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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- May/30/24 7:15:06 p.m.
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Madam Speaker, I am also from Quebec and I fully respect Quebec's jurisdictions.
I have a question for my colleague. Does he not know that, right now in Quebec, IUD fittings, for example, are not covered by insurance? Women have to pay every month for their method of contraception, which costs between $20 and $30. Many women choose not to take contraceptives.
Why not simply join a program that will give all women free access to their choice of contraception?
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Mr. Speaker, I will actually ask the member a question about the legislation. In Bill C-64, clause 6, “Payments”, it says very specifically that it is supposed “to provide universal, single-payer, first-dollar coverage”.
First-dollar coverage means that if a private insurance company today covers diabetic medication, it will not be able to do so if this legislation comes into force. In fact, it would be a crime. It would be illegal to do that, which means that there is a great potential for Canadians who are currently insured for their diabetes medication with a private insurer to lose it. They are actually the majority in this country.
How many Canadians would lose the coverage that they currently have because of this first-dollar coverage found in clause 6 of Bill C-64?
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- May/30/24 7:46:30 p.m.
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Mr. Speaker, I want to ask my Liberal friend a question. I come from Ontario, and the Conservative government has something called the Ontario drug benefit plan. It already covers diabetes and reproductive medications. To compare it to what my colleague was asking, there are a lot of people with private insurance, and they have this coverage. However, this plan may only cover certain medications that are not really specific to an individual who can tolerate different types of medications.
Can the member please confirm for Canadians that nobody would lose the medication that they are used to utilizing and that they stay healthy on because of this new program?
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- May/30/24 8:12:46 p.m.
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Mr. Speaker, I congratulate my hon. colleague across the way for a very impassioned speech, based on real lived experiences, that was not intentionally partisan. It was actually about reality. The class of by-elections of 2023, I think, includes some of the best around this place.
I will respond in kind with a bit of a personal reality. My beautiful wife, Cailey, was diagnosed with type 1 diabetes at age one, which I think was the earliest in the country at that point. Prior to meeting her, I did not know a lot about diabetes, so I personally had to learn a lot of the challenges of living with diabetes and what it entails, and I certainly can recognize the costs.
I am going to do a quick shout-out, while I have the opportunity, to wish Cailey a happy birthday tomorrow. I look forward to spending the day with her.
Cailey is on an insurance plan, as are many other Canadians, and a real concern is that the options available for specific products and insulin are adequately covered for the majority of people right now. Why the need to aim for universality when we could be more targeted and use taxpayer dollars more efficiently to still try to seek the same results? Obviously the expectation is to expand this to other products. We need to be smart with taxpayers' money while still trying to seek the results the member wants to achieve.
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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 10:21:00 p.m.
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Mr. Speaker, in Saskatchewan, in 2011, the Saskatchewan Party made a commitment to campaign on providing coverage for diabetics up to the age 18. Then, in 2016, we campaigned to move that to age 25. That is exactly what we did: we provided coverage for diabetics until the age of 25. The theory behind that was, after the age of 25, a lot of people had their own coverage when they were gainfully employed and had private insurance. There are still other programs to cover people who are less insured.
The problem I have with this is that we do not know what the coverage is going to be. Not all diabetics take the same medicine either, so we do not know which medicines would be covered in this program, as it is not going to be all of them, which goes to my point that consultations should be done before bringing in legislation so we know what works and what does not.
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- May/30/24 10:35:03 p.m.
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Mr. Speaker, I appreciate being recognized again.
It is a great honour for me to work with the hon. member for Thunder Bay—Rainy River on the HESA committee. Given his medical and legal background, I find him quite beneficial to me for my understanding of a lot of health care issues.
One of the things we heard a lot about at committee is the impact of this framework legislation on private health insurance. There was a lot of fearmongering on the Conservatives' part that somehow it would disappear.
Could the hon. member for Thunder Bay—Rainy River comment and give us his views on what impact this bill would have on private health insurance?
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