Dear Eric Hoskins: Here’s my wish list for national pharmacare in Canada

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  • Jane Hilliard says:

    Thanks for this, Cynthia. Working in pediatrics, the implementation of OHIP+ has provided a glimpse into what might work for universal pharmacare.I think it works well for those who had no drug coverage prior to implementation, but it has been problematic for those on “off-label” high-cost medications that were previously covered by private insurance along with patient assistance programs. And I entirely agree with the need to cover all strengths of a drug. We have a patient who needs to take thirty 2.5 mg Methotrexate tablets once a week because the 10 mg tablets aren’t covered by ODB. It complicates medication adherence and compromises patient safety.

  • Shawn Tracy says:

    Terrific wish list! I would only add that, as pharmacists become better integrated into primary care settings, it would be ideal if existing (and future) community-based medication review programs (such as MedsCheck in Ontario) were likewise better integrated with the primary care providers on whose shoulders falls the near-impossible task of managing the ever-growing number of meds being consumed.

    Oh, and it would also help if the work of Dr. Hoskins and the national pharmacare advisory council was not already being undermined by the federal Finance Minister. This should not be too much to ask.

    • Chris Bonnett says:

      Finance Minister Morneau’s comments were largely consistent with the initial Terms of Reference set by the Privy Council. The Advisory Council would advise the Ministers of Health and Finance “on how to best implement national pharmacare in a manner that is affordable for Canadians and their families, employers and governments.”

  • Chris Bonnett says:

    A helpful article that identifies some important considerations. Pharmacists clearly have an important role to play. Recognizing every group has their needs and biases, I think all stakeholders (point 10) can play a constructive role.

    So much of what national pharmacare will become depends on what problems we’re trying to solve. The need for common definitions and discussion on many contentious issues, such as principles, policy goals, scope of coverage, a role for private insurance and funding is already clear. Unfortunately, it seems as if positions are hardening even before Council members have been named and the terms of reference set. If we can’t find common ground quickly, the window will close and pharmacare will be back on the shelf.

  • michael gordon says:

    Develop a system whereby dosing can be done without wasting medications of the wrong dose–complex challenge but anyone who is being titrated on a medication understand how much waste can occur.

  • Cynthia Sunstrum says:

    Well stated!!

  • Paul Demenok says:

    Good article. I would add that there should be some opportunity for flexibility. Some patients can not tolerate a particular drug, but may do very well on another drug from the same class (eg., proton pump inhibitors, beta blockers, cholesterol lowering agents). Patients should have options within drug classes, managed by their MD.


Cynthia Leung


Cynthia Leung works as a pharmacist at Queen’s Family Health Team in Kingston, Ont. She is passionate about optimizing medication use in primary care and geriatrics and shares ideas and opinions on how medications are used in our healthcare system in her blog, Drugopinions.

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