OTTAWA — Doctors and nurses on the front lines of Canada’s health care system are sounding the alarm after the Liberal government appears to have put its promise of national pharmacare on hold.

When the Trudeau government presented its first federal budget in two years last month, it included more than $100 billion in new spending over the three years.

But while there was a brief mention of pharmacare in the 739-page document, it only reaffirmed a Budget 2019 commitment of $500 million for a national high-cost drug program for the elderly. rare diseases.

Dr. Melanie Bechard, a pediatric emergency physician and president of Doctors for Medicare, says she’s disappointed with the lack of new pharmacare funding in the budget. She believes this is an indication that the government is not making it a priority.

“I was very disappointed because the government promised national pharmacare. They did a study that really outlined the path to get there,” she said.

Even the 2021 budget document itself acknowledges that “the case for universal pharmacare is well established,” Bechard noted.

“The budget acknowledges that this makes sense. It is good public policy. But unfortunately, we only get words instead of any funding, so it’s completely ineffective.

The Liberals campaigned on a promise to “take the next critical steps to implement universal national pharmacare” in their 2019 election platform, and similar commitments have since appeared in Speeches from the Throne and mandate letters to the federal Minister of Health.

In 2019, a Liberal-appointed panel recommended that a universal, single-payer public pharmacare system be created in Canada to replace the current patchwork of prescription drug plans. The expert panel, led by former Ontario health minister Eric Hoskins, said such a plan would result in estimated savings of $5 billion a year.

Canadians spent $34 billion on prescription drugs in 2018, according to the expert panel report, adding that drugs are the second largest health care expense after hospitals.

Bechard says emergency room physicians and primary care physicians see patients whose health conditions have deteriorated every day trying to ration drugs they cannot afford.

“I’ve seen cases where kids have come into the emergency department with asthma attacks, and parents show me inhalers and they’re nearly empty. And when I say, “We have to fill it out to avoid situations like this”, the parents say, “Well, it’s expensive to fill in, Dr. Melanie, we can’t always afford to have a new one. every few months.’

“And it’s sad because the child probably didn’t need to go to the emergency room if he had enough medicine at home.”

While also expressing disappointment at not seeing new pharmacare spending in the budget, Sharon Batt, an adjunct professor of bioethics and political science at Dalhousie University and a health policy expert, said said she was not surprised.

“It looks like it’s been put on the back burner,” she said.

“There is certainly huge resistance to this plan … from the pharmaceutical industry, some patient groups and some researchers, and I think it definitely plays into government priorities and makes it more difficult for them to moving forward with pharmacare.

Some provinces and territories have also been lukewarm to the idea of ​​pharmacare, pushing instead for increases in federal health transfers.

Batt attributes this resistance to why Ottawa is instead focusing its efforts on creating a drug funding program for rare diseases, which enjoys greater political buy-in.

“I think they’re just kicking down the street and hoping the industry will back down or there will be more public pressure against the industry,” Batt said of the federal government.

“I think they don’t know what to do. I think they would probably like to present a plan, but they want public support. And that would include patient support.

Earlier this year, the NDP introduced a private member’s bill to establish the legal framework for national pharmacare, but it was defeated at second reading by a vote of 295 to 32. Only two Liberal MPs supported the bill.

NDP health critic Don Davies said he fears Canadians are becoming increasingly cynical about politicians who promise things, like pharmacare, during the elections, then do not follow through.

“They keep telling Canadians they believe in pharmacare, but opportunity after opportunity after opportunity to deliver on that promise is passing.

Health Minister Patty Hajdu was unavailable for an interview, but her spokesperson, Cole Davidson, pointed to the Budget 2021 paragraph that pledges to work with provinces and stakeholders to “build on building blocks that are already underway, such as the national strategy on expensive drugs for rare diseases, towards the goal of a universal national program.

He also noted that Ottawa has established a “transition office to create a new Canadian drug agency and a national formulary” and that officials are now working with provinces and experts to create a pharmacare plan for Canadians with rare diseases, with a target launch date of 2022-23.

“No Canadian should have to choose between paying for their prescriptions and putting food on the table,” Davidson said in a statement.

“We are committed to working collaboratively with consenting jurisdictions to develop a universal national pharmacare program, and this important work continues.

Linda Silas, who chairs the Canadian Federation of Nurses Unions, said nurses across Canada were confident pharmacare was a “done deal” after the last election.

The lack of budget focus to make this a reality is concerning, she said.

“You would think that because we are in the middle of a health crisis, they would have focused on a health crisis that already exists. One in four families does not have drug coverage, it is a crisis for these families.

However, Silas said she wasn’t entirely surprised to see no new money in the budget for pharmacare. Prior to its release, she said her organization had been consulted several times by Liberal ministers and officials seeking comment on what should be in the budget.

When she told them pharmacare was at the top of the list, she said there had been a noticeable shift in tone.

“The messages we were hearing were, ‘Well, Linda, is there anything (other) besides pharmacare?… You know, Linda, our priorities are pharmacare. But if pharmacare isn’t there, what else should there be? she said, recalling the conversations.

Speaking ahead of her shift at Ottawa Children’s Hospital, Bechard said she doesn’t understand how pharmacare has seemingly fallen into oblivion as she believes the implementation of a national health insurance scheme is “even more serious” due to COVID-19.

“The pandemic has resulted in massive job losses and unemployment, and in our current system people rely on employment to get drug coverage,” she said.

“It’s safe to say that now, more than ever, we need a national, universal pharmacare plan to make sure people can actually access the medicines they need to stay healthy.”