5 - National Pharmacare Flashcards
1
Q
What covers the services for hospital acute care?
A
- Canada Health Act
- Considered insured benefit
- All essential physician services are covered
2
Q
Under the Canada Health Act, what are drugs considered?
A
Non-insured health benefit
3
Q
Which level of government covers drugs?
A
- Provincial
- Every province decides what they want to cover outside of the Canada Health Act and decide how they will cover it (ex: deductible or not and what they will cover)
4
Q
Describe drug coverage in Manitoba
A
- Deductible based on household adjusted income (line 150 of income tax and subtract $3,000 for each dependent)
- Covers everyone regardless of health status
- No deductible if on palliative drug program or home cancer program
- For part 3, as long as has been approved, will go towards deductible
- If not on formulary, doesn’t count towards deductible (ex: Viagra, Botox)
5
Q
Who gets drug coverage in Manitoba?
A
- All residents w/ MB health care
- Those who aren’t covered by another government plan
6
Q
Describe how formularies were determined pre-2010
A
- One province couldn’t tell other provinces how much they pay for a drug; just know whether or not they cover it
- Each province decided whether they would cover a drug and negotiated their own price w/ a drug company (called “patchwork” drug coverage)
7
Q
Why isn’t marijuana on the formulary?
A
- Not standardized
- Lack of evidence for its indications
8
Q
What needs to be done for national Pharmacare to work?
A
- Federal dollars need to be added (provinces can’t add any more money)
- Consistent plan/ process across Canada
- Have a strong process for adding drugs to formulary that doesn’t leave provinces to “pick up the pieces” of what doesn’t get added
- Given how many stakeholders are involved, there is a lot of people to try to make happy
9
Q
Describe what would happen if national pharmacare only covered “essential medicines”
A
- Go based on WHO’s definition of “essential medicines”
- Non-essential medicines (ex: glyburide, test strips, newer products) would have to be covered by provincial pharmacare or pt
- This will make 2 programs do the same thing that 1 program does; likely won’t solve any problems
10
Q
Who are the stakeholders in national pharmacare?
A
- Patients
- Pharmacists
- Industry (increases sales b/c more people have access to drugs)
- Physicians
- Wholesalers/ distributors
- Provincial government
- Federal government
- Nurses
