diabetes medication or supplies due to a lack of insurance coverage through their work, or of an individual who has limited insurance coverage so they cannot choose the form of contraception that is best suited for them. For example, for a part-time uninsured worker who has type 1 diabetes and is also of reproductive age to manage her diabetes, it would cost up to $18,000 per year, leaving her unable to afford the $500 upfront cost of her preferred method of contraception, a hormonal IUD. With the introduction of this legislation, this individual would save money on costs associated with managing her diabetes and would be able to access a hormonal IUD at no cost, with no out-of-pocket expenses, once the legislation is implemented in her province.
Studies have demonstrated that publicly funded, no-cost universal contraception can result in public cost savings. Evidence from the University of British Columbia has estimated that no-cost contraception has the potential to save the B.C. health care system approximately $27 million per year. Since April 1, 2023, British Columbia is the only province in Canada to provide universal free contraceptives to all residents under the B.C. pharmacare program. In the first eight months of this program, more than 188,000 people received free contraceptives.
The same cost-cutting principle applies to diabetes medication.
Diabetes is one of the most widespread chronic diseases in Canada. Although there is no cure for diabetes, there are treatments to manage the disease.
One in four Canadians with diabetes has reported not following a treatment plan due to cost. Improving access to diabetes medications would help improve the health of some of the 3.7 million Canadians living with diabetes and would reduce the risk of serious life-changing health complications such as blindness and amputations. Beyond helping people with managing their diabetes and living healthier lives, if left untreated or poorly managed, diabetes can lead to high and unnecessary costs on the health care system due to its complications, including heart attacks, strokes and kidney failure. The full cost of diabetes to the health care system could exceed almost $40 billion by 2028, as estimated by Diabetes Canada.
The bill demonstrates the Government of Canada's commitment to consulting widely on the way forward and working with provinces, territories, indigenous peoples and other partners and stakeholders, including other political parties, to improve the accessibility, affordability and appropriate use of pharmaceutical products by reducing financial barriers and contributing to physical and mental health and well-being.
Beyond our recent work on Bill C-64, I would like to highlight some of the ongoing initiatives that this government has put in place to support our efforts toward national pharmacare.
On a national level, our government launched the first-ever national strategy for drugs for rare diseases in March 2023, with an investment of up to $1.5 billion over three years. As part of the overall $1.5-billion investment, our government will make available up to $1.4 billion over three years to willing provinces and territories through bilateral agreements.
The strategy marks the beginning of a national approach to meeting the need for drugs used to treat rare diseases.
This funding would help provinces and territories improve access to new and emerging drugs for Canadians with rare diseases and would support enhanced access to existing drugs, early diagnosis and screening for rare diseases.
I would also like to highlight another initiative under way, which involves the excellent work by Prince Edward Island through a $35-million federal investment. Under this initiative, P.E.I. is working to improve affordable access to prescription drugs, while at the same time informing the advancement of national universal pharmacare. The work accomplished by P.E.I. has been remarkable. Since December of last year, P.E.I. has expanded access to over 100 medications to treat a variety of conditions, including heart disease, pulmonary arterial hypertension, multiple sclerosis, psoriasis and cancer. In addition, effective June 1, 2023, P.E.I. reduced copays to five dollars for almost 60% of medications regularly used by island residents. I am pleased to share that through this initiative, P.E.I. residents have saved over $2.8 million in out-of-pocket costs as of March of this year.
Finally, on December 18, 2023, the Government of Canada announced the creation of Canada's drug agency, the CDA, with an investment of over $89.5 million over five years, starting in 2024-25. The CDA will provide the dedicated leadership and coordination needed to make Canada's drug system more sustainable and better prepared for the future, helping Canadians achieve better health outcomes. I am pleased to share that as of May 1, Canada's drug agency has officially launched.
In closing, members can see the extraordinary amount of hard work that has been dedicated to national pharmacare.
Bill C‑64 is a major step forward in our commitment to guaranteeing affordable, quality drugs for all Canadians. Our universal coverage plan for contraceptives and diabetes drugs will change the lives of individuals, families, society and our health care system.
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Madam Speaker, it is a pleasure to be able to rise and speak to this legislation today.
There are some aspects of public policy that I have had a great deal of interest in over the years, not only here in Ottawa, but also during the days I spent in the Manitoba legislature. Canadians have a justified expectation that provincial and federal governments will work together on the important issue of health care. It is part of our Canadian identity. In many ways, it is one of the biggest treasures we have as Canadians.
At the end of the day, when I look at this legislation, Bill C-64, I see it as a significant step forward in recognizing just how important it is, when we talk about health care, that medications need to be incorporated in a very real and tangible way into the discussions. I think of the number of people over the years who have ended up going to emergency services, had a premature death or were in situations where there were additional costs for health care. Imagine the number of different pharmacare programs that are scattered throughout the provinces. Even within a province, there are multiple different forms of pharmacare programs being provided. However, even with all of those hundred-plus national or provincial insurance programs that are out there, there are still many Canadians, hundreds of thousands, who have absolutely no insurance for prescribed medicines.
This policy that is sound and makes sense. Therefore, I am bewildered as to why, yet again, we see the official Reform Party across the way saying no to Canadians on what I believe is a significant step forward toward a national pharmacare program. It would start off with two medications, in two areas. I believe Canadians would overwhelmingly be in support of this. Whether it is people in Quebec, Manitoba, B.C. or Atlantic Canada, we will find resounding support for this initiative, and I would like to think that Conservatives, at some point in time, will open their eyes and have a better appreciation for the true benefits of this program.
This is not new for me. I have been talking about it in this House for many years. For the last half-dozen or so years, I have raised the issue. I have presented petitions on the issue. Whenever I had the opportunity to highlight the importance of pharmacare, I would often make reference to the importance of the federal government working with provincial governments across the country to encourage more participation in a truly national program. Interprovincial migration happens all the time. I have family members who live in different provinces. In fact, I have a brother who lives in B.C. and a sister who lives in Newfoundland and Labrador. The types of coverage vary. We all have opinions. Because this includes medication for people with diabetes and contraceptives for women, we would all benefit directly because we all have family members or know people who would benefit from that. I would personally love to see an add-on to it with respect to shingles.
I understand that in some provinces there is better coverage than in other provinces. That is one reason I would argue, as my daughter has in Manitoba, that we need to get provinces to come to the table in such a way that we could recognize the best pharmacare program that we could have, while expanding it to what it ideally could and should be into the future, with a higher sense of co-operation. I believe that is the answer. I think it was back in 2016 or 2017, I recall being on Keewatin Street in the north end of Winnipeg, asking people to sign a petition on the importance of national health care and on a national pharmacare program.
The NDP House leader made reference to a Quebec union and its thoughts about ensuring not only that this program sees the light of the day, but also that all politicians get behind it. There is a saying from the national nurses union that health care workers understand and they appreciate. If one goes into a hospital, one will find, at least in Manitoba, that one's medications are covered. When one leaves the hospital, depending on their situation and what kind of a plan they might have, they will get their medication. Many may not have a plan, so they will not get the medications, and often, the person returns to a hospital situation. I have talked to individuals, particularly seniors, who talk about medications versus food. That is a real discussion that takes place, sadly. From a personal point of view, the pharmacare program has been more important to me than the dental care program, and we have seen the success of the dental care program.
As a government, with the Prime Minister, we have seen how much Liberals value our health care system, our Canadian identity, virtually from the get-go with the buying of prescription medications to be circulated in order to support provinces, until not that long ago when we made a contribution of $198 billion over the next 10 years to support our health care system so that we can enhance programs such as staffing requirements, long-term care and mental health. Those are expectations our constituents have. That is the type of thing that we are delivering because we have seen agreement after agreement with provinces and Ottawa dealing with health care, and we recognize just how important the issue is. We continue to be able to work with the different jurisdictions.
I believe that when we think about issues like mental health, dental services, pharmaceuticals and long-term care, they are all things that I believe, through the Canada Health Act, we have a responsibility to show leadership for. I like to think that whether it is a territory or a province, there is a some semblance of what we could expect and that it would be of a similar nature. That is why we have transfer payments, equalization payments and so much more. That is why we have a government that not only understands it, but it brings in budgetary measures to support it and legislative measures like we are debating today on Bill C-64. The Conservative Party needs to wake up and understand what Canadians want. That is better quality health care, and Bill C-64 delivers just that. Conservatives should be voting in favour of it, not filibustering.
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- May/30/24 8:02:13 p.m.
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Madam Speaker, my colleague asked a very interesting question. I talked about that in my speech. It would have been better to target people who do not have access or who need a lot of prescription medication that they cannot afford. If the government had done that, then it would have to cover only about 1% to 2% of the Canadian population, and we might have supported the measure. However, it bothers us that that the government wants to scrap everything that currently exists in the public and private sector to implement an extremely onerous system with a lot of red tape.
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- May/30/24 8:02:50 p.m.
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Mr. Speaker, is it always an honour to rise in this House.
I want to start on a personal level. I was always so proud to grow up with my mother as a family physician, who continues to practice medicine in Winnipeg. In the past number of years, she has moved into working with people battling addictions. Much of my understanding of the health care system and how we care for people in our society has come through the compassion, expertise and professionalism that I have seen on my mother's part, so it is with her in mind that I rise today to speak about pharmacare.
Like so many of our colleagues in the House, I have heard from constituents who are eager for the government to move in a direction that will allow for a universal pharmacare plan. There are a variety of reasons for this, which I will get to later in my remarks. However, what I have heard primarily from seniors, whether it is on the government's plan for dental care, the proposed piece of legislation we are talking about today or investments in aging in place with dignity, is that they are extremely enthusiastic about the direction the government is headed in relation to a variety of different health care policies.
As members know, recently there was an election in my home province of Manitoba. We have been working collaboratively with the new government, and I was very proud to join other colleagues, as well as the premier and the Manitoba health minister, not too long ago to announce a $630-million health care deal with the Province of Manitoba. It is going to see us invest directly in a variety of areas that are going to make a difference in the lives of my constituents, and Winnipeggers and Manitobans broadly speaking. They include things like a reduction in wait times, investments in mental health and addiction and ensuring that we have greater efficiency in our health care system.
I have talked often in this chamber about my experience as a teacher, as a principal and as a coach, having worked for many years with young people, and I am proud of the investments we are making in youth mental health. I would also note that many of the students I have worked with in the northwest part of the city of Winnipeg are unfortunately, and in many instances disproportionately, impacted by type 2 diabetes. It is indigenous communities in particular that are facing those challenges. I come to this debate with some first-hand experience, having seen how difficult it can be to operate without coverage.
Our government promised to bring in a national, universal pharmacare plan so that all Canadians can have access to the prescription drugs that they need.
Our government worked on developing a solid foundation for building a national, universal pharmacare program. This work includes investments in the national strategy for drugs for rare diseases to help Canadians with rare diseases access the drugs they need. It also includes the announcement of the creation of a Canadian drug agency in December 2023.
With the help of the Canadian Agency for Drugs and Technologies in Health, we have also completed preliminary work toward a national formulary. This work included the establishment of a multidisciplinary advisory panel with a recommended framework and process for the development of a national formulary.
In Canada, the roles and responsibilities for health care services are shared between provincial and territorial governments and the federal government, as we know.
The provincial and territorial governments are responsible for the management, organization and delivery of health care services for their residents, which includes determining which drugs are reimbursed, and under what conditions, for their eligible populations.
We look forward to continuing to collaborate with our provincial and territorial partners to improve the accessibility to and affordability of prescription drugs for Canadians. The bill would do just that, starting with contraception and diabetes products.
By continuing our work together and making wise investments, we can ensure that the health care system is there for us when we need it, both now and in years to come.
I said at the outset of my remarks that I spent a number of years as an educator, and it was during that time that I got to know kids and their families on very personal levels. I did not just get to understand them as students, but I got to understand them as people, including all the challenges that come along with daily life. Some of those challenges included access to health care.
I cannot tell members how many times, for example, I would have a first nations single mother with a child in crisis in my office, and she was not sure how to advocate well for her child, because they had had so many challenges over the years in interacting with the health care system. I remember one particular instance where a child was having some significant mental health issues, and I said that I thought we really needed to call the son's doctor and get an appointment for him. The mother picked up the phone and called the doctor, and the receptionist at the office answered the phone and said that, unfortunately, they did not have a spot for the next four months. This was a young person who was contemplating taking their own life at the time.
I was fortunate enough to be able to help that family in that particular instance. This was by virtue of something I mentioned at the beginning of my remarks, and that is having seen my mother's ability to operate in and navigate the system. However, this is not uncommon, particularly for marginalized communities. In Manitoba more specifically, there are indigenous communities, whether first nations, Métis or Inuit, as well as newcomers, who have difficulty accessing our health care system for a variety of different reasons.
In addition, in many of these families, there were single mothers or single fathers working multiple jobs. They had to go long ways across the city in order to make ends meet and to provide for their families, and they did not have access to plans. They did not have access to medications that would allow them to live healthier and more prosperous lives.
I have those families and those kids in mind when I think about what the bill would mean for them and their future. I am proud to have the opportunity to rise today to talk about what we can accomplish through this historic piece of legislation.
I know that my time is running short, so with that, I will gladly take my seat for a moment and welcome questions from my colleagues across the way.
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- May/30/24 8:33:16 p.m.
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Mr. Speaker, I am pleased to rise today to participate in this important debate. The legislation before us contains the four principles of accessibility, affordability, appropriateness and universality.
Today, I will speak to the principle of appropriateness, which relates to the appropriate prescribing and use of medicines. I will outline the importance of achieving a pan-Canadian strategy on the appropriate use of drugs, which is a key feature of this legislation. Notably, the World Health Organization defines “appropriate use” as follows: “patients receive medications appropriate to their clinical needs, in doses that meet their own individual requirements, for an adequate period of time, and at the lowest cost to them and their community.”
Prescription drugs play a critical role in the day-to-day for Canadians. Every year, over 750 million prescriptions are filled by 18 million people in Canada. It is estimated that in any given month, 55% of adults and 23% of children and youth will take at least one prescription medication. Getting the right medication at the right time can be life-changing. Whether it is receiving a prescription for an inhaler to help an asthmatic patient breathe better or anti-hypertensive medication to bring down blood pressure and decrease the risk of heart attack or stroke, medications have the power to restore health and improve a person's quality of life. However, getting the wrong medication at the wrong time can cause significant unintended harms. In fact, adverse drug events are a leading cause of unplanned hospital visits, contributing to over two million emergency department visits and 700,000 hospital admissions in Canada every year.
Examples of appropriate use and action include an informed conversation between a patient and their health care provider on the best treatment to improve their health, opting to stop a medication that was once helpful and is now causing more harm than good, or a public awareness campaign on how to use antibiotics wisely. Unfortunately, a growing body of evidence suggests that inappropriate prescribing and use happen more often than they should. Consider that 21% of adults in Canada between the ages of 40 and 79 are currently taking more than five prescription medications at a time. This is called polypharmacy and it can increase a person's risk of falls by 75%, among other impacts.
Consider the story heard from a clinician about a patient who was taking over 25 different medications, the combined effects of which were taking a serious toll on their health and quality of life. This clinician stressed to us the significant time and effort required to support the patient and caregiver to slowly discontinue the inappropriate medications. A striking takeaway from this conversation was that this case was far from an anomaly in their practice.
Inappropriate prescribing can threaten patient safety and lead to negative health, social and financial impacts. Other significant examples, such as increased antibiotic resistance due to overuse that threatens patient safety, the risks of addiction and overdose from opioid misuse, and many problems and injuries related to the long-term use of sleeping pills, show this issue is widespread.
It is estimated that approximately 1.9 million Canadian seniors regularly use at least one inappropriate medication, which can lead to dizziness, memory problems, hospitalization and even death. The cost of these inappropriate prescriptions is over $419 million per year, and it rises to over $1.4 billion if the costs of hospital visits and the impacts of other harms are included.
Appropriate use was established as a shared priority among federal, provincial and territorial governments. Jurisdictions, health organizations and even local providers have implemented a variety of initiatives and programs to address the issue at hand. There is good work happening across the country, but those doing this important work have called for a unified approach so we can increase its impact and reach.
While there are several pockets of excellence addressing appropriate use, persistent gaps and challenges exist. Inconsistent reach, overlapping efforts and even duplication have limited the scale-up and spread of promising approaches across the health care system, which limits our ability to make these benefits available to people across the country. Without a devoted strategy to better connect our siloed work and improve collaboration, we risk stretching our already limited health system resources, and we will miss an opportunity to serve patients with the highest quality of care.
Other countries around the world have shown us that addressing appropriate use works and makes a difference in the health and safety of their citizens. Countries such as Australia, the U.K. and the Netherlands have developed a coordinated solution that addresses appropriate use at multiple levels and works to ensure that everyone, including patients, prescribers and the public, is motivated to make the necessary changes. In doing so, they have managed to improve prescribing and use behaviours while reducing the harms and health system costs of inappropriate care. Developing and implementing a pan-Canadian strategy that builds on this learning would help expand the impact and reach of successful appropriate use programs to better serve prescribers, patients, and diverse communities across the country.
To date, efforts to improve appropriate use, detect and respond to patient safety issues as they arise have been hampered by the uneven ability of prescribing data. This has significantly limited the supports available to patients and prescribers to make the best decisions regarding their care. Support to enhance the collection of and access to prescribing data will need to underpin any strategy. Addressing appropriate use of prescription drugs also presents a unique opportunity to tackle some of the most topical challenges facing our health system, such as appropriate therapies for mental health; access to safe, long-term care; and optimizing primary care.
The prescribing of antipsychotics in long-term care is a prime example where, at any given time, it is estimated that nearly one in four long-term care residents was receiving an antipsychotic drug while having no clinical reason for its use. These medications put patients at increased risk of falls, fractures and even strokes. Ultimately, healthier patients and fewer adverse drug events puts less stress on our health professionals and health care system.
Patients, health care providers and partners all agree that now is the time to act, and a pan-Canadian appropriate use strategy would bring the vision into reality. This means directing efforts towards implementing widespread programs and initiatives, collaborating closely to make meaningful change, ensuring that health policy promotes positive actions and bolstering evaluation of programs so we can scale and spread those programs that we know would make a difference.
We are already getting started. Last spring, the Canadian drug agency transition office established an appropriate use advisory committee, comprising organizations, prescribers, patients, insurers and health system partners, to provide guidance and advice for the development of a pan-Canadian appropriate use strategy. The committee will soon issue its final report. It is also working closely with key partners, including Choosing Wisely Canada and the Canadian Medication Appropriateness and Deprescribing Network to better coordinate existing efforts to further enhance its impact.
New health challenges continue to emerge, and the need for a coordinated appropriate use strategy to enhance quality of care, improve patient health and promote the judicious and equitable use of health care resources has become even more critical. Members can see that this strategy, guided by the CDA, would be an important element of moving forward with national pharmacare. Addressing appropriate use on a national scale would confront these challenges, knitting together our existing patchwork of programs to provide much-needed support for patients and prescribers while improving safety and outcomes, ultimately reducing the cost of burdens caused by inappropriate care.
We look forward to working closely with patients, prescribers, health partners and jurisdictions in making the program a reality.
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Mr. Speaker, I am proud to stand on behalf of the people of Edmonton Manning tonight.
When a bill is brought before Committee, I expect that during the study done there that committee members would be able to make amendments that would improve the legislation. Sadly, that has not happened with Bill C-64, the pharmacare act, which is probably because the legislation is so flawed that nothing can fix it. The only proper fix is to bury it.
I wish that tonight we were debating the merits of a proposed national pharmacare program. Many Canadians would like to see such a thing, although they might not be so enthusiastic once they saw the price tag. The only resemblance the bill before us has to pharmacare is in the name. If we had asked Canadians what they expected to receive from the NDP-Liberal coalition besides ever-increasing taxes, high inflation, sky-high crime rates and housing shortages, they would probably have said, “Well, at least they have promised pharmacare.”
If we had asked what that meant, they would have said, “free prescription drugs for everyone: drugs to treat heart disease or cancer, life-saving drugs and maybe penicillin to treat any number of less serious illnesses”. Instead, what the government is offering is a pledge to consider funding contraceptives and diabetes drugs. It is not a pharmacare plan; it is an empty promise. It is not what anyone was expecting, but it is no surprise. It is not as if the Liberals really want a national pharmacare program. If they did, they would not have needed the NDP to push them into creating the bill before us.
The Liberals' plan is empty and it is pretty simple. They want to delay as much as possible to convince the NDP that a plan is coming and that therefore the incompetent government must be propped up. I have to give the Liberals credit for their political skill in this matter. They have the NDP so completely fooled that the government faces no chance of defeat no matter the scandals and no matter how much Liberal polices are hurting Canadians. The NDP is blindly accepting a Liberal promise, apparently unwilling to admit that they have been fooled.
I think it is safe to predict that when Canadians go to the polls, whether it is in October 2025 or earlier, the NDP will not be able to point to a functioning pharmacare program, not even the limited one that the bill calls for. However, the promise will have accomplished its purpose: keeping an undeserving government in power. It is the Canadian electorate that will hold both the NDP and the Liberals accountable for their actions. It is the Canadian people who will elect a Conservative government that actually cares about serving them and does not just care about political power.
The bill is being shoved through in haste by a government that is so desperate for approval. The Minister of Health is assuring Canadians that the pharmacare plan should not jeopardize the drug coverage that millions of Canadians have through private insurers. I am sure he is well-intentioned when he makes that statement; he may even believe his words, but good intentions are not reality.
The CEO of the Canadian Life and Health Insurance Association says that the bill could indeed cause disruption for those who have existing drug plans. Either he is right or the minister is right; it cannot be both. Given the Liberal track record, I suspect the minister is indulging in some wishful thinking, which is not surprising from a government that thinks budgets magically balance themselves, something that has not happened under the current Prime Minister.
By using time allocation, the government is rushing the bill through the House without opportunity for proper scrutiny, which is no surprise. Despite having had two years to figure out how they were going to implement their deal with the NDP, the Liberals put together the legislation at the last minute.
It is window dressing, designed not to define pharmacare, but to keep the government in office for a few more months to deny Canadians what they want most, which is an end to Liberal overspending and incompetence.
The proposed bill is a promise, and Canadians know what happens when Liberals make promises. They have made promises in the past nine years. The reality is that, when the Liberals make a promise, things always seem to get worse. They promised affordable housing, and housing costs have doubled under their watch. They promised that the carbon tax would not cost us anything, and we find now that 60% of families are paying more than they collect. The Liberals promised that taxes would go down, and taxes have gone up. They promised safe streets, and then delivered crime, chaos, drugs and disorder. It is no wonder Canadians are afraid things will get worse when the Liberals promise pharmacare.
If the government were serious about helping Canadians, it would have gone about things differently. It would have consulted with the insurance industry, found out what the private insurance sector was offering and what the non-profit sector was providing, examined existing provincial coverage, and discovered if there were gaps that needed to be addressed. Instead, the Liberals decided to rush blindly ahead.
Canadians know the government is not worth the cost. That has been proven time and time again over the past nine years. Is this pharmacare program worth the cost? An honest answer is that nobody knows because the minister cannot tell us how much it will cost. Any numbers he tosses around are more wishful thinking than reality.
Canadians are struggling and looking to the federal government for help. Inflation eats away at their paycheques. Every trip to the grocery store, it seems the prices are going up. Liberals' catch-and-release bail policies are turning violent offenders loose to commit yet more crimes. Despite an ever-increasing carbon tax, the government has no plan to balance its books.
The Liberals apparently have no desire to fix the problems created by their wasteful spending. They believe that water runs downhill but never reaches the bottom. They know they will not be in government when the bill for this mismanagement comes due. Food Banks Canada's 2024 poverty report card shows that almost 50% of Canadians feel financially worse off compared to last year, while 25% of Canadians are experiencing food insecurity.
The cost of living has become so high that food banks have seen a 50% increase in visits since 2021. As a direct consequence of the government's inflationary spending and taxes, millions of Canadians are struggling to keep their heads above water, yet the Liberals ask us to take on faith that they know how to set up and run a pharmacare program without turning it into a disaster.
This is the government that spent more than $50 million on an app that was supposed to cost $80,000, and it cannot tell us how or when that cost overrun happened, or who is responsible. Why should Canadians trust it to run anything?
The good news is that this is not a serious piece of legislation. As I said, the Liberals have no idea what they are doing and no real intention to institute a pharmacare program. Bill C-64 is a public relations exercise with which they hope to fool the NDP and Canadians into thinking they are doing something to help people. Given the Liberals track record, I doubt many Canadians will be fooled.
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Mr. Speaker, I am rising in the House today to speak to what our government is doing, and plans to do, to help millions of Canadians who are struggling to pay for their prescription drugs.
Statistics Canada has indicated that one in five Canadians reported not having insurance to cover the cost of prescription medications in the previous 12 months. We have heard, time and time again, that Canadians who do not have drug insurance coverage struggle to afford medications and are left to make extremely difficult decisions to choose between paying for these medications or other basic necessities of life, such as food and housing.
No Canadian should have to make this type of a decision. This is why we introduced Bill C-64, the pharmacare bill, and continue to work with all parliamentarians and colleagues to ensure its speedy adoption.
This bill is needed for so many reasons. It proposes the foundational principles for the first phase of national pharmacare in Canada. These principles of access, affordability and appropriate use and universality have guided, and will continue to guide, our government's efforts in moving towards national, universal pharmacare.
We have seen these principles reflected in the work that is already under way, including launching the national strategy for drugs for rare diseases and improving affordable access to prescription drugs, which is the initiative with Prince Edward Island. I would like to take a moment to highlight the impact that both of these initiatives would have on national pharmacare.
In March last year, the Government of Canada launched the first-ever national strategy for drugs for rare diseases with an investment of up to $1.5 billion over three years. As part of the overall $1.5 billion investment, the federal government will make available up to $1.4 billion over three years to provinces and territories through bilateral agreements.
This funding would help provinces and territories improve access to new and emerging drugs for Canadians with rare diseases, as well as support enhanced access to existing drugs, early diagnosis and screening for rare diseases. This would help ensure patients with rare diseases, including children, would have access to treatments as early as possible for a better quality of life.
With respect to Prince Edward Island, the Government of Canada established an agreement with P.E.I., in August 2021, to improve the affordable access to prescription drugs and inform the advancement of national universal pharmacare. The $35-million investment has allowed for P.E.I. to add new drugs to its provincial formulary and lower out-of-pocket costs for drugs covered under existing public plans for island residents.
As of March of this year, P.E.I. has expanded access to over 100 new medications to treat a variety of conditions, including heart disease, pulmonary artery hypertension, multiple sclerosis, psoriasis and cancer. In addition, effective June 1, 2023, P.E.I. reduced copays to $5 for almost 60% of medications regularly used by island residents. I am pleased to share that, through this initiative, within the first nine months alone, P.E.I. residents have saved over $2.8 million in out-of-pocket costs on more than 300,000 prescriptions.
These two initiatives highlight how the principles of access, affordability, appropriate use and universality are reflected in our government's work, but they also underscore the importance of working with provinces and territories. Provinces and territories are, and will continue to be, a key partner in ensuring that Canadians get the health care they need. Our government will continue to work with provinces and territories to help ensure that this goal is met.
Finally, I would like to highlight another key component of Bill C-64, and that is the Government of Canada's intent to work with provinces and territories to provide universal, single-payer coverage for a number of contraceptives, as well as diabetes medications and supports. Similar to other initiatives that we have put in place, our work to provide contraception and diabetes medications would be guided by the principles I mentioned earlier and will involve working closely with our provincial and territorial partners. The importance of this provision within the bill cannot be understated.
We have likely heard over the past few weeks, since the introduction of Bill C-64, Canadians sharing their stories of how this bill would help them, how they are currently suffering from diabetes and do not have the insurance coverage, so they have to pay for their insulin, syringes and test strips out of pocket. Similarly, we are hearing stories of young women who do not have the drug coverage needed to pay for contraception or are limited in the choice available to them because more effective contraception is financially out of reach.
We have been receiving, and I certainly have received, numerous letters from Canadians across the country expressing their full support for Bill C-64 and asking the same question of when these drugs would be available to them. There is definitely a need for both of these sets of essential drugs, and I applaud the work of my parliamentary colleagues in getting the bill one step closer to a reality for Canadians.
Bill C-64 would allow for nine million Canadians of reproductive age to have better access to contraception and reproductive autonomy. This will help reduce the risk of unintended pregnancies and improve an individual's ability to plan for the future. As I mentioned, cost is the single most important barrier to access to these medications. Bill C-64 would ensure that Canadians will have access to a comprehensive suite of contraceptive drugs and the devices that they need. Similarly, we know that there is no cure for diabetes, but it can be treated with safe and effective medications.
Due to cost, 25% of Canadians with diabetes have reported not following their treatment plan. Improving access to diabetes medication, as outlined in Bill C-64, will help improve the health of almost four million Canadians living with diabetes and reduce the risk of serious life-changing health complications, which can include amputations or blindness. That is what Bill C-64 would do. It would give Canadians access to medications to maintain their health and give them a choice to determine which medication is best for them. In addition, these efforts will help avoid additional costs to the health care system.
In closing, our government will continue to work toward a national pharmacare plan that focuses on the principles of accessibility, affordability, appropriate use and universality. We will do so in partnership with provinces and territories, and we will do so knowing that Canadians need this immediately to help them access the drugs they need to live a healthy life.
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- May/30/24 10:22:58 p.m.
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Mr. Speaker, I am pleased to rise to speak to this issue and this bill, finally.
As others have already pointed out, Canada is the only country with a universal health care system that does not provide some sort of universal drug coverage. Under the British, Australian, New Zealand, French and Belgian systems, basically to some degree or another, people's medications are paid for by the government and they do not have to pay for them. Having said that, admittedly, in some countries there is copay.
This is an important bill. It is the first step in creating a national pharmacare system, and this I truly support. However, I did not always feel this way. As somebody who has long-practised in the health care system, I was a bit worried, because with the health care system as it presently is, we are struggling to pay for it. It occurred to me that what the government ought to be doing in health care is making sure that this sucker stays on the road. Certainly, I had a bit of trepidation with the idea that we were going to add another cost like pharmacare. However, having thought about it and having sat through committee meetings where we talked to experts, I have changed my mind because I think that a national pharmacare system would save the health care system money, not increase costs.
The current system, as we have it, which is a patchwork of private and public plans, is really inefficient. Multiple studies and recommendations since the 1960s have all basically said that. In fact, one study from the Canadian Medical Association Journal in 2017 concluded that we in Canada pay 50% more for our drugs than people do in 10 other wealthy countries that have national pharmacare programs. In addition, the inefficiency of our pharmaceutical system is demonstrated by the fact that we in Canada pay the second most for drugs of any people in the world. The Americans pay more, but other than that, we pay more for drugs than anyone else.
The inefficiency of our system comes from the fact that we provide pharmacare in Canada like the United States does. We, like the United States, have a patchwork system of private and public providers, and the private providers are often set up through employers. At times, these are non-profits, but for the most part they are for-profit companies. Similarly, there are public systems and public plans, and there are multiple public plans. For example, in Ontario, there is the Ontario drug benefit plan for those over 65, there is a Trillium plan for higher-cost medications and there is OHIP+.
Basically, we pay for our medications in Canada like Americans pay for all parts of their health care system, but our system for paying for medications, like the U.S. health care system, is really inefficient. Americans pay twice as much for health care as Canadians do. On average, Americans pay $12,000 per person for health care, and in Canada we pay $6,000 for health care per person, and they have worse outcomes than we do. For example, they have a lower life expectancy than we do in Canada.
I studied health law and policy both in Boston and at Georgetown University in Washington, D.C., and learned a bit about the health care system. I was certainly impressed by the inefficiency of the American health care system. They have private hospitals, private health care providers and private insurance companies, and each of these organizations has administrators who basically spend half of their time scheming on how they can decrease costs and increase profits. They have to pay for these administrators. Similarly, they have to pay the CEOs and the higher-up executives, who all bring in the big bucks, for working in those positions. On top of that, and most of all, a lot of money goes to the shareholders of corporations, which are legally obliged to financially benefit shareholders. All this money comes out of the health care system, money that ought to be going toward trying to improve the health care of Americans.
Similarly, in Canada, we currently have 1,100 private and public plans according to a Lancet 2024 study, although according to the Hoskins report, we have 100,000 private plans. If instead of having all these plans, we just had one plan, then surely there would be tremendous savings coming from economies of scale. We would not need 1,100 organizations with 1,100 sets of administrators administering their own plans. We would not need hundreds of CEOs siphoning money that would otherwise go to health care, and there would be no profits going to shareholders rather than going to health care.
There would be all sorts of savings from economies of scale and increased bargaining power. For example, if someone went to a provider or manufacturer of drugs and bought 10 million pills rather than 10,000 pills, I am sure they would get those pills at a cheaper cost, so there are savings there. Also, shipping costs are lower when buying in bulk, and there are fewer inspections needed.
When we add up all these savings, how much do they add up to? Well, according to the 2019 Hoskins report, with national pharmacare by 2027, which is when it would come into effect, total spending on prescription drugs would be $5 billion lower than it would be without national pharmacare. That is money we could use in the health care system for other things. That means more money to afford expensive cancer therapies, more money to address the long waiting times for either surgeries or diagnostic tests and more money to do research and try to find new cures for things like cancer, ALS, etc.
However, it is not just about saving money in the system. It is also about helping Canadians who struggle to meet the high costs of medications. According to the Hoskins report, between 5% and 20% of Canadians are either uninsured or under-insured, which amounts to two million to eight million people. Furthermore, one in five households reported that a family member in the past year had not taken a prescribed medicine due to its high costs, another three million Canadians said they were not able to afford one or more of their prescription drugs in the past year and almost one million Canadians borrowed money in order to pay for prescription drugs.
For all these reasons, I support this legislation and moving to the next step toward a national pharmacare system. I also welcome that we will be able to provide diabetic medications and contraception to people as one of the next steps in getting to a national pharmacare system.
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Mr. Speaker, it is a real pleasure for me to stand once again today to speak to this very important bill. Bill C-64 is an act respecting pharmacare.
The bill contains three key sections. One, it would establish a framework toward a national universal pharmacare in Canada for certain prescription drugs and related products. Two, it provides that the Canadian drug agency work toward the development of a national formulary to develop a national bulk-purchasing strategy and support the publication of a pan-Canadian strategy regarding the appropriate use of prescription medications. The third section is that, within 30 days of hopefully this bill receiving royal assent, the minister would establish a committee of experts to make recommendations regarding the operation and financing of national, universal, single-payer pharmacare.
The bill, along with other investments made by our government, would help millions of Canadians who are struggling to pay for their prescription drugs. Since this bill was introduced, we have heard many facts about access and affordability of prescription drugs within Canada. We know that Statistics Canada data from 2021 has indicated that one in five Canadians reported not having enough insurance to cover the cost of prescription medication in the previous 12 months.
We know that having no prescription insurance coverage was associated with higher out-of-pocket spending and higher non-adherence to prescriptions because of cost. We know that this results in some Canadians having to choose between paying for these medications or for other basic necessities, like food and housing. This is why we have consistently made commitments toward national pharmacare and have focused efforts on the key areas of accessibility, affordability and appropriate use of medications.
Let me start with the pharmacare act, which references the foundational principles of access, affordability, appropriate use and universality. We have heard a lot about these four principles this evening, but it is important to continue this conversation. Bill C-64 recognizes the critical importance of working with provinces and territories, which are responsible for the administration of health care. It also outlines our intent to work with these partners to provide universal, single-payer coverage for a number of contraception and diabetes medications.
This legislation is an important step forward to improve health equity, affordability and outcomes, and has the potential of long-term savings to the health care system. In our most recent budget, budget 2024, we announced $1.5 billion over seven years to support the launch of national pharmacare and coverage for contraception and diabetes medications. I would like to highlight the potential impact the two drug classes for which we are seeking to provide coverage under this legislation would have on Canadians.
We have heard of stories or know of someone in our constituency who is struggling to access diabetes medications or supplies due to lack of insurance coverage through their work, or of an individual who has limited insurance coverage so they cannot choose the form of contraception that is better suited for her.
For example, let us talk about a part-time, uninsured worker who has type 1 diabetes and is also of reproductive age. For this individual to manage her diabetes, it would cost her up to $18,000 every year, leaving her potentially unable to afford the $500 upfront cost of her preferred method of contraception, a hormonal IUD. With the introduction of this legislation, this individual would save money on costs associated with managing her diabetes and would be able to access a hormonal IUD at no cost, with no out-of-pocket expenses, once the legislation is implemented in her province.
Studies have demonstrated that publicly funded, no-cost universal contraception can result in public cost savings. Evidence from the University of British Columbia estimated that no-cost contraception has the potential to save the B.C. health care system approximately $27 million per year. Since April 1, 2023, B.C. is the only province in Canada to provide universal free contraceptives to all residents under the B.C. pharmacare program. In the first eight months of this program, more than 188,000 people received free contraceptives. That is wonderful.
With respect to diabetes, it is a complex disease that can be treated with safe and effective medications. One in four Canadians with diabetes has reported not following their treatment plan due to costs. Improving access to diabetes medications would help improve the health of some of the 3.7 million Canadians living with diabetes and reduce the risk of serious, life-changing health complications, such as blindness or amputations.
Beyond helping people with managing their diabetes and living healthier lives, we also know that, if left untreated or poorly managed, diabetes can lead to high and unnecessary costs on the health care system due to diabetes and its complications, including heart attack, stroke and kidney failure. The full cost of diabetes to the health care system could exceed almost $40 billion by 2028, as estimated by Diabetes Canada.
The bill demonstrates the Government of Canada's commitment to consulting widely on the way forward and working with provinces, territories, indigenous peoples, and other partners and stakeholders to improve the accessibility, affordability and appropriate use of pharmaceutical products by reducing financial barriers and contributing to physical and mental health and well-being.
Beyond our recent work under Bill C-64, I would like to highlight one or two initiatives, depending on my time, that the government has also put in place to support our efforts towards national pharmacare.
On a national level, our government has launched the first-ever national strategy for drugs for rare diseases in March 2023, with an investment of up to $1.5 billion over three years. As part of the overall $1.5-billion investment, our government will make available up to $1.4 billion over three years to willing provinces and territories through bilateral agreements. This funding would help provinces and territories improve access to new and emerging drugs for Canadians with rare diseases, as well as support enhanced access to existing drugs, early diagnosis and screening for rare diseases.
I would also like to highlight another initiative under way, which involves the excellent work by P.E.I. through a $35-million federal investment. Under this initiative, P.E.I. is working to improve the affordable access of prescription drugs, while at the same time informing the advancement of national universal pharmacare.
The work accomplished by P.E.I. has been remarkable. Since December of last year, P.E.I. has expanded access to over 100 medications to treat a variety of conditions, including heart disease, pulmonary arterial hypertension, multiple sclerosis, psoriasis and cancer. In addition, effective June 1, 2023, P.E.I. reduced copays to $5 for almost 60% of medications regularly used by island residents. I am pleased to share that through this initiative, P.E.I. residents have saved over $2.8 million in out-of-pocket expenses as of March of this year.
Finally, on December 18, 2023, the Government of Canada announced the creation of Canada's drug agency, with an investment of $89.5 million over five years, beginning this year. Built from the existing Canadian Agency for Drugs and Technologies in Health, and in partnership with provinces and territories, the CDA will provide the dedicated leadership and coordination needed to make Canada's drug system more sustainable and better prepared for the future, helping Canadians achieve better health outcomes. I am pleased to share that as of May 1, CADTH has been officially launched as Canada's drug agency.
In closing, we can see the extraordinary amount of work that has been and will continue to be dedicated to our commitments related to national pharmacare that focuses on accessibility, affordability and appropriate use of medications.
Bill C-64 represents the next phase of helping Canadians receive the medications they need, and we look forward to working with all parliamentarians to ensure its successful passing.
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Mr. Speaker, Bill C-64 would establish the framework of a national universal pharmacare program here in Canada. It is phase one of the proposed program, which would include prescription drugs and free coverage for contraceptives and diabetes medication, and we are hoping to expand the program.
As well, there are additional elements that would complement the national pharmacare program, which is our national strategy for drugs for rare diseases. Again, it is starting with a $1.5-billion investment over three years. I believe our intention is that we will be expanding it in the years to come.
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Mr. Speaker, I am pleased to have another opportunity to address Bill C-64, an act respecting pharmacare. It is an act with respect to pharmacare, and yet it would cover only diabetes and contraception. As a member of the Standing Committee on Health, I can say that the bill, which is really more of a pamphlet than a real piece of legislation, has been the main focus of committee for the last month or so, about as long as it took for the government to draft the legislation.
It is important to make sure that Canadians know what the pamphlet really is and, more importantly, what it is not, since many people are under the impression that Bill C-64 would mean free medications for all Canadians. This is absolutely not the case. Despite what the NDP-Liberal coalition is claiming, the pamphlet would do very little to improve the lives of the majority of Canadians, and overall it could have more negative impacts than positive.
One huge issue that I have with Bill C-64 is the way that it was rammed through Parliament so quickly. Typically when legislation comes to committee, we are given ample time to hear from witnesses and to read all the briefs, submissions and recommendations from stakeholders on the legislation. This is extremely important, as there are many groups that have valuable insight and input on issues as major as pharmacare. We on this side of the House believe that they all deserve to be heard and considered, yet due to closure on what Canadians think should be a piece of legislation intervening in provincial domains, it was rushed through.
When it comes to matters that would potentially affect a huge portion of the population, due consideration must be given to the opinions of experts. This is not an issue that should be handled by “Ottawa knows best”, which the Liberal-NDP coalition so often does. The Liberals think they know better than the professionals who are said to be the most impacted by the pharmacare pamphlet, so they are fine with pushing the weak legislation through. Why is that? It is because they want to be able to tell Canadians that they gave them universal pharmacare, even though that is blatant misinformation because what the bill would provide is anything but universal.
There were 10 hours of committee time to hear from witnesses with respect to Bill C-64, which was not nearly enough time to cover all the industries, organizations and individuals who would be affected by the poor piece of legislation before us. My inbox was inundated with emails from groups that were pleading with the government to have a chance to give their input at committee. However, because the NDP-Liberals were so desperate to ram Bill C-64 through Parliament, their voices were not heard.
It astounds me that the costly coalition is trying to tout the pamphlet as being historic and groundbreaking, when the Liberals neglected to listen to the very people who would be most impacted by the shoddy work of the file. Many groups who were fortunate enough to appear at committee said they were not consulted by the NDP-Liberals before or during the development of the pharmacare pamphlet. In what world is this acceptable?
It is not just the medical field that the NDP-Liberal coalition failed to consult in advance. One of the biggest industries that would have to deal with all of the changes caused by Bill C-64 is the insurance industry. We were fortunate to be able to hear from some industry representatives on the matter at committee. Mr. Stephen Frank, president and chief executive officer of the Canadian Life and Health Insurance Association, made some important observations.
Mr Frank said, “The Minister of Health has stated that people who have an existing drug plan are going to continue to enjoy the access they have to their drugs. If that's the minister's intent it's not...clear from this bill. As many of the questions reinforced today, its text is ambiguous, it repeatedly calls for universal, single-payer, pharmacare in Canada with no mention of workplace benefit plans. Read in its entirety the bill could result in practical, and even legal, barriers to our ability to provide Canadians with the drug benefits that they currently have.
“For the majority of Canadians, therefore, this plan, as it's currently written, risks disrupting existing prescription drug coverage paid for by employers, limiting choice, and using scarce federal resources to simply replace existing coverage while leaving a huge gap for uninsured Canadians who rely on other medications beyond diabetic drugs and contraceptives.”
There are a number of different drug insurance plans out there: government-sponsored plans, employer-sponsored plans, association-sponsored plans and private plans. The Conference Board of Canada found that 36.8 million Canadians, or 97.2%, are eligible for some form of prescription drug coverage. The Canadian Chamber of Commerce indicates that the uninsured population is 1.1 million, or 2.8%, and 3.8 million are eligible but not enrolled. That is basically 4.9 million, a little over roughly 10% of the population, yet Statistics Canada in 2019 indicated that 86.2% of Canadians are covered by at least one type of drug insurance.
When an issue as important as access to medications and prescriptions comes up, it is the minister's job to ensure that all policies are clear and comprehensive and that all possible implications have been considered. Obviously, this is not being done with Bill C-64.
Another witness who appeared at committee and had concerns about the clarity of this bill was Carolyne Eagan, the principal representative for the Smart Health Benefits Coalition. She stated, “thousands of our advisers have received thousands of phone calls and engaged discussion with the misperception that people can go ahead and cancel their plan and essentially replace it by the free plan, not knowing what is on that list of coverage and who it's intended for.
“My own mother, who's turning 80 this year, got her letter. She was completely confused and figured she would cancel her plan and have free coverage with everything included. Luckily, I'm in the business and could explain it to her.
“It is a risk and there's a great risk of employers and Canadians thinking they would lose access to a longer list of medications where their health is stable on the treatment plan that they have been prescribed. Losing that access puts everything at risk. It puts the sustainability and health of Canadians and families, and our workforce and productivity, at great risk.”
This is alarming to say the very least. How many seniors in this country are going to lose their private insurance plan because the NDP-Liberal coalition failed to be clear about what the pamphlet would actually do and cover? How many seniors might have already cancelled their plan? What will stop employers from cancelling the benefit plan they offer and telling their employees to use universal pharmacare, which covers medication for only two things?
These are the questions that were asked at committee, yet the minister was unable to answer. Even more alarming is that only 44% of new drugs launched globally are distributed in Canada, and only 20% of them are covered by public plans. According to a study by Innovative Medicines Canada, which, by the way, asked to present at committee and was denied.
The fact of the matter is that the minister came to committee and gave blatant misinformation to Canadians, telling them that everything is going to be okay and that they must just trust him. After nine years of the Prime Minister's ruining our country, it is absurd that he is expecting public trust. The NDP-Liberal coalition has broken promise after promise, and somehow the minister thinks that he deserves or is entitled to something as sacred as the trust of Canadians.
One of the briefs that was received at committee was sent by Chris MacLeod, a 54-year-old lawyer who has cystic fibrosis. This disease is one that hits home very personally, and I am grateful to Mr. MacLeod for sharing his experiences with public drug plans in this country. He stated that unfortunately Bill C-64 looks like it could be another major barrier to access for patients, especially those with rare diseases, and that notably, the federal government's attempt to force substandard public formulary coverage on everyone across the country could prove to be a disaster, with potentially deadly consequences.
People who live with diseases like cystic fibrosis do not deserve to have their life made even more difficult because of incompetence with respect to the bill. The bottom line is that most Canadians already have solid drug plans that they are happy with and they do not want to have them replaced.
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Mr. Speaker, I am very pleased to rise in the House to speak to Bill C‑64.
It is a great pleasure to join the debate today about the pharmacare legislation that is going to bring in the first steps of pharmacare in Canada, as well as to be the last person to give a speech before we actually vote on this important piece of legislation.
Quality health care, including access to prescription drugs, is vital to protecting and promoting the health and well-being of Canadians. Prescription medicines allow millions of Canadians to prevent and fight disease, manage chronic illness, ease pain and breathe better; in other words, they allow Canadians to live healthier and more productive lives. I must say, there are few issues that I hear more about than health care. It is a priority for my constituents.
With rising costs, some Canadians are facing difficult choices between paying for their prescriptions and covering essentials, such as food and heat. Nobody should be put in that circumstance. We need to ensure that prescription drugs are more accessible and affordable for Canadians, including those facing the greatest financial barriers to accessing medications. That is why our government has introduced the pharmacare act. The bill proposes foundational principles for national universal pharmacare and describes the government's intent to work with provinces and territories to provide Canadians with universal, single-payer, first-dollar coverage for a range of contraceptive and diabetes products.
When medicare was introduced in Canada in the 1960s, prescription drugs played a relatively limited role in health care. Most drugs outside of a hospital were inexpensive medicines for common conditions. However, in the intervening decades, the development of drugs has surged as pharmaceutical companies have pushed the science further in search of new treatments and cures. Prescription medicines are now an essential part of health care. As a share of overall health care costs, spending on prescribed drugs has risen from six per cent in 1975 to nearly 14% in 2022. This makes prescription drugs the second-largest area of health care spending in Canada, after hospital services.
Today, the landscape of prescription drugs available in Canada is robust and complex, with pharmaceutical companies launching dozens of new products every year. To support effective management, in government-run, public drug plans in Canada, as well as some privately run plans, a formulary is developed, which is a list of drugs and related products that are eligible for coverage under the drug plan. To develop the formularies, public plans consider both how well a drug works and whether these products offer good value for money relative to other treatment options. While there are over a hundred public plans in Canada, there is generally good alignment with regard to the list of drugs that are eligible for coverage across provinces and territories.
Many Canadians are only eligible for public drug coverage with high deductibles or premiums that provide little relief for more routine drug expenses, such as for prescribed contraception and diabetes medications. A national formulary would outline the scope of prescription drugs and related products that all Canadians should have affordable access to under national universal pharmacare.
In 2019, the advisory council on the implementation of national pharmacare, chaired by Dr. Eric Hoskins, recommended a national formulary service, one of the standards for national universal pharmacare. He proposed pharmacare coverage to be phased in, starting with a short list of essential medicines. In budget 2019, the government announced funding for a number of foundational steps towards national pharmacare, including the development of a national formulary. Back in 2022, the government announced continued progress towards this by introducing a pharmacare act and tasking the drug agency to develop a national formulary of essential medicines and a bulk purchasing plan. Preliminary work has already been completed, and a framework and process for developing a future national formulary was recommended.
The panel released its final report in 2022, including giving guiding principles for the formulary and a process for bringing it into place, as well as a sample list of commonly prescribed drugs and related products for three therapeutic areas with a high volume of drug use in Canada. These are cardiovascular disease, diabetes and mental illness. This list has been expanded by looking at equity-seeking groups to make sure that we are closing the gaps in access between different communities in Canada.
Actually, this foundational work is already having real-world impacts. In 2021, our government announced that it would work with the Province of Prince Edward Island on the improving affordable access to prescription drugs initiative. Under this initiative, P.E.I. is receiving funding to add new drugs to its list of publicly covered drugs and to lower the out-of-pocket costs for island residents.
I just want to say that, with the legislation, P.E.I. residents have already saved $2 million in out-of-pocket costs on more than 230,000 prescriptions, and the savings continue. Our government remains firmly committed to taking the next steps in pharmacare, and the legislation today is going to help us do that by providing coverage for contraception and diabetes medicine. This is part of our overall approach to support the provinces to improve health care in Canada, including with a new deal we signed with all the provinces last year to provide better care, as well as making it easier to get access to such things as a medical practitioner in rural areas, including where I live, by providing student loan forgiveness for people to operate there.
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