May 3, 2024: Equity Must be the Priority for National Pharmacare

You might not believe it, but debate about pharmacare predates the implementation of our globally recognized public healthcare system and the 1984 Canada Health Act. When the topic of national pharmacare made a resurgence in 2018, the Canadian Breast Cancer Network (CBCN) continued advocacy for an equitable and comprehensive approach to national prescription drug coverage. We have advocated that a national plan should provide Canadians with better access to life-saving medications than they currently have and improve equity of access nationally.

To this end, the newly announced legislation for a universal, single-payer, phased approach is a welcomed first step towards improving access to medications for Canadians. Although not directly related to oncology, covering the cost of diabetes medication and contraceptives is still a win for Canadians affected by breast cancer. For example, diabetes management can be an important part of breast cancer treatment because patients with diabetes are more likely to develop breast cancer, and some breast cancer treatments may increase the risk of type 2 diabetes. What’s more, access to contraceptives represents a significant victory in women’s health. Yet, in our calls to action regarding pharmacare, it has always been with the intention of bolstering equity and improving access to breast cancer treatments – two things the pharmacare act fails to concretely do.

Public funding for breast cancer treatment varies significantly by province, and research has shown that prescription drug costs can vary by more than $500, depending in which province a patient lives. As a result, the 1 in 8 Canadians who will be diagnosed with breast cancer face uncertainty about how some of their medicines will be funded, and some are more vulnerable to these variabilities than others. In our 2023 TNBC report, nearly 17% of triple negative breast cancer patients (TNBC), a rarer subtype of breast cancer, reported that cost prevented them from taking prescribed medicines. This was a statistically significant difference compared to those diagnosed with subtypes of breast cancer other than TNBC. This means the current state of varied funding has a greater financial impact on people with TNBC, which has fewer treatment options to begin with.

With the announcement of pharmacare legislation, Canadians have the chance to consider whether to view access to medicines as a pillar of healthcare, or simply an add-on service. We remain hopeful that the legislation will rekindle Canadian values of affording people access to healthcare based on need, not ability to pay. At the same time, considering how some provinces have already stated their intention to opt-out of the national plan, it leaves one to wonder when our current patchwork of coverage will truly be addressed.

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