C-340 – The Canada Pharmacare Act – sets up a system that has the federal government reimburse provinces for their pharmacare programs as long as certain conditions are met.
Criteria
Once a year the federal government will give provinces money to help cover the cost of their pharmacare programs, but only if all the following criteria are met.
Public Administration
The first criteria for C-340 is how the program is administered. There’s three points here, starting with the requirement that the program needs to be operated on a non-profit basis by a public authority appointed by the government. Second, this authority needs to answer to the government. Finally the authority must be subject to audits along with the rest of the province’s finances.
This condition can still be met if the public authority has the power to designate another organization to receive any payments under the pharmacare plan as long as their accounts are open to public audits.
Comprehensiveness
This one’s easy, C-340 requires any pharmacare plan to cover the full cost of any insured drugs as well as any dispensing fees.
Universality
Every insured person in the province needs to benefit from the same coverage. You can’t have multiple tiers for it. Note that an insured person doesn’t include prisoners, and provinces are allowed to set a minimum amount of time for someone to live in the province before they can benefit from the program.
Portability
This section covers the pharmacare plan when you’re in a different province, and there’s a few conditions here. The first is that the mentioned minimum amount of time living in a province before being covered by the pharmacare plan can’t be longer than three months. During this waiting time if you’re moving between provinces the one you previously lived in still needs to cover you until your new province’s plan kicks in.
When paying for drugs in another province the one providing your coverage will need to pay whatever the cost is in the province you’re in unless the two provinces have an agreement otherwise.
Accessibility
Simple enough here, everyone needs to have equal access to the insured drugs and the plan can’t impede that access in any way. The payments also need to cover any potential tariffs that might apply in that province.
Defaults
Bit of a process here but if a province isn’t meeting all of the above conditions or refuses to provide the information showing they’re meeting those conditions the Minister of Health can cut back on the federal contributions to the province’s pharmacare plan. The province has to be given a chance to fix any problems and an effort needs to be made between the two to resolve the issue before this can happen. If this fails then the feds can withhold any or all of the payments for that year. Note that this process needs to be repeated each year.
Federal-Provincial Arrangement
The federal government will be able to work with the provincial governments to establish an independent drug agency. That agency will:
- Assess the clinical and cost effectiveness of drugs compared to their alternatives
- Advise on which drugs should be covered by the pharmacare program
- Negotiate prices and supply with manufacturers
- Provide information to doctors on how best to use prescription drugs
- Monitor the safety and effectiveness of prescription drugs
Regulations
Through an Order in Council the federal government can create regulations on how C-340 will work, including on which prescription drugs need to be covered by provincial pharmacare plans.
Report to Parliament
And of course, each year the Minister of Health needs to report back to Parliament on how well each province is following C-340.
Progress
C-340 is currently outside of the Order of Precedence and is waiting for its chance to be brought before the House.