A government-run pharmacare monopoly could potentially lead to the loss of coverage for certain treatments covered by private insurance

Krystle Wittevrongel: How federal pharmacare could impact your drug coverageDrug coverage in Alberta would have been at risk if not for Premier Danielle Smith’s decision to opt out of an ill-conceived federal government-run pharmacare plan.

The crux of the issue is that the federal pharmacare plan would create the framework necessary to impose a government-run monopoly on drug insurance. While it would cover diabetes and contraceptive medication at first, other categories of medications, as the New Democrats put it, would be added to that monopoly over time. This would mean waving goodbye to private insurance coverage for those treatments.

The thing is, the vast majority of Canadians already benefit from private prescription drug insurance plans. Nationwide, over 24 million of us have one. In Alberta, 63 percent are covered by those plans.

For those of us covered by such plans, the progressive imposition of a government-run insurance scheme replacing privately-run plans could mean losing coverage for certain specific treatments.

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Just look at the number of treatments covered. A recent Montreal Economic Institute study highlighted that Alberta’s drug insurance plan covers 4,465 unique medications.

That doesn’t sound bad, until you consider that private insurers in the province cover 8,994 unique medications. That’s more than double the coverage of the public plan!

Forcing all Albertans to revert to the public plan could result in the sudden removal of a lot of medication from insurance coverage.

And this is not unique to Alberta. Across Canada, on average, coverage is 51 percent more extensive in a province’s private plans than in its public plan.

A government-run pharmacare plan impacts not only what drugs are covered but also which ones are accessible in the Canadian market.

Some pharmacists, such as Dr. Alan Low of the Medicines Access Coalition in British Columbia, have already begun sounding the alarm.

When you consider that public plans cover less than half of the new drugs entering the Canadian market over the past decade, we could potentially miss out on a lot of new medications.

Then, there is the issue of approval delays for coverage of new treatments.

On average, it takes 226 days for a private insurer to add a new medication to its list of covered treatments once Health Canada approves it.

While that might appear a long period of time, it pales in comparison to the delays experienced by individuals on government-run plans. They take an average of 732 days after Health Canada’s approval to be added to the list. Many could, therefore, soon be waiting over three times as long!

This is typical of what happens when Ottawa doesn’t mind its business.

The federal government is responsible for regulation, market entry, and patents when it comes to medication. Full stop.

It is not responsible for setting up expensive new health-related programs and offloading those costs onto the provinces. Pharmacare legislation joins environmental and energy-related matters and child care on the long list of areas where the federal government is stepping into areas of provincial jurisdiction.

The Premiers of Alberta and Quebec were quick to point that out and notify Ottawa that they would opt out of the plan if it were adopted.

By protecting provincial autonomy, they just might have saved the quality of our prescription drug insurance coverage.

Krystle Wittevrongel is a Senior Policy Analyst and Alberta Project Lead at the Montreal Economic Institute.

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