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Pharmacare Act
An Act respecting pharmacare
This bill is from the 44th Parliament, 1st session, which ended in January 2025.
This bill is from the 44th Parliament, 1st session, which ended in January 2025.
Mark Holland Liberal
This bill has received Royal Assent and is now law.
This is from the published bill. The Library of Parliament has also written a full legislative summary of the bill.
This enactment sets out the principles that the Minister of Health is to consider when working towards the implementation of national universal pharmacare and obliges the Minister to make payments, in certain circumstances, in relation to the coverage of certain prescription drugs and related products. It also sets out certain powers and obligations of the Minister — including in relation to the preparation of a list to inform the development of a national formulary and in relation to the development of a national bulk purchasing strategy — and requires the Minister to publish a pan-Canadian strategy regarding the appropriate use of prescription drugs and related products. Finally, it provides for the establishment of a committee of experts to make certain recommendations.
All sorts of information on this bill is available at LEGISinfo, an excellent resource from Parliament. You can also read the full text of the bill.
Bill numbers are reused for different bills each new session. Perhaps you were looking for one of these other C-64s:
This is a computer-generated summary of the speeches below. Usually it’s accurate, but every now and then it’ll contain inaccuracies or total fabrications.
Bill C-64, also known as the Pharmacare Act, proposes a framework for a national universal pharmacare program in Canada, starting with coverage for contraception and diabetes medications. The bill aims to improve accessibility, affordability, and equity in prescription drug coverage while also establishing the Canadian Drug Agency to oversee a national formulary and bulk purchasing strategy. However, some argue that the bill infringes on provincial jurisdiction, duplicates existing programs, and does not address the root causes of affordability issues.
Liberal
Conservative
NDP
Bloc
Second readingPharmacare ActGovernment Orders
The Deputy Speaker Chris d'Entremont
Order. Let us just make sure we get the questions and comments, and we can continue on.
The hon. member for Kingston and the Islands has the floor.
Mark Gerretsen Liberal Kingston and the Islands, ON
Mr. Speaker, the Leader of the Opposition has been suggesting recently that he will use the notwithstanding clause where he sees fit.
On Friday, the member for Lanark—Frontenac—Kingston specifically said, “A common-sense Conservative government would use the notwithstanding clause only on matters of criminal justice.” Well, performing an abortion back in the nineties was considered a crime.
The member could very easily put my concern to rest by answering this question. Can the member categorically say that a future Conservative government would absolutely protect a woman's right to choose and not use the notwithstanding clause on a matter such as that, yes or no?
Michelle Ferreri Conservative Peterborough—Kawartha, ON
Mr. Speaker, what a question coming from a man. I would love him to tell me what to do with my uterus. That is great. That member will never tell me what to do with my body. We know the Liberals are losing really bad when they bring up abortion. We will never bring this up. If the member opposite wants to talk about my reproductive rights, he had better put a woman up and stop mansplaining to me.
Second readingPharmacare ActGovernment Orders
Sébastien Lemire Bloc Abitibi—Témiscamingue, QC
Mr. Speaker, in her speech, my colleague quite pointedly criticized various aspects of this bill. She explained why it should not be passed.
In my opinion, she left out one thing, and that was jurisdictions. It is not the federal government's place to become involved in health issues or, by extension, in drug management.
Does my colleague have anything to add about the federal government's jurisdiction over pharmacare?
Michelle Ferreri Conservative Peterborough—Kawartha, ON
Mr. Speaker, absolutely, we believe in provincial jurisdiction. Again, we have just seen a federal government and a Prime Minister that want more control weighted into an area that has nothing to do with the Liberal government.
Lori Idlout NDP Nunavut, NU
Uqaqtittiji, this is such an important bill, because it would help individuals who need it most, whether it is women who may need medicines for their reproductive health or people who suffer from diabetes. These are two areas of pharmaceutical care that are desperately needed throughout Canada, in the territories and in all the provinces.
Could the member better explain how this bill is not supporting those people, specifically women who may need access to abortion because of an unplanned pregnancy that they may have experienced?
Michelle Ferreri Conservative Peterborough—Kawartha, ON
Mr. Speaker, I want to tell the member that I was actually with a constituent of hers on the weekend. His name was Josh, an incredible young boy who was accessing the services at Toba child advocacy centre. What that young man has been through and what his family endured up north is absolutely incredible. He said to me, “I'd like to see the Conservative government win so that we can deal with drugs and drug addiction and help people who are most vulnerable”, which is what I would like to focus on.
I think we can help all of the folks the member is referring to, in particular women, to be out of poverty, have access to housing and have access to all the things they need. There are truly people struggling in this country, and it is just not in the bill; that is the reality.
This is a failed Prime Minister who will not deliver anything he says he will. It is time for a competent government that delivers what it says it will and restores confidence in the people, restores trust and makes life affordable again.
Francesco Sorbara Liberal Vaughan—Woodbridge, ON
Mr. Speaker, it is always a pleasure and an honour to rise in this most honourable of houses. This evening, I will be sharing my time with the hon. member for Milton.
Before beginning my formal remarks, I would say that, when I think of Bill C-64, an act respecting pharmacare, and the implementation of a piece of legislation that would obviously strengthen our health care system and the delivery of it, I would not be remiss to say that this is not only an excellent piece of legislation that would help Canadians, specifically those in need of contraceptives and the nearly 4 million Canadians dealing with diabetes, but also another sign of our government's strengthening of our social fabric and social system. It would build on other programs that we have implemented, including the Canada child benefit, which we know has lifted hundreds of thousands of children out of poverty and helps families every month. In my riding, nearly $80 million or $90 million a year arrives, tax-free and monthly. We know that the Canada workers benefit, which helps our working poor and those trying to make ends meet and get ahead, helps literally millions of Canadians. We introduced middle-income class tax cuts in 2015, raised the basic personal exemption amount and accelerated the pace. We know those are delivering $10 billion annually in tax relief to Canadians, as we speak.
More recently, the Canadian dental care program, which thousands of dentists have signed on for, is benefiting individuals in my riding of Vaughan—Woodbridge. In fact, in the heart of my riding at Weston Road and Rutherford Road, there is a big billboard, put up by one of the dentists in the community, stating that they welcome patients who are eligible and approved for the Canadian dental care program. This program is already helping thousands of residents in the riding of Vaughan—Woodbridge and in the city of Vaughan. The work that we are doing on Bill C-64 would continue to build on that work of helping Canadians to receive the services they need, which, in this case, is to improve health care.
With respect to health care, I was at the announcement with the Prime Minister and the Premier of Ontario, Doug Ford, when we announced a $3.1-billion bilateral agreement of health care funding for more nurses, more doctors and more health teams across the province of Ontario, a part of the $200 billion the federal government is committing to health care across this beautiful country.
I appreciate the opportunity to speak to the important work under way through Bill C-64 with regard to the Canadian drug agency, or CDA. The CDA is one of the key features contained in Bill C-64. On December 18, 2023, the Government of Canada announced the establishment of the CDA, which is to be built from the existing Canadian Agency for Drugs and Technologies in Health, in partnership with provinces and territories. The government committed $89.5 million over five years to establish the CDA, providing dedicated leadership and coordination to make Canada's drug system more sustainable and better prepared for the future. This investment would be in addition to the existing funding of $34 million per year to support CADTH's current work.
The CDA would build on CADTH's existing mandate and work, expanding to include new functions such as appropriate prescribing and use, data and analytics, and system coordination. Developing the CDA recognizes the organization's reputation of excellence, performance and results. It also ensures that we would be adding value to the system by building on what is already working with the CADTH.
Let me say a bit about how we got to this important milestone. Canada's pharmaceutical system evolves slowly over time, often responding to address new challenges as they developed. When medicare was first introduced in Canada in 1966, drugs used outside hospitals were primarily inexpensive medicines for common conditions. A growing number of specialized drugs are now helping to cure or manage a range of conditions, and rising rates of chronic disease have made prescription drugs a central part of our current health care system.
New pharmaceutical system organizations and functions have been created to manage the access and use of prescription drugs, but this has happened in an ad hoc and fragmented manner. Canada currently has over 100 public drug plans and 100,000 private drug plans, creating a patchwork of access and coverage for Canadians. Despite improvements in recent years, high prices and the patchwork of drug coverage leave many people in Canada facing barriers to access the prescription drugs they need when they need them.
Stakeholders in landmark reports have underscored the need for federal leadership in addressing these gaps. In recognition of concerns about the sustainability of the Canadian pharmaceutical system, budget 2019 provided $35 million over four years to establish the Canadian Drug Agency Transition Office, or CDATO, to provide dedicated capacity and leadership to work with provinces, territories and key partners on a vision, mandate and plan to establish the CDA. Since its establishment in 2021, the CDATO has conducted extensive engagement and analysis, holding over 400 meetings and round tables with a diverse range of stakeholders to understand the gaps and challenges in the pharmaceutical system and obtain advice on how to make improvements.
Extensive engagement has taken place with provinces, territories, patients, pan-Canadian health care organizations, health care professionals, industry insurers and international partners. Based on this engagement analysis, the CDA will build on CADTH's existing mandate and functions, expanding to include new work streams that better support patients and system sustainability, namely improving the appropriate prescribing and use of medications, increasing pan-Canadian data collection, expanding access to drug and treatment information, and reducing drug system duplication and lack of coordination.
Through our engagement, we learned that the appropriate prescribing and use of medications is a clear priority for many stakeholders. This is about ensuring that patients are prescribed the safest and most effective treatment for their outcomes and conditions. Each year, $419 million is spent on potentially harmful medications for seniors, and $1.4 billion is spent to treat harmful effects. However, there is no unified approach to guide and inform prescribers or patients on appropriate prescribing and use.
To date, we have launched an appropriate use of advisory committee involving patients, clinicians, experts and leading organizations in the field. The committee is advising on the development of a pan-Canadian appropriate prescribing and use strategy. Later this spring, the committee will issue its final report that will inform the work of the CDA to create and implement an appropriate prescribing and use program in collaboration with partners.
Stakeholders have also pointed to the need to improve pharmaceutical data and analytics to better understand the impact of drug treatments. However, there is limited ability to access, link or share drug data, which is siloed in different sources, such as hospitals, private drug plans, physicians' offices and jurisdictions. This fragmentation limits our ability to understand a drug or treatment's use pattern and effectiveness, including how it performs once it is being used by patients in the real world and how it compares to other available treatments.
We are working with several organizations in the health data field, such as CADTH, the Canadian Institute for Health Information, Canada Health Infoway, Health Data Research Network Canada and the pan-Canadian Pharmaceutical Alliance, to improve access to and use pharmaceutical data. Stakeholders also consistently emphasize the importance of incorporating patient equity and lived experience in the CDA's developments and operations. They noted that patient engagement in the pharmaceutical system is limited. Incorporating patient perspectives through engagement and governance were key recommendations for an organization that is transparent, accountable and meaningfully involves those who need it most, the patients.
We have also heard of significant challenges regarding system coordination. During the course of our engagements, most stakeholders highlighted at least one coordination-related issue that they face. Challenges include a lack of information sharing, confusion about roles or responsibilities or limitations to meaningful engagement. Our pharmaceutical ecosystem is managed by multiple organizations that have different purposes, priorities and areas of jurisdiction.
There is one organization mandated to convene players, focus the agenda, ensure efficiency and enhance collaboration. Because of this, there are both gaps and duplication in the system. Building from CADTH is a significant step in promoting system alignment. CADTH is a highly reputable organization with strong leadership and a shared federal, provincial, territorial governance model that works.
Through CDATO and CADTH's extensive partnerships and building on the work to date, we will build a CDA that is well positioned to convene key players and focus on promoting better outcomes for patients. We will develop an organization that has the capacity to adapt to the ever-changing pharmaceutical landscape. Our work to date reflects the significant input provided by stakeholders over the last three years. It also highlights a strong interest across the system to make meaningful improvements.
The CDA will support pharmaceutical system modernization in Canada and lay a strong foundation for future growth, including by providing the capacity to support the commitments outlined in Bill C-64, which is now before the House. The CDA will assume a leading role in the pharmaceutical system to ensure Canadians have better health outcomes and are well informed about the medications that they need now and into the future.
Marilyn Gladu Conservative Sarnia—Lambton, ON
Mr. Speaker, by now, Canadians are used to broken promises from the Liberals. In 2015, members will remember that they were going to make housing affordable, and now housing prices, mortgages and rents have doubled. They also promised the last election under first-past-the-post, but maybe not.
However, on pharmacare, I think maybe Canadians need a history lesson because the Liberals have been promising to do pharmacare since 1992, and they have never done it. The bill before us is also not pharmacare. It is a plan to get a plan to maybe do pharmacare. It is not going to be national. Quebec has already said that it is not going to participate.
Could the member just admit that this is an attempt to pacify the NDP to make sure that it does not pull its support and trigger an election?
Francesco Sorbara Liberal Vaughan—Woodbridge, ON
Mr. Speaker, since 2015, when I was first elected to this most honourable House, my focus has been on helping and ensuring the success of the residents of my riding of Vaughan—Woodbridge and of all Canadians, and that is what we continue to do. We continue to implement policies that strengthen our social system, including what is contained in Bill C-64, specifically for folks with diabetes and individuals in need of contraceptives.
Obviously, the rare disease strategy is something near and dear to my heart as I have a nephew who suffers from a rare genetic disease. I understand the issues that my brother and sister-in-law go through in taking care of my nephew. The issue of expanding pharmacare, expanding our national system and strengthening our social safety net is very near and dear to my heart.
Taylor Bachrach NDP Skeena—Bulkley Valley, BC
Mr. Speaker, we heard several times this evening from Conservatives talking about child care. If we look at how that legislation came about, which is something the NDP pushed for for years, it was eventually written into legislation and passed in a very similar format to pharmacare, and it required the participation of provinces. We heard all sorts of opposition from the Conservatives, but what we saw is that provinces, one by one, came on board. Now, we see the same thing with pharmacare.
I am just wondering if the member can project on whether we are going to see, over the coming months and the coming year, as agreements are signed with British Columbia and Manitoba, that other provinces are going to have a hard time explaining to their people why they do not get free contraception and free diabetes medication, and slowly they are all going to sign on to a national universal pharmacare plan. Is that how it is going to roll out?
Francesco Sorbara Liberal Vaughan—Woodbridge, ON
Mr. Speaker, leadership is about having the confidence to invest in Canadians and invest in Canada. We continue to work with all the provinces. We have signed all the agreements for the national early learning and child care agreements across the country with all the provinces, Conservative, New Democrats or Liberal. We have done the same on health care.
As I said in my speech, I was there with the Prime Minister and the Premier of Ontario, Doug Ford, the morning we signed the bilateral health care agreement of injecting $3.1 billion as part of the agreement with the Province of Ontario. That is real leadership. That is not hot air. That is real leadership, which is providing real solutions to individuals in the province of Ontario and across this country that we call home.
We will continue to introduce measures that I know make a real difference in the lives of everyday Canadians, including the ones who live in my riding of Vaughan—Woodbridge.