Health benefits provider GreenShield is launching a no-cost prescription drug plan that will offer underserved communities access to essential medications, saying it hopes to shape a blueprint for Canada’s national pharmacare plan.
On Thursday, GreenShield will introduce the GreenShield Cares Essential Medicines Program, a pilot project that will offer medications to low-income Canadians who do not have public or private prescription drug coverage – a gap that the company says accounts for more than one million Canadians.
Ned Pojskic, vice-president of pharmacy benefits management at GreenShield, said while 97 per cent of people in Canada have some form of coverage for essential medications, some vulnerable populations fall outside the age limits for many provincial prescription drug plans, which typically cover the elderly and some provinces’ young people under age 25.
“There is this middle cohort between 25 and 65 that, unless they are on a social assistance program, will have no formal coverage unless it comes from an employer,” Mr. Pojskic said in an interview. “From single parents working multiple jobs to keep their family afloat to widowed early retirees who no longer have dependent coverage … this means that a subset of Canadians often must choose between paying for prescription medication or meeting their basic needs.”
As well, about 29 per cent of immigrants reported having no prescription drug coverage, compared with 17 per cent of nonimmigrants, in a recent survey conducted by GreenShield.
“Many Canadians are without access to essential medicines due to lack of affordability, with those from marginalized and/or racialized groups struggling the most,” GreenShield’s chief executive Zahid Salman added.
In partnership with the Niagara Falls Community Health Centre and the Windsor Essex Community Health Centre, the pilot project will offer individuals in the Niagara and Windsor regions in Ontario up to $1,000 a year in drug coverage for an approved list of medications, including antibiotics, blood pressure and diabetes medications.
The launch of the pilot program comes in the midst of a political debate around how best to create a national universal pharmacare program by the end of 2023, a condition of the House of Commons supply and confidence agreement between the Liberals and the NDP.
Last month, the NDP pressed the Liberal government to pass a bill when it tabled the NDP’s own legislation to establish a universal single-payer pharmacare system in Canada. The single-payer system would provide a national list of prescription medicines that would be covered by the taxpayer at an estimated cost of $15-billion a year.
But Mr. Salman says the single-payer model would see individuals who have employer-sponsored plans to move onto provincial drug plans in lieu of their company benefits. Such a move, he said, would not only see employees lose access to certain drugs that are not approved by governments (provincial drug lists only cover about half the drugs a typical employer sponsored plan does), but would also shift some of the $13-billion in insurance claims that Corporate Canada currently pays as part of employee benefits.
“We absolutely agree that all Canadians should have affordable access to prescription drugs,” Mr. Salman said in an interview. “We just don’t agree that the best way to go about that is a single-payer model that would disrupt coverage for the almost 27 million Canadians who have coverage through their employers.”
Rather, he said, the government should focus on the 1 million Canadians who do not have any public or private access to drugs. GreenShield hopes to demonstrate to policy-makers that a stand-alone plan for underserved communities would be easier to implement and less expensive than what has been proposed by the NDP.
As a not-for-profit company, GreenShield administers group health benefits and pays out claims directly with no intermediary, GreenShield is able to dispense the medications for the pilot project free of charge through its own digital pharmacy, the Health Depot. An anonymous drug manufacturer is also supplying the medications at no cost.
“We have introduced a viable solution that we see as a potential blueprint for the national pharmacare model,” said Mr. Salman.
The Liberals have yet to announce their plans in response to the NDPs’ move last month. In the meantime, Mr. Salman plans to expand his pilot project and has already started discussing it with certain levels of government, but says it is a model that will need funding assistance as it grows.
“There is only so much we can do on our own, but now we have an alternative plan that the government can put their arms around, help shape and improve,” Mr. Salman said. “Because we firmly believe that access to essential medicine is a fundamental human right.”