Work of St. Michael’s researchers cited in report as “a starting point” for federal government to implement pharmacare

By Jennifer Stranges

A much-anticipated report prepared for the federal government on the future of pharmacare in Canada cites the CLEAN Meds study, a project by St. Michael’s Hospital researchers, as “a starting point” for determining which drugs all Canadians should have free access to.

Millions of Canadians could not afford one or more of their prescription drugs last year, and according to Dr. Nav Persaud, a family physician and a scientist at St. Michael’s MAP Centre for Urban Health Solutions, the solution is clear and so are our next steps.

We connected with Dr. Persaud to chat about how his research was included in the report, “A Prescription for Canada: Achieving Pharmacare for All, the Final Report of the Advisory Council on the Implementation of National Pharmacare,” and the recommendations made for implementing universal, single-payer, public pharmacare in Canada.

The CLEAN Meds study, of which you are principal investigator, was one of two lists of essential medicines that the report recommends the Canadian Drug Agency use as a starting point for determining which drugs should be funded for all Canadians. Tell us a bit about your study and its objectives.

The study tests the effects of providing patients with free and convenient access to a carefully selected set of medications. This is a randomized controlled trial where half of the participants are randomly put into the group that gets free medications, while the other half are randomly put into the group that has their usual access to medications. By comparing people in the two groups we can determine the effects of free and convenient access to medications on whether or not people take their medications as instructed, whether the medications are prescribed properly, how well diseases are controlled, and costs.

We developed the list of essential medications by taking the list of essential medicines published by the World Health Organization and removing treatments not needed in Canada through peer review by clinicians.

How rewarding is it to see your work acknowledged and used to potentially influence policy, the health care system, and the health outcomes of Canadians?

This is very rewarding as a researcher. We often write articles that only a small number of people read or are interested in. It’s very heartening for a government report to mention our work. We only hope that this will lead to improvements so people can access the medications they need. Ultimately, we’re pleased with the report and with the mention of our study, but this comes in the lead up to an election and will only have its desired effects if implemented.

The report predicts it would cost governments an additional $15.3 billion annually (by the time it is implemented in 2027). What are your thoughts on the predicted costs?

We are paying more now. This is not a case of finding new money. The difference is that we’re paying in ways that are hard to see – inflated insurance premiums, emergency department visits. The implementation of this report would lead to the end of overpayment of prescription medications, and people returning to their doctor with the same problems because they cannot afford their prescribed treatment.

Insulin was discovered in this country almost 100 years ago, but right now there are people who can’t afford insulin. The consequences can be amputation, stroke or death. It’s best to keep people healthy so they don’t end up in the hospital with a heart attack that costs tens of thousands of dollars to treat.

The chair of the report, Dr. Eric Hoskins, said that universal health care can be this generation’s legacy, but this report will only have its intended outcome if it’s implemented by the federal government elected in October 2019. What is your hope for the future of Canadian health care?

The problem is clear. People are suffering because they can’t afford their prescriptions. The best approach is also clear. Canadians should receive needed medicines with the same health card that allows them to visit their family doctor or see a doctor at a hospital. This has been recommended in multiple government and academic reports over decades. The ideal circumstance is that every political party includes a clear commitment to implementing the needed change. I hope that in the fall we have a government that is clearly committed to implementing pharmacare and making sure that access to medication is fair and equitable.

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

About Unity Health Toronto

Unity Health Toronto, comprised of Providence Healthcare, St. Joseph’s Health Centre and St. Michael’s Hospital, works to advance the health of everyone in our urban communities and beyond. Our health network serves patients, residents and clients across the full spectrum of care, spanning primary care, secondary community care, tertiary and quaternary care services to post-acute through rehabilitation, palliative care and long-term care, while investing in world-class research and education. For more information, visit www.unityhealth.to.