In 2004, Canada’s provincial and federal governments created the National Pharmaceutical Strategy (NPS) in an effort to make prescription drugs accessible and affordable for all Canadians. Five years later, the NPS is at a standstill, says the Health Council of Canada, and only a renewed spirit of co-operation can get it back on track.
A key element in the 2004 health accord that saw a major injection of new federal money into Canada’s healthcare system, the NPS’s main directive was to address the issue of catastrophic drug coverage—the amount a patient must pay for steep drug costs—and all stakeholders agreed to work to that end. However, that is not where the strategy stands today.
“There was an unprecedented level of commitment and cooperation among governments when the strategy first started,” says Dr. Alex Gillis, a councillor with the Health Council of Canada. “But then governments changed, and progress stalled.”
In September 2008, provincial and territorial ministers of health announced that they had done all they could do on their own and asked for federal leadership and cost-sharing measures to complete the task.
“This impasse needs to be resolved,” says Health Council of Canada chief executive officer John Abbott. “Although there have been some achievements under the NPS, most of the promised reforms have still not happened.”
Along with catastrophic drug costs, the NPS’s mandate includes reducing the cost of prescription drugs—which are higher in Canada compared to most countries—and improving the safety of the drug supply by eliminating medical errors.
“Medication errors cost the health system billions of dollars in unnecessary hospitalizations,” says Dr. Ian Bowmer, vice-chair of the Health Council of Canada. He explains that simple mistakes such as illegible handwritten prescriptions result in 3% to 9% of hospital admissions.
“We recognize that finding the funding for this will be difficult in the current economy,” said Bowmer. “But in our view, a changing economy does not exonerate government from fulfilling a critical commitment.”
According to Gillis, Canadians assume they’re receiving safe and effective medications from their doctors.
“That’s not always the case,” he says. “Too many people receive the inappropriate medication. They may get the wrong dose, or they may have drugs that react with other prescription medications in ways that cause unforeseen complications.”
Gillis cites a 2007 survey in which 6% of Canadian adults said they had been given the wrong medication or wrong dose in the past two years.
“The health council is disappointed that the NPS has not delivered on its promises,” says Abbott. “There have been some advances, such as the recently announced Drug Safety and Effectiveness Network, which will collect information on new medications after they are released on the Canadian market. However, the primary objective of the NPS, which is affordability of required drugs for all Canadians, has not been attained.”
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