This week Bill C-64, the Pharmacare Act has been passed and is now law. The intention of phase one of the act is to provide universal access paid up front by the government (also known as single-payer, first-dollar access) to a range of contraception and diabetes medications. Now that the Bill has passed, the plan will provide coverage in provinces that reach agreements with the federal government.
Negotiating these agreements will take time, and the hope is that all provinces and territories will be on board by next spring. All provinces may be a pipe dream however as both Alberta and Quebec have expressed their intention to opt out of pharmacare. British Columbia has already signed a memorandum of understanding to provide coverage. Since oral contraceptives are already covered under a provincial program, this share of funding will be used to cover the cost of hormone replacement therapy for women in B.C..
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Up to nine million women and gender diverse people in Canada require access to contraception. Additionally, the 3.7 million people in Canada living with diabetes will have universal access to a suite of diabetes medications and devices. Ultimately, the goal will be to expand the number of covered medications in the future.
Why Contraception?
Contraceptive drugs were chosen as part of this next step of universal pharmacare specifically because improved access to contraception improves equality. It reduces the risk of unintended pregnancies and improves reproductive rights.
Cost has been identified by Canadian contraceptive care providers as the single most important barrier to access to these medications. Oral contraceptives cost approximately $25 per unit, or $300 per year. Intrauterine Devices (IUDs), which are effective for five years, cost approximately up to $500 per unit.
Cost can discourage people both from accessing contraception, and from choosing more effective methods of contraception with a higher upfront cost. For example, oral contraceptives have a typical use failure rate of 9% compared to 0.20% for IUDs. Not having affordable access to effective contraception can increase the risk of unintended pregnancies, which can impact life plans such as going to school and advancing in one’s career.
Studies have demonstrated that publicly funded (no-cost) contraception can result in public cost savings. Evidence from the University of British Columbia (BC) estimated that no-cost contraception has the potential to save the BC health care system approximately $27 million per year.
See here for a list of specific contraception on the table to be discussed with provinces and territories for coverage.
Why Diabetes Coverage?
Diabetes is one of the most common chronic diseases affecting people living in Canada. Around 3.7 million people in Canada, or 9.4% of the population, live with diagnosed diabetes. The number of people living with diabetes has doubled over the last decade and is expected to continue to increase as Canada’s population ages and grows.
In 2015, 25% of Canadians with diabetes indicated following their treatments were affected by cost, in some cases rationing medications to save money. Uncontrolled diabetes can have very serious short and long-term health impacts and represents a burden to individuals, families, and Canadian society. The full cost of diabetes to the healthcare system in 2018 is estimated to be around $27 billion and could exceed $39 billion by 2028.
See here for a list of diabetes medication on the table to be discussed with provinces and territories for coverage.
People living with diabetes must also closely monitor their blood sugar levels to ensure they are in a safe range, and to adjust their medication as needed. Equipment to monitor sugar levels can include glucometers, test strips and lancets, as well as flash and continuous glucose monitoring devices (CGM). Use of CGM or Flash GM devices leads to fewer complications and reduces long-term costs associated with hospitalization.
These devices and supplies can cost thousands of dollars per year. Separate from Bill C-64, the federal government is announcing its intention to establish a fund to support access to diabetes devices and supplies.
Stay tuned to The Health Insider for details regarding this fund, its rollout and all things pharmacare.
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The information provided on TheHealthInsider.ca is for educational purposes only and does not substitute for professional medical advice. TheHealthInsider.ca advises consulting a medical professional or healthcare provider when seeking medical advice, diagnoses, or treatment.
