Thank you, Mr. Chair.
On behalf of the Canadian Medical Association and our over 83,000 physician members, I appreciate the opportunity to appear before the committee as part of its study on the development of a national pharmacare program. My name is Dr. Cindy Forbes. I'm a family physician from Nova Scotia and president of the Canadian Medical Association.
Prescription medication plays a critical role in health care. This is indisputable. However, Canada stands out, as you've heard certainly from the last speaker and I'm sure from many others, as being the only country with universal health care that does not also have universal pharmacare coverage. As a result, there are far too many Canadians who simply cannot afford to take the medication that they need.
Allow me to share some examples that illustrate the scope of this issue. At the national level, The Commonwealth Fund's 2013 international health policy survey revealed that 8% of Canadian respondents had either not filled a prescription or skipped doses because of cost. At the provincial and territorial level, there is wide variation in average household out-of-pocket spending. According to the 2014 survey of household spending, the poorest Prince Edward Island households spent more than twice as much, so $645, as did the poorest in Ontario at $300. We're also seeing patients being released from hospital having their prescriptions suddenly cut off, or we see patients covered for a drug in one province but not covered in another. This is especially common with cancer drugs, which are particularly expensive.
We all know that we can and that we must do better. However, we're unlikely to address the significant access gaps in prescription medication coverage without the leadership and support of the federal government. The CMA is therefore putting forward three recommendations for federal action to improve access to medically necessary drugs.
Our first recommendation to the committee is that the Parliamentary Budget Officer conduct a detailed examination of the financial burden of prescription medication coverage across Canada and develop costing options for a federal contribution to a national pharmacare program.
We recognize that these are fiscally challenging times at all levels of government. That's why our second recommendation, a proposal for a federal funding program, is fully scalable. We're recommending that the federal government establish a cost-shared program of coverage for prescription medications as a positive first step towards comprehensive universal coverage. This gradual and scalable approach would help ensure that Canadians have comparable access to the prescription drugs they need regardless of their ability to pay and wherever they live in Canada.
Finally, there are several other crucial elements that must be addressed in the development of a national pharmacare program. These include the need to influence prescribing behaviour, to advance electronic prescribing, and to mitigate drug shortages.
To ensure that these elements are captured in work going forward, our third and final recommendation is for the federal, provincial, and territorial health ministers to direct their officials to convene a working group on a national pharmaceuticals strategy. This working group would consult with stakeholders representing patients, prescribers, and the health insurance and pharmaceutical industries, and report their recommendations by the spring of 2017.
Few would argue that prescription medications are less vital to the health and health care of Canadians than are hospital and medical services. We would not have the medicare program that Canadians cherish today without the leadership and financial contribution of the federal government. Similarly, without it now we will not have any form of a national pharmacare program in future.
I thank you for your time, and I'd be pleased to answer any questions you may have.