As a growing number of Canadians face the lingering effects of long COVID and other serious viral illnesses that continue to spread, could national pharmacare help with the burden of prescription medications?
For Marc-André Gagnon, a public policy professor at Carleton University, the answer is a clear yes. He says prescription coverage is the missing piece to Canada’s publicly funded health-care system, in particular after the COVID-19 pandemic’s upheaval of jobs and the private drug insurance that often comes with them.
“As long as you are employed, basically, you have coverage, but what happened with COVID-19 is a lot of people lost their job,” says Gagnon.
“Especially with a disease like long COVID, you might end up losing your job. When you lose your job, you lose your coverage as well.”
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Post-acute COVID-19 syndrome (PACS), also known as long COVID, may affect up to 50 per cent of patients that contract COVID-19, according to a recent study in Ontario, but more research has to be done to further understand the syndrome.
This along with the surge in respiratory syncytial virus (RSV) infections could contribute to a higher demand for prescriptions in Canada.
Lung and cognitive therapies, inhalers and beta blockers are among some of the remedies prescribed to help treat the most common symptoms of long COVID, however, the syndrome includes a wide range of symptoms.
For Canadians already struggling with the cost of prescription medications, the wait for progress towards some form of a national pharmacare plan as laid out in the Liberal-NDP governance deal is daunting.
Shayla Hele, a 24-year-old student at the Canadian College of Massage and Hydrotherapy in Nova Scotia, says universal pharmacare would mean she wouldn’t have to worry about affording prescriptions she needs to live with Type 1 diabetes.
Turning 25 in February and graduating in April, Hele will be ineligible for both the Ontario Health Insurance Plan (OHIP) and workplace benefits from her parents.
“I have to start paying for insulin after I turn 25, which is pretty absurd considering my body doesn’t produce it.”
She says the loss of coverage will likely force her to move back to Ontario.
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“They’ll cover at most, like, $2,500 of medical supplies, and I’m looking at (spending) 10-12 grand a year,” says Hele. “That doesn’t include if I had to buy a new insulin pump.”
Hele says medical costs are a major influence in her decision-making.
“We’re talking about basic needs being met here. It’s really unfortunate because I feel like it’s dictated a lot of my life and the decisions that I’ve made,” says Hele. “I would love to see that change.”
A 2021 survey from Statistics Canada says 21 per cent of Canadians reported not having insurance to cover any of the cost of prescription medication in the past 12 months.
From the same report, close to one in 10 Canadians who were prescribed medication in the past year said they resorted to delayed filling or skipped doses because of costs.
Canada is the only country with universal health care that does not include universal coverage of prescription medication, even though universal pharmacare has been in Canadian conversation since a royal commission recommendation in the 1960s.
In June of 2019, the federal Advisory Council on the Implementation of National Pharmacare led by Dr. Eric Hoskins issued its final report, which recommended a universal public pharmacare program to be implemented between 2022 and 2027 at a cost of $15.3 billion a year.
According to the report, national pharmacare will reduce annual spending on prescription drugs by $5 billion and the average family will save $350 per year. Global News reached out to members of the advisory council but did not receive a response by publication.
The federal Liberal Party also proposed pharmacare as a main component of its 2019 election campaign, and has vowed to take initial steps toward it as part of its confidence-and-supply agreement with the NDP, which agrees to support the minority Liberal government in exchange for progress on certain files – including pharmacare.
Pauline Worsfold, a registered nurse and chair of the Canadian Health Coalition (CHC), says national pharmacare would be a “triple win” for provinces, governments and patients.
“People are suffering. They can’t go without their medications and it’s leading to early deaths on an annual basis,” says Worsfold. “They only get half of the efficacy if they only take half of the dose.”
She says implementing pharmacare would be a legacy for the government that decides to take action.
But not everyone agrees that national prescription drug coverage is the answer Canadians are looking for.
Brett Skinner, CEO of the Canadian Health Policy Institute (CHPI), says the focus should be on improving coverage under the current public system.
Skinner lives with Parkinson’s disease and doesn’t respond to traditional therapies. He relies on new medications to treat his condition.
“The real problem is folks in my position who are dependent on new drugs coming through the pipeline. But if they are on a public drug plan, they would not see immediate coverage of those new therapies,” says Skinner.
Many critics point to the spending limits of the public coverage system in the U.K., connecting it to its lower cancer-survival rates compared with other countries. The direct relation, however, has yet to be proven.
Skinner says the best solution is to match current public drug plans to private ones.
“It’s really not an uninsured problem, it’s an underinsured problem,” he said.