Health Minister Mark Holland issued the long-awaited details of the federal government's drug care plan today, Thursday, with a commitment to cover some diabetes treatments and contraceptives.

If Parliament approves Bill C-64, Holland will begin negotiations with provinces and territories regarding the funding commitment that covers the cost of providing these medicines to people for free.

The federal government also said it will establish a fund to support Canadian diabetes patients who need access to syringes and glucose test strips to manage their condition but struggle to afford them.

The government pointed out that one in four Canadians with diabetes – about 3.7 million people living with this condition – reported that they do not follow their treatment plans due to cost.

Covering the "first dollar" of these medications – a term in the insurance industry meaning the government pays the entire bill – particularly helps diabetes patients.

The government said in its press release that the drug care plan will give nine million Canadians of reproductive age better access to contraceptives to ensure "reproductive autonomy, reduce the risks of unintended pregnancy, and improve their ability to plan for the future."

The specific types of contraceptives covered by this program have not yet been selected, but the government promises that a "comprehensive range" of drugs and devices will eventually be covered in the provinces and territories that sign on.

This is the first step in what could be a more robust system in the coming years, although its future is uncertain. Some provinces are already demanding the opportunity to withdraw from the federal program, or outright rejecting Ottawa's efforts.

The federal government confirmed it ultimately intends, along with diabetes treatments and contraception, to implement broader coverage for other medications.

Bill C-64 calls for the establishment of a national formulary – a list of essential medicines that the government could eventually cover – and the development of a national bulk purchasing strategy.

The government explained that it will form a panel of experts to advise on how to create a universal single-payer program, then will seek to negotiate bilateral deals with each province and territory before launching this kind of larger drug care plan.

 Holland: The goal is "full coverage."

The government said it wants to take a gradual "step-by-step" approach to implementing universal drug care, which could come at a cost of billions of dollars and upend the current drug coverage network in the country.

Most Canadians already have prescription drug coverage through a mix of public and private insurance plans. It is not immediately clear what impact the universal national program might have.

Holland said Ottawa will assess how the first phase of covering diabetes treatments and contraception is implemented before deciding to fund something more comprehensive.

But he insisted the government is committed to continuing "full coverage so that everyone can afford their medications."

Holland cited the cost of the universal single-payer drug care system as a barrier at a time when the federal government is trying to rein in spending after years of significant budget deficits during the pandemic era.

The Parliamentary Budget Officer (PBO) estimated the cost of the comprehensive drug plan for all medications at about $40 billion annually.

Another option may be to provide pharmaceutical coverage for people who are currently uninsured, or to expand regional drug coverage plans to include more people.

Cost uncertain

Federal officials speaking to reporters during a press conference said the government does not yet know how much this first phase of the taxpayer-funded pharmaceutical program will cost.

Officials said the final price for diabetes treatment and contraception will be determined after negotiations with provinces and territories.

After being pressed to provide some kind of cost estimate, Holland said the first phase will cost about $1.5 billion, adding that this number could change depending on uptake rates among the provinces and territories.

This kind of national drug care program has long been a demand of pharmacists, healthcare professionals, and progressive activists who say Canada’s single-payer health system should be paired with coverage for drugs and other treatments to improve population health.

The details were announced after months of protracted negotiations with the New Democratic Party, which demanded the rollout of drug care as a condition of the supply and confidence agreement that keeps the minority Liberal government in power until 2025.

Holland called Thursday "an important day" in Canadian history, "Today marks a giant step forward for our health system."

He added that Canadians will no longer have to lie awake at night worrying about the cost of diabetes treatment, and that women and girls will be able to control their bodies through free contraception."

Holland said, "Cost remains a barrier. Today, we are taking action to remove that barrier."