Thank you very much.
Heart and Stroke applauds the Government of Canada and Parliament for introducing Bill C-64, which will lay the groundwork for equal access to life-saving drugs for all.
People in Canada appreciate our universal health care system, but the reality is that Canada is the only country with medicare that does not include prescription drugs as part of its universal health care program. The current patchwork of public and private plans in Canada has created fragmented drug access, leaving millions struggling to afford their prescription medications. I don't think there's any disagreement with this.
While many people in Canada have some form of drug coverage, it is often insufficient and poses affordability issues. The 2019 Hoskins report indicated very clearly that 7.5 million people in Canada had either no coverage or insufficient drug coverage.
As well, the 2021 survey on access to health care and pharmaceuticals during the pandemic found, once again, that one in five people did not have insurance to cover any of the cost of their prescription medications in the previous year.
Furthermore, a poll commissioned by the Heart and Stroke Foundation and the Canadian Cancer Society in 2024 found that one in five people in Canada do not have sufficient prescription drug coverage. One in four had to make difficult choices to afford prescription drugs, such as cutting back on groceries; delaying paying rent, mortgage or utility bills; and incurring debt. The same poll also found that one person in 10 in Canada who had been diagnosed with a chronic health condition was more likely to visit the ER due to a worsening health issue because they were not able to afford their prescription medications.
A study in 2016 also found that 16% of people in Canada went without medication for heart disease, cholesterol and high blood pressure because of cost.
With the introduction of this bill, the foundation is being laid for the first phase of national universal pharmacare through single-purchaser coverage of diabetes and contraceptive medications. This will ultimately provide equal drug coverage for all people in Canada, regardless of their gender, race, geography, age or ability to pay.
We do feel that this needs to be expanded in the future to cover drugs for heart disease and stroke. The reality is that millions of people in Canada live with heart disease and rely on daily prescription medicines to help keep them alive and to manage their conditions at home. In fact, in 2022, 105 million prescriptions were dispensed for cardiovascular diseases, making it the second-highest disease category for prescriptions.
Universal coverage of essential medicines will reduce pressure on the health system by cutting costs, because treating a condition such as high blood pressure, which is a leading risk factor for stroke, is more cost-effective for our health care system than the specialized care required to save a life after a stroke.
The Heart and Stroke Foundation has made a number of recommendations for amendments in its submission, but I would like to highlight one today. It pertains to subclause 8(1), regarding a national formulary.
We recommend that a definition be inserted here for “essential medicines”. In particular, essential prescription drugs should initially be defined as those included in the CLEAN meds trial. That's one way to define essential medicines.
We feel that the government must take quick action to close the gap in coverage that leaves out essential medicines for chronic diseases, including heart disease and stroke, that affect many in Canada. We also recommend that the minister prioritize the signing of bilateral agreements with provinces and territories in tandem with the progression of the bill and to pass this bill before the House adjourns for the summer.
Finally, I would like to address some other key points and misinformation about pharmacare. The reality is that the federal government, as a single drug purchaser, would be able to negotiate much lower prices compared to the myriad private and public plans. This would have a significant deflationary impact on the average drug price.
We heard comments earlier on about bulk purchasing. It's very well known in the world of business procurement that a company that buys 100,000 widgets from a manufacturer is going to get a much better price per widget than is a company that buys five widgets per year from the manufacturer. The reality of bulk purchasing and the fact that it leads to lower prices is well known throughout the world. In New Zealand and Australia, with respect to drug purchasing, or even just in general if you look at Costco, bulk purchasing leads to lower prices.
Another point is the notion that coverage is going to be decreased through a national pharmacare program. In fact, it's going to be the opposite. We're going to get enhanced coverage. The reality is that we have 7.5 million people who have no coverage or inadequate coverage. The objective is to increase coverage for those people. It's just not a reality that we're going to get reduced coverage. If the government, the federal payer, is covering a diabetes generic drug, whether that's in the private plan, the public plan or the federal plan, it doesn't matter: It's going to be covered one of those three ways. I don't foresee a reduction in potential coverage. It's the opposite. We're aiming for the opposite.
To conclude, the Heart and Stroke Foundation applauds the federal government and Parliament for the introduction of this legislation and for proposing an affordable plan that will give 7.5 million uninsured and under-insured people access to prescription drugs for diabetes and contraception. We really hope that in the future this can be increased and expanded. As my colleague mentioned, I think we do want an expansion of this formulary in the future, but this is a good start.
Thank you very much.