On October 10, 2024, the Senate voted to pass Bill C-64, An Act respecting pharmacare ("Bill C-64") into law. This is an update to our previous bulletin titled, "Federal Pharmacare Bill Proposes Universal Drug Coverage" on Bill C-64, An Act respecting pharmacare.
Bill C-64 passed through the Senate's social affairs, science and technology committee without amendments on October 3. On October 10, it proceeded to pass the third and final vote on the Senate's floor.
Originally tabled on February 29, 2024, Bill C-64 outlined the first phase of the federal government's commitment to national universal pharmacare by providing universal, single payer coverage for certain drugs through collaborative agreements with willing provinces and territories.
To this end, Bill C-64 proposed to provide universal single-payer, first-dollar coverage for two categories of medicines: contraceptives and diabetes treatments. The lists of diabetes medications and contraceptives to be discussed with provinces and territories for specific coverage were also published by the government. Bill C-64 permits the Minister of Health to seek the advice of the recently created Canadian Drug Agency on a number of topics, including the prescription drugs and related products that should be included in drug coverage plans in Canada, as well as the conditions of such coverage.
Health Minister Mark Holland ("Holland") estimated the cost of the first phase of pharmacare to be $1.5 billion.1
Following the announcement by Holland and British Columbia Minister of Health Adrian Dix in September, British Columbia signed a Memorandum of Understanding with the federal government, becoming the first province to opt into the federal pharmacare program. Since British Columbia already provides free oral contraceptives under its existing provincial plan, federal funding will instead provide free treatments for menopausal symptoms with hormone replacement therapy ("HRT"), in addition to diabetes treatments. Holland indicated that British Columbia's share of funding is estimated at $195 million of the $1.5 billion national plan.
There have been mixed responses from the other provinces.
Alberta2 and Quebec3 have clearly indicated their intention to opt out of the national pharmacare program.
Other provinces have indicated support for the federal pharmacare program. For example, following the announcement of the Memorandum of Understanding in British Columbia in September, Manitoba's Premier Wab Kinew said that "There are so many ways [the British Columbia] government is leading the way".4 Prince Edward Island has also signaled its support, indicating that it mirrors the work being done at the provincial level.5
Other provinces, including Ontario,6 New Brunswick,7 Nova Scotia8 and Newfoundland and Labrador,9 said, when Bill C-64 was first tabled, that they felt that more information was needed before making a decision on participation.
With the passing of Bill C-64 as law, their official positions remain to be seen; Holland has said he hopes to have all provinces and territories on board by next spring.10
Footnotes
2 Alberta not aligned with federal pharmacare: provincial health minister | CBC News
3 Where every province and territory stands on the federal pharmacare bill | iPolitics
4 Hormone replacement therapy for women may be coming to Manitoba | CTV News
5 P.E.I. health minister gives thumbs up to Ottawa's pharmacare plan | SaltWire
7 Higgs government cool to Ottawa's national pharmacare proposal | CBC News
8 Where every province and territory stands on the federal pharmacare bill | iPolitics
9 Where every province and territory stands on the federal pharmacare bill | iPolitics
10 Health minister says he's on track to strike pharmacare deals with provinces by spring | CBC News
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