In a significant move toward universal drug coverage, Canada’s parliament has passed a bill that will fully cover the cost of contraception and diabetes drugs for Canadians.
The Liberal government has framed this as the initial step toward a broader national pharmacare program that will be publicly funded.
Currently, Canadians pay for prescription drugs through a mixture of private, public, and out-of-pocket plans.
According to the federal government, an estimated one in five Canadians struggle to afford these costs. The new bill aims to ease this burden, with the government covering 100% of contraception and diabetes medication costs for those without coverage, while also reducing out-of-pocket expenses for those already on drug plans.
This initiative, which is expected to increase federal spending by C$1.9 billion ($1.3bn; £1bn) over the next five years, is part of a more comprehensive plan that the government hopes will eventually extend to other essential medications.
Prime Minister Justin Trudeau celebrated the bill’s passage during his appearance at the Association of Southeast Asian Nations Summit, calling it “real progress” and urging provincial leaders to expedite negotiations to implement the program. The plan has been met with a mix of support and resistance across the country. British Columbia has already signed a memorandum of understanding with Ottawa, signaling its support. However, Alberta and Quebec have expressed hesitations, accusing the federal government of interfering in provincial jurisdiction and signaling they may opt out of the program.
Federal Health Minister Mark Holland has expressed hopes that several provinces will have agreements in place by the end of the year, with the entire country participating by next spring.
The bill is also a significant victory for reproductive health advocates. With this new plan, an estimated nine million Canadian women of reproductive age will gain access to various forms of contraception. Birth-control pills and intrauterine devices (IUDs), which typically cost between C$100 and C$300 annually, will now be available at no cost for those without coverage. The Society of Obstetricians and Gynaecologists of Canada praised the bill as a “historic achievement,” noting that it will allow women to make decisions based on what’s best for their lives, rather than financial constraints.
The program also aims to support the 3.7 million Canadians living with diabetes. The legislation will cover insulin for both type 1 and type 2 diabetes, as well as Metformin, which helps lower blood sugar levels for those with type 2 diabetes. Insulin can cost patients between C$900 and C$1,700 annually, which the government hopes to alleviate with this program.
Despite its potential benefits, the bill has faced criticism from various quarters. The Canadian Chamber of Commerce has expressed concerns that the universal, single-payer model chosen by the government may actually limit access to drugs and overburden taxpayers. Conservative leader Pierre Poilievre, whose party leads in national polls, has also voiced opposition to the bill, warning that it could violate provincial autonomy and worsen drug access.
The bill’s origins stem from a political agreement between the Liberal Party and the New Democratic Party (NDP). The left-leaning NDP initially supported the Liberals’ minority government in exchange for advancing key policies, including this national pharmacare initiative. However, the NDP pulled out of the agreement in September, heightening speculation about the possibility of an early general election ahead of the scheduled October 2025 date.
As the pharmacare program takes shape, it remains to be seen how it will be received by provinces and whether it can deliver on its promises without sparking broader political fallout.
Canadians spent C$41 billion on prescription drugs last year, with C$15 billion covered by private insurance and over C$8 billion paid out-of-pocket, according to the Canadian Institute for Health Information. With this new legislation, the government hopes to reduce those costs for millions of citizens and lay the groundwork for a more comprehensive national pharmacare system.
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