What Would a National Pharmacare System in Canada Look Like?

Canada has some of the highest drug prices in the world. Canadians pay the third highest price for drugs per person in the OECD, behind the U.S. and Switzerland. The country's fragmented drug coverage system also leaves 20% of the population foregoing taking their prescription medicines because of cost considerations.

Drug affordability has been a persistent problem in Canada, and after decades of discussion the government has started to pave-the-path towards the creation of a national Pharmacare system. The system will introduce a National Formulary and Essential Medicines List (EML) as well as establish a new Canadian Drug Agency (CDA). Private insurance will provide supplemental coverage for drugs off the EML and branded products.

Prescription drug coverage was part of Canada's original 1964 Medicare plan but lacked the political-will to materialize. Will it work this time? What could stop it? This paper examines the issues, obstacles and considerations for a national Pharmacare program to be successful in Canada.