Of course, I have a bias as a federal organization. We have to sometimes deal with the complexity of the coverage between the different provinces. Our spectrum of care as set out in our P and T committee is that when we look at different drugs we also have to look at what's being covered by other provinces to provide some kind of equity to our members. Some areas—not all, and I can't really put a number on it—are more challenging than others.
For example, fertility drugs, are we covering them or not? Some provinces are and some are not. With the more common diseases such as hypertension and diabetes, it's not a problem. For the more common diseases, there's going to be a wide floor that is going to be there. The CDR, which is being followed by all the provinces and the departments, is going to be there.
I think it will be a huge advantage to have one national pharmacare or formulary. Currently, the hospitals are trying to align their formularies with the provincial benefits. If you're hospitalized, they start medication in the hospital, then you're released into the population, so your coverage needs to extend there.
If each province has a different formulary, then the hospitals also have to adapt to it. The hospital may benefit and they have already benefited from doing bulk purchasing through contracting. If we had a national formulary, there could be opportunities for all the hospitals across Canada to negotiate as one entity rather than doing it by province. Similar to what we are doing in the military, we could have a procurement power as well as the agreements we get with pCPA.
If we had one national formulary, there would be many more benefits to be had. There might be more political challenges to get there, but I think the end result would be better.