May 18th, 2022

Horwath’s NDP will deliver comprehensive Universal Pharmacare

KINGSTON and OTTAWA – Andrea Horwath and the NDP will deliver hundreds or even thousands of dollars in savings for every family every year with Ontario’s first comprehensive Universal Pharmacare program.

“Pharmacare is health care, and you shouldn’t have to rack up credit card charges to get the medicine you need,” said Horwath. “New Democrats will take another cost off your hands. With pharmacare, you’ll get the medicine you need with your OHIP card, not your credit card.

“Everyday people should be able to afford everyday life. Together, we can make sure families can always get the prescriptions they need. We can make sure no one ever again in Ontario has to cut their grocery budget in order to afford their child’s medicine.”

Under Horwath’s Universal Pharmacare plan:

  • Families will save about $350 a year.
  • People who need take-home cancer drugs will save thousands of dollars every year — even if they already get help from provincial drug plans.
  • People with excellent benefits plans, but are managing a chronic disease, will also save thousands of dollars per year.
  • Seniors will save at least $100 every year.

When elected, Horwath and the NDP will make PrEP, birth control and all take-home cancer drugs free on Day 1. Then quickly begin implementation of Canada’s first pharmacare plan. Horwath is also committing to lead the country in creating a national Universal Pharmacare program by using Ontario’s example and seat at the Council of the Federation to help build a Canada-wide plan that Ontario can roll into.

In his first week in government, Ford cut drug coverage for young people, and then rallied Conservative premiers across the country to shut down talks on a national pharmacare plan.

In addition to the savings for families, comprehensive universal pharmacare will save the province more than $1,200 per person every year in hospitalizations, emergency room visits and doctors appointments. That will free up $1.8 billion to reinvest in the health care system every year, and small businesses will save at least $835 million through lower drug costs.

Quotes

Izzy Myers, Kingston

"I’m currently prescribed four different life-saving medications, but still have to pay out-of-pocket even with private insurance. This adds to the financial stress I feel and makes living with a chronic health condition harder than it needs to be. A universal pharmacare plan would alleviate this stress and ensure that I’d always have access to the essential medicine I need to survive."

Dr. Dick Zoutman, Kingston

"Canada has some of the highest prescription drug prices in the world. Not being able to afford the medications prescribed for your health can result in you ending up in hospital. Not being able to afford your medications and landing in hospital costs the healthcare system more than if a pharmacare program helped to pay for your medications in the first place.

Too many Ontarians have trouble affording their essential prescription medications- this is simply not right."

Background

New Democrats believe that we must make prescriptions affordable and accessible for all Ontarians – and all Canadians – no matter where you work, how old you are, or how much you earn. Canada needs universal and comprehensive national Pharmacare but Ontario can and must lead the way. Ontario families need drug coverage now, and New Democrats will make it happen.

Ontario Today

  • Ontarians face a patchwork of private employer-provided benefits and public drug benefit programs. OHIP+ still is not universal for all Ontarians, even though Ontario spends more than $6 billion a year to include some coverage for residents.
  • Ontarians spend hundreds of millions of dollars on prescription drugs every year.[1] The cost burden led to a quarter of Canadians deciding not to fill or renew a prescription.[2]
  • Ontarians paid $2.5 billion out-of-pocket for prescription drugs in 2015, representing 22 percent of total drug costs in Ontario.[3]
  • Canada remains the only high-income country with universal health care that does not have universal coverage for prescription drugs.

How we’ll fix it: Universal Pharmacare

  • Universal Pharmacare will begin with universal coverage for approximately 125 essential medicines. This represents almost 80 per cent of all prescriptions written in Ontario today. Coverage will grow and expand to a comprehensive program as savings are realized. Listed drugs will be determined through an independent process led by the Committee to Evaluate Drugs.
  • Our plan will provide access to essential drugs for all Ontarians, including the 2.2 million Ontarians who have no drug coverage today. The plan will reduce drug costs faced by individuals, businesses, and municipalities.
    • No Ontarian will pay any deductible or premium as part of our Pharmacare plan. Pharmacare will be the first drug program in Ontario to be delivered to all Ontarians with no deductible or premium, removing a significant financial barrier to accessing prescription drugs.
  • Pharmacare will be administered by the Ontario Public Drug Program Division of the Ministry of Health, which is currently responsible for the Ontario Drug Benefit and other public drug programs.
  • Pharmacare will help reduce reliance on institutional long-term care, hospitals, and emergency care; with proper medication management support in the community, aging people can delay admission into long-term care and avoid hospital stays.
  • Essential medicines will be chosen on the basis of the demonstrated health needs of Ontarians. They will be commonly-prescribed medications of proven efficacy, safety, quality, appropriateness, and cost-effectiveness. Decisions will be made based on the best-available and highest quality evidence.
  • The Committee to Evaluate Drugs already has the mandate and expertise to evaluate the therapeutic value and cost-effectiveness of drug products. We will work with health experts, patient groups, and the Committee to lead the development of the list of essential medicines.
  • Based on the list of essential medicines, the NDP expects that the Ontario Public Drug Programs Division will issue tenders for generic drugs and engage in negotiations with brand-name pharmaceutical manufacturers. The OPDP will undertake these activities in an independent manner and at arms-length of government. The expanded number of beneficiaries and a dedicated budget from government will significantly increase bargaining power to obtain the best deal for all Ontarians.

Costs and Implementation

  • Pharmacare will incorporate a copayment geared to income, which will be no higher than the current copayments through Ontario Drug Benefit – $6.11 for most people and $2.11 for low-income people (based on incomes less than $19,300 for single seniors and less than $32,300 for senior couples). This means that through the NDP’s plan, Ontarians will have access to essential medicines for a maximum copayment of $6.11 per prescription.
  • An NDP government will allocate an annual budget of $475 million to support the implementation of Pharmacare. This calculation is based on work by Dr. Steve Morgan and published in the Canadian Medical Association Journal in 2017.[4]

Savings from Implementing Pharmacare

  • For families:The largest impact of free distribution of medication was the ability for families to make ends meet. According to a pharmacare study by School Mental Health Ontario, there was a 57 per cent increase in families’ ability to afford basic necessities. Participants also reported better perceived health and quality of care.
  • Using the most conservative projection of $835 million in savings, the NDP anticipates that individuals will realize out-of-pocket savings of approximately $201 million.
  • In the health care system: Pharmacare should save more than $1200 per person in avoided health care expenses such as hospitalizations, intensive care, and emergency department visits.
  • This would translate into savings of around $1.8 billion per year in Ontario, based on a projection of the results of the CLEAN Meds study onto the population of Ontario.
  • For government:Pharmacare should save more than $1.2 billion annually in Ontario based on lower drug prices driven by bulk purchasing power of the government as a single buyer.
  • Total annual savings would be greater than $3 billion ($1.8B + $1.2B). Much of the savings related to lower drug prices would involve moving spending into the public system, and for avoided healthcare utilization all the savings would be in the publicly funded system.
  • For business: With Pharmacare, Ontario’s private payers will realize savings of at least $835 million through lower drug costs. Private sector savings could reach as high as $1.9 billion.

[1] 2019/20 OPDP At A Glance: Data Report. (March 2021)

[2] Angus Reid Institute, “Access for all: Near universal support for a pharmacare plan covering Canadians’ prescription drug costs” (October 29, 2020)

[3] 2015/16 Report Card for the Ontario Drug Benefit Program, slide 6, http://health.gov.on.ca/en/public/programs/drugs/publications/opdp/docs/odb_report_16.pdf

[4] Morgan et al., “Estimated effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada,” Canadian Medical Association Journal, February 27, 2017.

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