Thank you, Mr. Chair and members of the committee.
I will give my presentation in English, but will be pleased to answer your questions in French and English.
I'm here today on behalf of Canada's 42,000 pharmacists who work primarily in community pharmacies, but also in hospitals and primary health care settings. I think probably our biggest contribution to the economy is helping Canadians stay healthy in their day-to-day lives. But I would be remiss not to mention that pharmacies and the pharmacists that work in them are also important contributors to our economy.
With over 10,000 pharmacies in Canada, either owned directly by pharmacists or pharmacies that employ our members, pharmacists create almost 250,000 jobs and contribute over $16 billion to our GDP. It might interest some of the committee members to know there are probably about 340 pharmacies in your ridings alone that create over 8,000 jobs and contribute $500 million annually to our GDP. We have that many pharmacies so we can provide care in rural, northern and remote areas, offer specialized treatments, and offer and ensure patient choice.
Many of you will think of pharmacists as people who dispense drugs, but we do a lot more than that, particularly as the needs of our patients are changing. I will leave one parting message to the members here, which is that as flu season approaches I would encourage all of you to get your flu shots from your local pharmacists.
Today I would like to speak to our three budget recommendations.
Our first recommendation relates to pharmacare. Because pharmacists are on the front line of drug access and act as drug plan managers, we see the issue from a unique perspective and believe it's time for us to complete the coverage for Canadians. Recognizing that the consultation process is ongoing, we also felt it was important for us to highlight some of the areas where the federal government could invest some funding more immediately to address some of the gaps in coverage.
Specifically, we recommend that budget 2019 support a more harmonized catastrophic drug approach across Canada to limit out-of-pocket costs. To achieve this, we have envisioned a federal catastrophic drug transfer to the provinces requiring all provinces to limit out-of-pocket costs to 3% of household income. We estimate that such a transfer would likely cost the government approximately $1.4 billion a year, but would improve access and alleviate the financial burden for over 5% of Canadians who spend over 3% of their annual income on drugs.
We would also like to use this opportunity to stress the importance of improving drug utilization as part of any pharmacare program that's implemented and to recognize the importance of medication services. These services help improve drug safety, adherence, issues associated with medication over-prescribing, misuse and wastage, which are all key to a sustainable pharmacare system moving forward.
The second issue we would like to speak to is whether or not the cannabis excise tax should apply to patients, which we believe it should not. Patients who use cannabis for medical reasons have very different needs from recreational users. Unlike recreational cannabis users who seek the more euphoric effects of THC, medical cannabis patients tend to require strains that will alleviate symptoms while minimizing intoxication like those available through CBD. By applying the same recreational excise tax to the medical cannabis stream, a real concern is that cannabis patients won't be able to afford their medication, and they will have little incentive to remain in the medical stream, which will lead to them to self-medicate without any clinical oversight.
Our last recommendation is probably one that everybody is thinking about on the current opioid crisis in Canada. Pharmacists are on the front lines of the opioid crisis, and we want to play an even bigger role in addressing the underlying causes of opioid use and supporting people who are living with addiction. While there's a lot to be done in this area, our last recommendation is focused on medication return programs, and their important role in reducing drug diversion.
Like many Canadians I am sure we all have unused medications sitting in our medicine cabinet. About 90% of pharmacies currently accept medication returns. However, many Canadians are not aware of this, and more could be done to promote the programs to Canadians. Unused opioids in the home could accidentally be ingested by children, stolen by family members for their own use, or diverted to the black market.
I will leave you with the statistics. In 2017, on the Ontario student drug use and health survey, 11% of Canadian teenagers had admitted to using opioids to get high, and 55% of these teenagers say they obtained it from their homes. Therefore, we recommend that the federal government invest $1 million a year for five years in a nationwide awareness campaign for pharmacy-led medication return programs.
Thank you.