Implementation of a Universal Publicly-Funded Drug Plan is Possible in Canada

The implementation of a universal publicly funded drug plan is important for Canada. Although adopting this policy will be difficult, it is possible to overcome some of these barriers.


Boothe, K. (2015). Ideas and the Pace of Change: National Pharmaceutical Insurance in Canada, Australia, and the United Kingdom. Toronto, ON: University of Toronto Press

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What is this research about?

The lack of a universal drug plan in Canada causes real hardship to Canadians who are not well served by existing provincial plans and private insurance. The absence of a broad public program also limits the government's ability to negotiate drug prices, provide new drugs to patients on an equitable basis, and support patients regardless of the therapy or the location in which it is delivered. The purpose of this research is to understand reasons why Canada lacks a nation-wide, public and universal drug insurance program.

What did the researchers do?

The researcher from McMaster University compared the development of public pharmaceutical insurance in Canada, Britain, and Australia over the course of more than 30 years.

What did the researchers find?

The researcher found that:

  • The institutions, ideas, and electoral conditions that were present in an initial critical moment shape the pace of policy development.
  • The slow pace of healthcare reform in Canada restricts the range of services that can be introduced and limits how much existing services can change.
  • Extraordinary conditions, such as those that influenced the development of Canadian medical insurance, are needed to change existing health policies. Although major reform is difficult, it is not impossible.
  • The ideas of political elites have a large impact on voters' expectations. Therefore, politicians can play a big role in helping to implement a universal drug plan in Canada.

The researcher also made suggestions that may help initiate a drug reform:

  • The public needs to be convinced that public drug insurance is important and should be implemented. Carefully framing problems caused by the lack of a universal public pharmaceutical insurance may stir up public interest in this issue.
  • Provinces should share information or collaborate on tasks related to pharmaceutical policy. This may help provinces negotiate with pharmaceutical companies for lower drug prices. However, provinces should also acknowledge the limits of collaboration while maintaining separate and segmented public plans.
  • Slowly increasing public drug coverage may not ultimately lead to a universal drug program. More bold actions by politicians are needed to try to implement a universal program.

How can you use this research?

This research is useful for health policymakers as a roadmap of possible barriers to implementing a universal drug plan. The findings from this research should also encourage healthcare reformers that a universal drug program is feasible in Canada.

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