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Bill C-64

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First Session, Forty-fourth Parliament,

70-71 Elizabeth II – 1-2 Charles III, 2021-2022-2023-2024

HOUSE OF COMMONS OF CANADA

BILL C-64
An Act respecting pharmacare
Reprinted as amended by the Standing Committee on Health as a working copy for the use of the House of Commons at Report Stage and as reported to the House on May 28, 2024

MINISTER OF HEALTH
91171


RECOMMENDATION

Her Excellency the Governor General recommends to the House of Commons the appropriation of public revenue under the circumstances, in the manner and for the purposes set out in a measure entitled “An Act respecting pharmacare”.

SUMMARY

This enactment sets out the principles that the Minister of Health is to consider when working towards the implementation of national universal pharmacare and obliges the Minister to make payments, in certain circumstances, in relation to the coverage of certain prescription drugs and related products. It also sets out certain powers and obligations of the Minister — including in relation to the preparation of a list to inform the development of a national formulary and in relation to the development of a national bulk purchasing strategy — and requires the Minister to publish a pan-Canadian strategy regarding the appropriate use of prescription drugs and related products. Finally, it provides for the establishment of a committee of experts to make certain recommendations.

Available on the House of Commons website at the following address:
www.ourcommons.ca


1st Session, 44th Parliament,

70-71 Elizabeth II – 1-2 Charles III, 2021-2022-2023-2024

HOUSE OF COMMONS OF CANADA

BILL C-64

An Act respecting pharmacare

Preamble

Whereas the Government of Canada recognizes that quality health care, including access to prescription drugs and related products, is critical to protecting and promoting the health and well-being of Canadians;

Whereas the Government of Canada plays an important role in ensuring that prescription drugs and related products are safe, effective and of high quality;

Whereas the Government of Canada acknowledges that when Canadians do not have their prescriptions filled for financial reasons, their health may worsen, which can lead to increased use of the health care system and increased health care costs;

Whereas the Government of Canada recognizes the role of the provinces, territories and Indigenous peoples in the provision of health care, including coverage for prescription drugs and related products, and is committed to collaborating and maintaining partnerships with them to support their efforts to improve the accessibility and affordability of prescription drugs and related products;

Whereas the Government of Canada provides, within federal jurisdiction, health care services, including coverage for prescription drugs and related products, to certain populations;

Whereas the Government of Canada recognizes that the Advisory Council on the Implementation of National Pharmacare as well as several studies have recommended establishing universal, single-payer, public pharmacare in Canada;

Whereas the Government of Canada is committed to continued collaboration with the provinces, territories, Indigenous peoples and other partners and stakeholders on the step-by-step implementation of national universal pharmacare, which is to be guided by the Canada Health Act and carried out in accordance with the recommendations of the Advisory Council on the Implementation of National Pharmacare;

Whereas the Government of Canada recognizes the importance of modernizing the health care system with standardized health data and digital tools, such as electronic prescribing, to support better health outcomes and greater efficiency of the health care system;

Whereas the Government of Canada is collaborating with the provinces and territories and other partners and stakeholders to support the work of the Canadian Drug Agency to improve coordination within the pharmaceutical system in Canada and better prepare it for the future;

And whereas the Government of Canada has launched the National Strategy for Drugs for Rare Diseases to improve the accessibility and affordability of those drugs for Canadians;

Now, therefore, His Majesty, by and with the advice and consent of the Senate and House of Commons of Canada, enacts as follows:

Short Title

Short title

1 This Act may be cited as the Pharmacare Act.

Definitions

Definitions

2 The following definitions apply in this Act.

Indigenous peoples has the meaning assigned by the definition aboriginal peoples of Canada in subsection 35(2) of the Constitution Act, 1982.‍ (peuples autochtones)

Minister means the Minister of Health.‍ (ministre)

pharmacare means a program that provides coverage of prescription drugs and related products.‍ (régime d’assurance médicaments)

pharmaceutical product means a prescription drug or related product that is funded, in whole or in part, through a pharmacare agreement to which the Government of Canada is a party.‍ (produit pharmaceutique)

Purpose and Principles

Purpose

3 The purpose of this Act is to guide efforts to improve, for all Canadians, the accessibility and affordability of prescription drugs and related products, and to support their appropriate use, in collaboration with the provinces, territories, Indigenous peoples and other partners and stakeholders, with the aim of continuing to work toward the implementation of national universal pharmacare. Its purpose is also to support the development of a national formulary of essential prescription drugs and related products and to provide for the development a national bulk purchasing strategy.

Principles

4 The Minister is to consider the following principles and the Canada Health Act when collaborating with provinces, territories, Indigenous peoples and other partners and stakeholders with the aim of continuing to work toward the implementation of national universal pharmacare:

  • (a) improve the accessibility of pharmaceutical products, including through their coverage, in a manner that is more consistent across Canada;

  • (b) improve the affordability of pharmaceutical products, including by reducing financial barriers for Canadians;

  • (c) support the appropriate use of pharmaceutical products — namely, in a manner that prioritizes patient safety, optimizes health outcomes and reinforces health system sustainability — in order to improve the physical and mental health and well-being of Canadians; and

  • (d) provide universal coverage of pharmaceutical products across Canada.

Funding

Funding commitment

5 The Government of Canada commits to maintaining long-term funding for the provinces, territories and Indigenous peoples to improve the accessibility and affordability of pharmaceutical products, beginning with those for rare diseases. The funding for provinces and territories must be provided primarily through agreements with their respective governments.

Payments

6 (1) The Minister Insertion start must Insertion end , if the Minister has entered into an agreement with a province or territory to do so, make payments to the province or territory in order to increase any existing public pharmacare coverage — and to provide universal, single-payer, first-dollar coverage — for specific prescription drugs and related products intended for contraception or the treatment of diabetes.

For greater certainty

(2) For greater certainty, any agreement referred to in subsection (1) with a province or territory is to provide for first-dollar coverage to patients.

Payment out of C.‍R.‍F.

(3) Any amount payable under subsection (1) may be paid by the Minister out of the Consolidated Revenue Fund at the times and in the manner, and on any terms, that the Minister considers appropriate.

Minister’s Powers and Obligations

Request for advice

7 The Minister Insertion start must Insertion end seek advice from the Canadian Drug Agency on

  • (a) the clinical effectiveness and cost-effectiveness of prescription drugs and related products compared to other treatment options;

  • (b) the prescription drugs and related products that should be included in prescription drug coverage plans in Canada and the conditions of that coverage;

  • (c) the collection and analysis of data on prescription drugs and related products;

  • (d) information and recommendations to be provided to health care practitioners and patients on the appropriate use of prescription drugs and related products; and

  • (e) improvements to be made to the pharmaceutical system, including through greater coordination between health system partners, patients and other stakeholders.

National formulary

8 (1) The Minister must, after discussions with the provinces and territories, request that the Canadian Drug Agency prepare, no later than the first anniversary of the day on which this Act receives royal assent, a list of essential prescription drugs and related products to inform the development of a national formulary that will establish the scope of prescription drugs and related products to which Canadians should have access under national universal pharmacare.

Discussions

(2) The Minister must, after the list referred to in subsection (1) has been prepared, initiate discussions based on the list with provinces, territories, Indigenous peoples and other partners and stakeholders with the aim of continuing to work toward the implementation of national universal pharmacare.

National bulk purchasing strategy

9 The Minister must, after discussions with the provinces and territories, request that the Canadian Drug Agency develop, in collaboration with partners and stakeholders and no later than the first anniversary of the day on which this Act receives royal assent, a national bulk purchasing strategy for prescription drugs and related products to support the principles set out in paragraphs 4(a) to (d).

Appropriate Use Strategy

Publication

10 (1) The Minister must, no later than the first anniversary of the day on which this Act receives royal assent, publish on the website of the Department of Health a pan-Canadian strategy regarding the appropriate use of prescription drugs and related products.

Progress reports

(2) The Minister may, after discussions with the provinces and territories, request that the Canadian Drug Agency prepare, no later than the third anniversary of the day on which the strategy is published and no later than every three years following that anniversary, a report on the progress made in advancing that strategy.

Committee of Experts

Committee of experts

11 (1) The Minister must, no later than 30 days after the day on which this Act receives royal assent, establish a committee of experts, and provide for its membership, to make recommendations respecting options for the operation and financing of national, universal, single-payer pharmacare.

Report

(2) The committee must, no later than the first anniversary of the day on which this Act receives royal assent, provide a written report to the Minister setting out its recommendations.

Tabling of report

Start of inserted block

(3) The Minister must cause a copy of the report to be tabled in each House of Parliament on any of the first 20 days on which that House is sitting after the day on which the Minister receives the report.

End of inserted block
Published under authority of the Speaker of the House of Commons

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