TORONTO - The Canadian Health Coalition renewed its call for a national pharmacare program Tuesday, releasing a report detailing the hardships faced by Canadians without a drug plan.
The stories were compiled following public hearings across the country where more than 250 Canadians talked about how prescription drug costs are affecting their lives.
"What really struck me was the plight of people who are falling through the cracks," Michael McBane, national co-ordinator of the coalition, said in an interview from Ottawa.
"The people who need coverage the most, that is people with chronic illness and not a lot of money, they're the ones who don't have drug coverage."
Colin Spencer, 61, of South Pinette, P.E.I., was diagnosed with kidney cancer in August, and didn't take part in the hearings. But his difficulties are not unlike those recounted in the report.
He's had to cash in his pension and put his home up for sale because he needs to take a new drug called Sutent, which costs about $7,000 a month, says his daughter, Sheila MacMurdo.
A specialist in Halifax recommended the drug, but MacMurdo said Prince Edward Island is the only province that hasn't approved it.
"It's frustrating because it's really his only option at this point," said MacMurdo, who lives in Summerside.
The coalition's report entitled Life Before Pharmacare, is published by the Canadian Centre for Policy Alternatives (www.policyalternatives.ca). Financial assistance came from a number of organizations, including the Canadian Auto Workers, the Canadian Federation of Nurses Unions and the Public Service Alliance of Canada.
McBane said the number of people who don't have drug coverage is growing because of the rise in unemployment.
"We're calling for a universal system," he said, adding that P.E.I. alone has 22 different drug plans that the provincial government administers.
"It would be so much more efficient and more equitable to have one plan that covers everybody for the country."
The principle involves paying for every drug that works so that essential needs are met, and not paying for drugs that don't work.
"That would take a lot of drugs out of your drug plan," McBane said. "And if you want drugs that aren't effective or aren't safe, then you have to find another way to pay for them."
The report states that according to Health Canada, only 15 per cent of newly approved drugs are an improvement or a breakthrough over existing drugs. The others are just a different version of what already exists but at a higher price and with monopoly protection for 20 years, it says.
Kathy Kovacs Burns, associate director for the Health Sciences Council at the University of Alberta, says the pharmacare concept has been discussed a lot by various committees nationally and provincially since the time of the Romanow commission.
She belongs to a different organization - the Best Medicines Coalition - made up of national disease and patient groups, and is concerned that McBane's group is looking at the issue from too narrow a perspective.
"When Best Medicines Coalition really examined it thoroughly we realized that to alter what happens at the provincial level means that you have to open up that Canada Health Act," she said in an interview from Edmonton. Under Canada's Constitution, health is a provincial and territorial responsibility.
"We would hate to see anything happen to that Canada Health Act because it's the only thing that's preserving drug coverage totally when you're in a hospital."
Her group is becoming disillusioned by the lack of progress, she said, and is now looking at a different approach.
"I fear that we're already shooting a dead horse here when we're talking about a national public pharmacare plan, and the government has already put that into the garbage can, I think," she said.
"What might be more appropriate is looking at the high-cost drugs."
But McBane argued that almost every province and territory wants a national co-ordinated approach to pharmaceuticals.
Even employers said they would prefer a public plan "because it's a headache to administer privately and more importantly, the costs are skyrocketing out of control in private plans," he said.
The report says prescription drug costs have risen on average by 11 per cent a year over the last decade.
Canada and the United States are the only two countries in the industrial world without a universal public drug plan, McBane said.
Under a public drug plan, better prices could more easily be negotiated, he said.
"You would have one purchaser for all of the government plans, and that would give you much more bargaining power to lower the prices."
He said New Zealand does this, bargaining collectively for the drugs covered by the formulary.
Dr. Jim Wright, a clinical pharmacologist at the University of British Columbia, said New Zealand has taken "a very proactive stance" and has been successful in keeping costs down. He said the country has shown it can be done without having any impact on people's health.
Wright said there's tremendous potential to decrease costs through a single national formulary, but people would have to realize that not having coverage of all drugs would not compromise their health.
"The drug industry would be lobbying against it," he noted.
