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By Susan Martinuk
Research associate
Frontier Centre for Public Policy

The Liberal federal government made a pre-election promise to establish a single, universal pharmacare program that would cover all, or most, of the costs of prescription drugs for Canadians.

The idea has been discussed for decades, but the public conversation has rarely gone beyond unproven hopes that it will save billions of dollars and that it’s the only way to save those who fall through the cracks of existing programs and can’t afford to pay for their medications.

As the conversation has stayed within these parameters, Canadians have been enthusiastic about pharmacare, with oft-quoted polls showing the support of more than 90 per cent.

However, one poll suggests there may be diminishing support (67.8 per cent) for the idea, even as it comes closer to becoming a reality.

Some of this hesitation may be a result of recent news stories that have provided Canadians with much-needed education about some of the issues associated with maintaining our national drug supply. We are becoming increasingly aware that our prescription drug supply is far from secure. In fact, it is tenuous and unstable at best.

The news headlines have primarily focused on our ongoing problem with drug shortages. Recently, it was nifedipine, a common pill used to treat blood pressure and angina. In early August, it was three chemotherapy drugs; their scarcity has meant that cancer specialists have had to find alternate medications and/or piece together treatments that, ultimately, may prove to be substandard.

Frustrated oncologists have gone directly to the media to inform Canadians about the issue and encourage them to  pressure the government and drug producers to find a permanent solution to such shortages, saying, “It’s not really clear that any efforts are being made to solve this problem in a more permanent way.”

In early August, the Canadian Pharmacists Association wrote an open letter to Prime Minister Justin Trudeau, warning that there have been “significant increases” in drug shortages over the past three to five years.

Those shortages were emphasized by media coverage of prescription drug caravans – Americans who routinely cross the border to purchase their medications from Canadian pharmacies at significantly lower prices.

Those concerns were multiplied as the U.S. announced a grand plan to allow wholesalers, distributors and pharmacies to make bulk purchases of cheaper drugs in Canada, for resale in the United States. Sixteen states have already created such legislation and, once they gain federal support, are prepared to raid our medicine chest.

All of the above has happened while Trudeau assures Canadians that they have a “steady and solid supply” of prescription drugs (there are 1,848 drugs currently on the drug shortage list for Canada), and that our federal government remains focused on a pharmacare program and creating new rules to restrict drug company profits.

It appears our government has far more urgent issues to resolve than creating a bureaucracy to dispense free medications. After all, free prescription drugs won’t mean a thing if Canadians can’t access the drugs they need.

Aside from sudden, unexpected demands for a particular drug, there has to be a better way to manage our drug supply.

With today’s advanced technology and the fact that many of the drugs in short supply have been produced for years, it’s difficult to accept that we still can’t predict, prepare for and prevent drug shortages. It’s called supply chain management.

So where is the primary problem? A shortage of ingredients? Manufacturing issues? Delays in shipping? Or drugs that go off patent and are quietly discontinued?

Before there is any further conversation about pharmacare, we need to know the answers to these questions.

For that reason, the Canadian Pharmacists Association also encouraged Trudeau to take the lead in determining the causes of our medication shortages and developing a plan to secure our drug supply chain.

Right now, it’s the best – and most important – thing the government can do to ensure Canadians can access prescription drugs.

Perhaps the most frustrating problem in all of this is the cost. Once again, valuable health-care dollars are shuffled away from patient care and used to resolve administrative problems.

Susan Martinuk is a research associate with the Frontier Centre for Public Policy.

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