Health Committee on Feb. 2nd, 2017

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Oh, you have not?

[Cdr Sylvain Grenier]

No, the Canadian Armed Forces have not joined it. About a year ago, Health Canada asked us to evaluate that. The challenge we have is that, because 90% of our medications are procured, we already have a series of contracts in place.

As you know, the pCPA process is very secretive, so it was very hard for us to get the information necessary to make sure that joining pCPA would not put us in conflict with the current contracts we had already signed with other companies.

We have evaluated that, and because there is always an opt-out option with the pCPA with the product listing agreement, it is clear to us now that there will be some benefit for some drugs that are not on contract right now. We're looking at the process now and getting involved, so it's a matter of months before we're going to get there.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

All right. Has anyone looked at what the potential savings would be once that happens, or is there not enough information yet?

[Cdr Sylvain Grenier]

It's a very rough estimate, because we can't get the real values, but for us—because, again, we procure 90% of our medication—the cost savings would definitely not be as big as what Health Canada and Veterans Affairs have seen, because they rely much more on the rebates from the pCPA negotiations, whereas we have many more contracts because we do our own procurement.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

All right, thank you.

Ms. Balon and Ms. Wurzer, regarding Blue Cross and public versus private plans, would you be able to give any estimate of the impact on the private insurance industry if there were a national, public, universal pharmacare system?

[Dianne Balon]

In what context...?

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

Financially. What would it do to that industry from a financial business perspective?

[Dianne Balon]

Certainly. I think the question of impact to business has been an ongoing strategic exercise, for sure, because you need to look and determine what type of model or scenario it's going to be. I'll use some examples.

For example, if the principles were that it was based on a basket of drugs that were required by insurers and governments across Canada, and then employers were able to still have wraparound coverage for that, then that would be one impact to the benefit carriers.

There would be a different impact, for sure, if the principles were that there was a direction to have one national payer. Then, of course, there would be a major impact to the benefit carriers. I would say that, as a not-for-profit organization with capabilities, we would look at that as an opportunity as well, from the Blue Cross perspective. Again, it depends on what the scenarios are and which way you go.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

All right, thank you.

If there was a national system, would you foresee a role for private insurance industries in that? Is there a possibility for that? Would that be an efficient way of going about it?

[Dianne Balon]

Absolutely. As CLHIA indicated, infrastructures, several of them, are already in place coast to coast. We do this for a living, and we do it very efficiently. Certainly, I can say that from our own perspective. Yes, there would be an opportunity, and there would be no need to rebuild and replicate the systems that already work in Canada today.

[Doug Eyolfson, Liberal, Charleswood—St. James—Assiniboia—Headingley, MB]

That's all I have. Thank you.

[The Chair, Liberal, Bill Casey]

Thank you very much.

Mr. Paul-Hus, go ahead.

[Pierre Paul-Hus, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

Thank you, Mr. Chair.

Commander Grenier, you gave some explanations about the cost of drugs for the Canadian Forces. The cost of drugs for military pharmacies is lower than that of civilian pharmacies, since civilian pharmacies have higher operating costs. Savings are possible because military pharmacies are on military bases. I understand that.

You said that 71,000 CF members are covered. The system covers members of the regular forces and class B and C reservists, but it does not cover class A part-time reservists. If we disregard reservists, how many permanent CF members are covered?

[Cdr Sylvain Grenier]

Currently, about 66,000 members of the regular forces are covered under our plan.

[Pierre Paul-Hus, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

Does that include class B and C reservists?

[Cdr Sylvain Grenier]

Including those reservists, the number is 71,000. That's everyone who is covered.

[Pierre Paul-Hus, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

Right. That's the total number of people currently covered.

[Cdr Sylvain Grenier]

That's right.

[Pierre Paul-Hus, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

Are the families of CF members covered, too?

[Cdr Sylvain Grenier]

No, but there is one exception to that. We have a military base in Germany, and we provide medications to the dependants of CF members, but they have to pay because the costs aren't covered. That is the only case where we provide medications to dependants.

[Pierre Paul-Hus, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

If the families of military members are included, the 71,000 increases two- or threefold. Those people don't have coverage. Dependants of CF members living in Quebec City, Valcartier, or elsewhere, aren't covered by any plan and must get insurance from Blue Cross or another company.

[Cdr Sylvain Grenier]

No, because CF members have access to the Public Service Health Care Plan. It's the same plan that public servants have access to. So, the families of CF members are covered as dependants under that private plan.

[Pierre Paul-Hus, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

Right.

Do these people make their purchases in military pharmacies?

[Cdr Sylvain Grenier]

No, they use civilian pharmacies.

[Pierre Paul-Hus, Conservative, Charlesbourg—Haute-Saint-Charles, QC]

They can't buy their medication in military pharmacies?