Evidence of meeting #39 for Health in the 42nd Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was military.
A recording is available from Parliament.
Cdr Sylvain Grenier
No. As I explained earlier, Germany is the only exception. It's a matter of supply. The products in Germany aren't the same as we have here.
Conservative
Pierre Paul-Hus Conservative Charlesbourg—Haute-Saint-Charles, QC
Okay.
The cost of drugs is quite low in the Canadian Forces. However, as we know, these are people who are generally healthy.
Do the Canadian Forces provide drugs to treat allergies or other problems like that?
Cdr Sylvain Grenier
This is clearly the case. The cost per CF member is much lower than the national average. We're talking about $800 as the national average, compared to $375 for members. As you said, our population is generally healthier. It's also younger. So they aren't big users of medication.
However, biologics are putting pressure on our drug plan. Even though the population is healthy, many health problems are being treated with extremely costly biologics. But these individuals are entirely functional as CF members. The share of our budget currently allocated to these drugs is 15%.
The other drugs that are extremely costly, which my colleague talked about earlier, are for treating rare diseases. Since they are less frequent in the Canadian Forces, it affects us a little less.
Conservative
Pierre Paul-Hus Conservative Charlesbourg—Haute-Saint-Charles, QC
We're talking about active members, but when they get sick, they are discharged from the Canadian Forces and are then covered by Veterans Affairs Canada.
Are you required to support veterans, as far as drugs are concerned, or are you completely not responsible for that?
Cdr Sylvain Grenier
Under our current policy, we allow members who leave the military up to three additional months of coverage to help them to transition to civilian pharmacies, to find a doctor, and so on.
My section also deals with the transition of members. We print the complete drug profile for all members who are transferred to Veterans Affairs Canada and send that profile to the department. Veterans Affairs Canada then tells us what will and won't be covered for these people who will now be veterans.
We pass on the information to patients so they can determine whether they will be adequately covered when they leave the military. In our case, it's full coverage, but it isn't necessarily for the veterans. For them, health problems related to service are covered. There are other aspects that are also covered, but I'm not sure which exactly.
Conservative
Pierre Paul-Hus Conservative Charlesbourg—Haute-Saint-Charles, QC
Is there specific federal funding to pay for veterans' drugs or is it a private plan that is associated with the public service?
Cdr Sylvain Grenier
There is a drug plan for veterans. As with the Canadian Forces, Medavie Blue Cross manages this. However, as we also do for coverage, veterans make the decisions about coverage.
Liberal
Sonia Sidhu Liberal Brampton South, ON
Thank you, Chair.
Thank you to all the presenters.
I would like to bring up an issue close to my heart, both as the co-chair of the all-party diabetes caucus and as a former diabetes educator. I have heard that people presently serving actively in the military can be discharged from active duty if they contract type 2 diabetes. Is that correct?
Cdr Sylvain Grenier
It depends on the situation. What will determine if the patient can stay in the military or not is whether they can meet the universality of service requirement. In the case of diabetes, it is not the condition that is necessarily the issue; it is the medication they take that is required to maintain their health. If the patient can function with oral medication, then there is normally no issue unless there are other conditions for that patient, but there is no issue with staying in the military.
If they are at the stage where they require insulin, because the complications of not taking their insulin can be dramatic for a patient.... In our military operation we may be in a situation where the patient may not get access to their medication for days, and that may not allow the patient to stay in the military for that reason. This is not only for diabetes. It is true for any condition.
In a case where a patient gets a medical condition, physicians would be looking at the medical condition first and then the drugs. They would see, based on that, if the patient could still meet universality of service. We do not have a black and white rule. All of them are assessed case by case.
Liberal
Sonia Sidhu Liberal Brampton South, ON
There are other military programs abroad, such as one the CDC runs in the U.S., to help those working to prevent diabetes. They speak to those who are pre-diabetic or high risk—high risk can be due to lifestyle—to improve their lifestyle.
Do we have that type of program so we can prevent it?
Cdr Sylvain Grenier
We do have health promotion programs in the forces. Just to name a few, we have smoking cessation programs. We have programs to lose weight. We have multiple programs in the forces under health protection. Many programs I'm not even aware of, but they exist.
Liberal
Sonia Sidhu Liberal Brampton South, ON
Can DND confirm that its drug benefits list provides as much patient choice as other provincial and territorial plans do? Can you advise on how you consulted patient groups within the military to ensure there was enough choice and to reflect issues related to rare diseases?
Cdr Sylvain Grenier
In the case of the coverage of the medication, as I said, we always end up having 100% coverage for our members. If it's not part of our benefits list and our patients have a need, because of the exceptions process, they will always have a solution for those patients.
With regard to how our programs compare to the provinces, when we do our evaluation, after the CDR evaluation we do our P and T evaluation. We look at the drug to see where it's covered across the country. Based on that coverage, we determine whether or not we will include it in our formulary. We do take into consideration the coverage across the provinces.
Sorry, the second part of your question was regarding...?
Liberal
Sonia Sidhu Liberal Brampton South, ON
I asked if there were enough choices reflecting issues related to rare diseases.
Cdr Sylvain Grenier
The rare diseases don't happen very often in our population. We're really a subset of the population. In cases where we might have a patient who has a rare disease who would still meet the universality of service—and we'd have to look at that because of the exceptions process—there would be a vehicle to make sure the patient received the medication they required.
February 2nd, 2017 / 12:05 p.m.
Liberal
Sonia Sidhu Liberal Brampton South, ON
Thank you.
My question is about Alberta. What have some of the challenges been with Alberta Health providing some streams of drug coverage and Alberta Blue Cross providing others? Has any consideration been given to consolidation?
Vice-President, Government, Alberta Blue Cross
Yes and no.
Certainly in the province, as with other provinces, we have coordination of benefits with the programs. If the government offered a program, we would ensure that the individuals went to that program and then used their private coverage insurance as well, so we would have the coordination of benefits.
From a program perspective, they are quite separate in the sense that the government runs its programs and private programs run theirs separately, and then the individual programs are separate from that. There is also collaboration, of course, as I said earlier, in the way we procure the drug costs in the province of Alberta, for both public and private, those who are covered under Alberta Blue Cross. As well, collaboration with the pharmacies has occurred around the dispensing fees in the province so that for both public and private they pay the same.
I hope that answers your question about integration. We work carefully to make sure than an individual has access to all the programs possible.
NDP
Don Davies NDP Vancouver Kingsway, BC
Thank you.
I heard Commander Grenier say, if I understood correctly, that he was a proponent of having a national formulary so that we have national bulk buying. I'm just wondering if Alberta Blue Cross shares that position. Would that be helpful?
Vice-President, Government, Alberta Blue Cross
Yes, for sure. I will certainly say that we support the principles of a pharmacare program. Certainly for us the definition of that needs to be clarified. The first step, as I said before, is that we think the value for money with regard to access is to substantially reduce the costs for all Albertans.
NDP
Don Davies NDP Vancouver Kingsway, BC
Obviously, a national formulary with national bulk buying would be one factor that would, obviously and logically, help to reduce costs.
