Ensuring Pharmacare delivers fair access for all and innovation
As originally published in The Hill Times Policy Briefing on May 14, 2025, by Dr. Bettina Hamelin President, Innovative Medicines Canada.
No one should ever have to choose between buying groceries for their family and filling their prescription. That’s the promise at the heart of Canada’s Pharmacare Act, which aims to give all Canadians access to essential medications.
It’s an ambitious goal, but if we don’t work together now to make a few changes, the pharmacare plan could come with unintended side effects for Canadians—ones that would restrict access to new, innovative drugs and treatment choices.
The main reason is in the program’s structure. The federal government is moving ahead with a single-payer system for prescription drugs, starting with diabetes medications and contraceptives. The problem is, 97.2 per cent of Canadians already have some form of drug coverage. Moreover, approximately 24 million Canadians have employer-sponsored plans that often give them quicker, broader access to innovative treatments than public programs do.
If those private plans are replaced or scaled back to match a more limited national list of approved drugs under Pharmacare, millions of Canadians could have fewer treatment options and longer wait times for new therapies.
As the president of Innovative Medicines Canada (IMC), I’ve seen heartbreaking consequences for Canadians who are forced to wait for drugs that are already improving outcomes for patients in other countries. Canadians already wait longer than anyone in the G7 for access to new drugs.
Consider this: Once Health Canada approves a medication, it takes an average of 736 days for patients on public plans to receive it, due to a longer process for drug approval. Compare that to just 226 days for those on private plans. For someone living with ALS or an aggressive cancer, those extra months aren’t just numbers on a spreadsheet—they’re lost chances.
So how can we structure and build on the new pharmacare plan to ensure no one falls through the cracks? At IMC, we proposethat instead of replacing systems that are already serving most Canadians well, we focus on building up systems that aren’t working for Canadians in need.
This is what Prince Edward Island did in 2021, when the province partnered with the federal government to reduce out-of-pocket drug costs and improve access through a tailored agreement. This “fill-in-the-gaps” approach focused resources where they were needed most—and it worked. It’s a model we can replicate across the country.
A major concern I have is that a national list of approved medications will ultimately restrict access to cutting-edge therapies in the name of cost control. Newer or niche drugs will likely be excluded from the list early on. This might not be because they don’t work, but because they’re more expensive. Up to 1,400 drugs could be excluded compared to current plans, according to a 2023 Parliamentary Budget Office report. By allowing those with private insurance to keep their coverage while helping those without, the plan could provide a broader list of approved drugs, making it more cost-effective.
IMC’s member companies discover, develop, and deliver medications. Collectively, we have a vast amount of unique knowledge that would be invaluable to Canada’s pharmacare plan as it is structured and rolled out. Leaving pharmaceutical companies out of the discussion is a missed opportunity. We have insights on global pricing, innovation pipelines, and regulatory strategies that could help make pharmacare stronger and smarter. We can explain how to:
- Expand fast-track reviews for high-priority treatments
- Work with trusted international regulators to speed up approvals and access
- Use real-world data to support quicker, evidence-based decisions
- Modernize Health Canada’s infrastructure so it can keep pace with innovation
Pharmacare doesn’t have to mean choosing between access for all or innovation. We can have both if we design the system thoughtfully.
We deserve no less.
