Sun Life proposes national pharmacare model

By Kate McCaffery | October 29 2018 11:30AM

Photo: Freepik

In Budget 2018, the federal government established an advisory council to provide independent advice on how best to implement a national pharmacare program for Canadians. Sun Life Financial put one proposed model forth in a paper recently, entitled National Pharmacare: Getting It Right.

“The best solution for Canadians is not one based on a single payer model, but rather one that builds on the strength and assets of both the private and public sectors,” writes Jacques Goulet, president of Sun Life Financial Canada.

Using the wrong model, he says, could result in a number of unintended consequences for Canadian consumers including the loss of workplace supplementary health benefits (paramedical services) and a significant reduction in the number of medicines for which they are currently covered.

Risk of job losses

In addition to employers losing the value of supplementary health benefits to attract and retain employees, within the industry, he says the wrong national pharmacare program could also result in significant job losses in group benefits advisory firms and brokerages across Canada and reduced private sector investment in patient support technology.

Adding its voice to the national debate, the Sun Life paper proposes a solution where all Canadians are covered under a standard formulary used by both public and private insurance plans. It also calls on the government to provide catastrophic coverage for those in need of high cost treatments which are difficult for many employer-sponsored plans to cover.

Finally, it says private insurers need a seat at the negotiating table – the pan-Canadian Pharmaceutical Alliance (pCPA) which facilitates the joint negotiation of prescription medicine prices, to ensure the lowest prescription medicine costs for all. (Currently the pCPA only negotiates prescription medicine prices for provincial, territorial and federal governments).

Private sector plays a critical role

“We cannot ignore that the current system is working well for Canadians. 98 per cent have access to public and/or private coverage and most enjoy affordable access to a broad range of prescription medicines. The private sector plays a critical role in this system, covering 25 million Canadians and almost 40 per cent of total prescription medicine costs, mostly through workplace benefits,” say the report’s authors.

“In this paper we outline a solution that is affordable and effective in extending coverage to all Canadians while also protecting the workplace health benefits that millions of employees and their families rely on. This is not a single payer solution, but one where private and public sectors work together.”

To learn more, consult the paper here.