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NDP Leader Jagmeet Singh holds a press conference on Parliament Hill in Ottawa on Feb. 13.Sean Kilpatrick/The Canadian Press

The federal government is considering covering the costs of birth control as part of its negotiations with the NDP on new pharmacare legislation, according to sources with direct knowledge of the secret talks.

Three sources told The Globe and Mail that the possible birth-control funding is in addition to coverage for diabetes medications, which is also being discussed. The Globe reported in December that drugs to treat the chronic disease could be covered under a deal.Negotiators are discussing how many drugs to cover and how to determine which drugs qualify, two of the sources said.

For example, under contraceptives, a source said negotiations continue over whether the government would only cover pills or whether intrauterine devices (IUDs) would also be covered.

The Globe is not identifying the sources because they were not authorized to discuss the sensitive negotiations.

The Liberals struck a deal with the NDP almost two years ago to prop up their minority government in the House of Commons. Under what’s called a supply-and-confidence agreement, the NDP supports the Liberals in the House in exchange for policy concessions such as anti-scab legislation, dental care and pharmacare legislation. However, the talks on pharmacare appear to be going beyond what the Liberals initially agreed to.

The March, 2022, deal included no stipulations that the government put cash toward the pharmacare pledge; instead, it promised to table and pass legislation by the end of 2023 and then develop a national formulary of essential medicines and a bulk purchasing plan by the end of the agreement. When the NDP agreed to extend the deadline for the legislation to March 1, they said they expected to get more from the government in exchange for the concession.

One source said direct funding for some medicines is the quid pro quo for agreeing to push back the timeline.

With just two weeks to go before the revised deadline, NDP Leader Jagmeet Singh has been ramping up the public pressure on the Liberals as negotiations come down to the wire. He maintains the deal won’t survive if the Liberals don’t acquiesce to NDP demands on pharmacare. Cabinet ministers, though, have repeatedly said they believe a deal will be reached, and two sources told The Globe this week that they believe an agreement is in sight.

One source said meaningful progress is being made toward covering treatment under the two categories of diabetes and contraception; however, they said the NDP is pushing for more categories of medications to get federal funding.

In December, The Globe reported that government officials have done various cost analyses as part of the negotiations. At the time, a source said supplying diabetes drugs alone would cost $1-billion annually.

The Conservatives have not previously supported pharmacare. When asked to comment on the possibility of direct birth control and diabetes medication coverage, the party did not provide comment Wednesday.

Bloc Québécois Leader Yves-François Blanchet told reporters on Parliament Hill that his party will support nothing that infringes on Quebec’s jurisdiction. Provincial governments hold direct responsibility for health care.

The NDP first called for public coverage of contraception almost two years ago. In 2022, Mr. Singh described birth control as an essential medicine that is prohibitively expensive for people who don’t have private insurance.

Last year, British Columbia became the first province to cover the costs of prescription contraception. The Manitoba government announced it would do the same last fall. Those provinces are the only two with NDP governments.

IUDs can cost anywhere from $300 to $500, according to Planned Parenthood Toronto. A single device can provide contraception for up to five years. Private drug plans often cover a portion of the cost. It’s also covered for some people through public plans such as Ontario’s OHIP+.

A 2019 report from researchers with the University of British Columbia faculty of medicine said birth-control pills can cost women as much as $50 a month, depending on the brand and insurance coverage.

Canada is the only country with universal health care that does not also have universal pharmacare.

Currently, Canadians pay for prescription drugs through extended workplace health plans, privately purchased plans or out of pocket. Government drug plans are typically reserved for people with low incomes, seniors and those with catastrophically high drug bills.

In 2019, Eric Hoskins chaired a pharmacare advisory council that recommended Ottawa establish a universal, single-payer, public system for prescription drug coverage. The council’s report said such a program would cost $15.3-billion a year if fully implemented in 2027.

Last year the Parliamentary Budget Officer estimated that, once fully implemented, a single-payer, universal pharmacare program would cost $38.9-billion a year. However, given how much is already spent in public plans and direct federal drug costs, the incremental additional cost of a universal program was estimated at $13.4-billion.

The Heart & Stroke Foundation and the Canadian Cancer Society on Wednesday urged the federal government to introduce national pharmacare.

“Too many loved ones are carrying a heart-wrenching secret: They can’t afford to pay for critical prescriptions,” said Heart & Stroke chief executive officer Doug Roth. “It’s time for the federal government to step up.”

A Leger poll conducted in December showed that Canadians do not believe creating a new pharmacare program is as important as other health care priorities. If Ottawa has additional funding available, the survey respondents said, the top three priorities should be reducing surgical waiting times, improving senior care and expanding mental-health services.

A universal pharmacare program was ranked sixth out of eight priorities by respondents in the poll.

The online poll had 1,622 respondents. The Globe does not report the margin of error for online polls because such surveys are not considered truly random samples.

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