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Linda Silas“Canadians face some of the highest prescription drug prices in the world,” admitted the federal government when announcing the interim report from its Advisory Council on the Implementation of National Pharmacare.

If Canadians hoped this report would provide details on how a national pharmacare program might be implemented and funded, they only got a taste. The report instead contained three basic recommendations: the creation of a national drug agency; a national formulary of prescribed drugs; and IT systems to support both.

Those are baby steps in the right direction, with some funding in the recent federal budget.

According to a recent national survey, at least 20 percent of Canadians have insufficient or no drug coverage at all. And 23 percent of respondents say they or someone in their household wasn’t able to take necessary medication because of the cost. In 2016, over 700,000 Canadians had to forego spending on food to afford their prescription medications.

So, what’s the holdup?

Deep-pocketed interests that already profit generously from the dysfunctional patchwork of private-public drug plans and considerable out-of-pocket pharmaceutical costs have been revving up their anti-pharmacare campaign since the federal government expressed interest in studying the issue. In our recent report on the issue, we call them “The Big Money Club,” made up of pharmaceutical and insurance giants and domestic and foreign billionaires.

Prescription drug policy in Canada ought to be decided in the interest of Canadians, not based on the power of industry sector lobbies. This is why nurses have advocated for more than 20 years and continue to lobby for national pharmacare based on the principles of universality, accessibility, comprehensiveness, with portable coverage and public and single-payer administration.

It was no surprise our report found that the pharmaceutical and insurance sectors enjoy a business environment that’s immensely profitable to them – and costly to the rest of us. To protect these profits, the pharmaceutical and insurance lobbies have engaged in a methodical and well-financed campaign, with the goal of convincing the federal government not to pursue a common-sense, single-payer pharmacare plan.

How much money is at stake?


Pharmaceutical giants live in a golden age of profits (over 20 per cent a year). Drug prices have been rising – 40 percent of the share of drug sales in Canada are now high-priced patented drugs, up from eight percent in 2006. Health insurance companies in Canada, deregulated in the 1990s, are enjoying billions in profits from the lucrative health benefits market.

Our report found that The Big Money Club’s anti-pharmacare campaign has taken three main routes.

First, by targeting the centre of power by flooding Parliament Hill with lobbyists and targeted advertisement. Between 2017 and 2018, the non-trade-related lobbying activity of Canada’s big pharma group, Innovative Medicines Canada, increased by 500 percent (from 18 meetings in 2017 to 104 in 2018, the year Prime Minister Justin Trudeau announced the advisory panel on pharmacare). 

Secondly, by sowing doubt among the general public by creating echo-chambers of opposition to a single-payer national pharmacare program through mainstream media.

And finally, by calling on the U.S. government to exert diplomatic and commercial pressure on Canada.

What we don’t want in Canada is fake pharmacare – a fill-the-gaps mix of public and private insurance that would benefit the Big Money Club but lose all the advantages of a single-payer system, which would provide bargaining power and lower drug prices. 

A disciplined and well-built pharmacare plan for all with a single public payer would mean billions in healthcare dollars saved, a strong health system and better care for millions of Canadians.

A new Environics public opinion poll shows 84 percent of Canadians support including prescription drugs in our public healthcare coverage, the same as doctors and hospitals. Canadians are ready for pharmacare.

Linda Silas is a nurse, longtime pharmacare advocate and president of the Canadian Federation of Nurses Unions, representing nearly 200,000 nurses and student nurses across the country.

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