Summary#

This bill sets rules and timelines for building national pharmacare. It directs the federal Minister of Health to fund, by agreement with provinces and territories, universal no‑cost coverage for certain contraception and diabetes medicines and related products. It also launches work to create a national list of essential medicines, a bulk purchasing strategy, an “appropriate use” strategy, and an expert committee to advise on how to run and finance universal, single‑payer pharmacare.

• Provinces and territories that sign agreements will receive federal payments to provide universal, single‑payer, first‑dollar coverage (no patient charges) for prescription contraception and diabetes treatments (Payments (1)-(2)).
• The Minister must ask the Canadian Drug Agency (CDA) to draft, within 1 year of Royal Assent, a list of essential medicines to inform a national formulary (National formulary (1)).
• The Minister must ask the CDA to design a national bulk purchasing strategy within 1 year (National bulk purchasing strategy).
• The Minister must publish, within 1 year, a pan‑Canadian strategy on the appropriate use of prescription drugs and related products, with progress reports every 3 years (Appropriate Use Strategy (1)-(2)).
• An expert committee must be created within 30 days to recommend options for operating and financing universal, single‑payer pharmacare, and must report within 1 year; the report must be tabled in Parliament (Committee of experts (1)-(3)).

What it means for you#

• Households

  • If your province or territory signs an agreement, you will have universal, single‑payer, first‑dollar coverage for specific prescription drugs and related products for contraception and diabetes treatment. First‑dollar means no deductibles or co‑pays at the point of care (Payments (1)-(2)). Start date depends on when your province or territory signs and implements its agreement.
  • If your province or territory does not sign an agreement, there is no change to your current coverage under this Act (Payments (1)).

• Workers with employer drug plans

  • The bill does not change private insurance rules. Any impact on your workplace benefits will depend on provincial implementation and how plans coordinate benefits. The Act is silent on private plan coordination (No specific section; Payments (1)-(2) describe public coverage only).

• Businesses and insurers

  • No direct new duties in the bill. In participating provinces, public first‑dollar coverage for contraception and diabetes drugs could reduce employer plan payouts. The Act does not set rules for how private plans adjust (Payments (1)-(2)).

• Health care providers and pharmacists

  • In participating provinces, more patients will have public coverage for contraception and diabetes drugs and related products. Coverage details and dispensing rules will follow provincial agreements (Payments (1)).
  • The CDA will provide advice and information on appropriate use to practitioners and patients (Request for advice (d)). A national “appropriate use” strategy will be published within 1 year, guiding safe and effective prescribing (Appropriate Use Strategy (1)).

• Provinces, territories, and Indigenous peoples

  • Provinces and territories may enter agreements to receive federal payments for first‑dollar coverage of contraception and diabetes treatments (Payments (1)-(3)).
  • The federal government commits to long‑term funding to improve access and affordability, beginning with drugs for rare diseases; details are not specified in the Act (Funding commitment).
  • The Minister must consult you on the essential medicines list, the bulk purchasing strategy, and the national formulary work (National formulary (1)-(2); National bulk purchasing strategy).

Expenses#

Estimated net cost: Data unavailable.

• No fiscal note is attached to the bill. The Act authorizes payments from the Consolidated Revenue Fund for provincial/territorial agreements covering contraception and diabetes treatments; amounts, timing, and terms are at the Minister’s discretion (Payments (1), (3)).
• The Act includes a general commitment to maintain long‑term funding, beginning with drugs for rare diseases, but provides no dollar amounts (Funding commitment).
• Administrative activities (essential medicines list, bulk purchasing strategy, appropriate use strategy, expert committee) will have costs, but the Act provides no figures (National formulary; National bulk purchasing strategy; Appropriate Use Strategy; Committee of experts).
• Overall federal and provincial spending will depend on which jurisdictions sign agreements, the scope of covered products, and implementation timelines. Quantitative estimates: Data unavailable.

Proponents' View#

• Reduces out‑of‑pocket costs immediately for contraception and diabetes treatments in participating provinces by requiring universal, single‑payer, first‑dollar coverage (Payments (1)-(2)).
• Addresses cost‑related non‑adherence. The preamble notes that when people skip prescriptions for financial reasons, their health may worsen and overall health system costs can rise (Preamble).
• Uses bulk purchasing to lower prices paid by public plans, improving affordability system‑wide (National bulk purchasing strategy).
• Builds national consistency through an essential medicines list and a future formulary, aiming for more even access across Canada (National formulary (1)-(2)).
• Promotes safe, effective prescribing and patient information through a pan‑Canadian appropriate‑use strategy and CDA advice (Request for advice (d); Appropriate Use Strategy (1)-(2)).
• Creates a clear path to universal pharmacare by setting timelines and an expert committee to recommend operating and financing options for a single‑payer model (Committee of experts (1)-(2)).

Opponents' View#

• Fiscal uncertainty. The bill provides no cost estimates and leaves payment amounts and timing to ministerial discretion, creating budget risk and limiting parliamentary scrutiny (Payments (3)). Quantitative impact: Data unavailable.
• Uneven access risk. Because coverage depends on provincial/territorial agreements, benefits may vary by location, contrary to the goal of consistent access (Payments (1); Principles (a)).
• Potential displacement of private coverage. First‑dollar, single‑payer public coverage may shift costs from private insurers to governments; the bill does not set coordination rules with private plans (Payments (1)-(2); no coordinating provisions).
• Implementation risk. Tight timelines (30 days to form the committee; 1 year for the essential list, bulk purchasing, and appropriate‑use strategy) may be hard to meet, leading to delays or incomplete deliverables (Committee of experts (1); National formulary (1); National bulk purchasing strategy; Appropriate Use Strategy (1)).
• Narrow scope versus expectations. The Act focuses initial funding on contraception and diabetes treatments while referring to universal pharmacare, which may create public expectations not met in the short term (Purpose; Payments (1)).
• Key decisions deferred. The bill leaves the contents of the formulary, coverage conditions, and the financing model to future processes, creating uncertainty for patients, providers, and provinces (National formulary (1)-(2); Committee of experts (2)).