Ottawa needs to move forward with a national plan to strengthen health and economic stability
doug ross
As we enter a new year, Canada’s pharmacare plan is at a crossroads. Will we provide universal access to prescription drugs or maintain a patchwork system that puts millions of people at risk?
Right now, access depends on where you live, not your needs. It wasn’t fair and it wasn’t what Canadians were promised.
The federal government must act quickly to finalize agreements with all states and territories to deliver a truly national program.
In September, Prime Minister Carney announced that a bilateral pharmacare agreement would be concluded “as quickly and fairly as possible” and said the agreement was a “clear commitment” that would be kept. Supporters including Heart & Stroke are calling on the government to comply.
Although progress is being made, gaps still remain.
So far, Manitoba, P.E.I., British Columbia and Yukon have signed on to the plan, which now covers diabetes medications and contraceptives. This first phase sets the stage for a universal single-payer system that will soon cover other essential medicines for chronic and life-threatening conditions.
The federal government has pledged $1.5 billion in 2024 to start the effort, but so far only $928 million has been transferred to the first four partners. The good news means there is now enough funding left to add New Brunswick, Nova Scotia, and Newfoundland and Labrador to the plan, a cost-neutral move that would immediately expand access.
Expanding participation to the remaining provinces and territories should be the next priority to ensure Canadians across the country receive the maximum benefit. Pressure is mounting across the country as states without a deal feel the burden.
Health advocacy groups, including Physicians of Canada for Medicare, are joining forces with Ontario’s elected officials to urge the provincial government to sign an agreement with Ottawa. Every day of delays means thousands of Ontarians, and many others across Canada, will not be able to get the medicines they need to stay healthy.
Delays will force more Canadians into dangerous trade-offs between health and finances. And it’s not just a theory, it’s actually happening right now.
A poll commissioned by Heart & Stroke and the Canadian Cancer Society found that more than one in four Canadians struggle to pay for essential medicines. Almost a quarter said they split pills, skipped doses, or skipped prescriptions because of cost.
These choices have a profound impact on health and a lasting impact on people’s lives. Additionally, Canada is the only country in the Western world with universal healthcare, which still excludes comprehensive pharmacare. This is a reminder that this approach is not revolutionary, but a proven model that works.
Therein lies the argument in favor of national planning.
A Health Canada expert panel recently recognized that prescription drugs are not a luxury, but are essential to equity, health, national identity, and make economic sense. These principles reflect the Canada Health Act, which guarantees equal access to care.
The federal government’s fall budget signaled commitment to important social programs such as pharmacare, but words alone are not enough.
Given today’s economic climate and rising costs, hesitation is unjustified. It cannot deny the need for action. A volatile job market means that health benefits are lost and families are left vulnerable when their jobs end.
Disruptions to global supply chains and changes in U.S. trade policy threaten to increase drug prices. And as of 2026, seniors, the group most likely to require multiple medications, will officially make up one-fifth of Canada’s population.
All of this points to one truth: Pharmacare is not an option.
When people can’t afford drugs, preventable complications, such as crises caused by uncontrolled blood pressure or heart disease, often send them to the emergency room, putting a strain on already stretched services.
Canadians understand this and overwhelmingly support increased access to health care. A Canadian Medical Association survey found that 89 per cent believe improving access to universal health care should be a top priority in building a stronger country.
This isn’t just about health. It’s about economic security and national resilience.
Amid global uncertainty and threats to Canada’s sovereignty, pharmacare is key to safeguarding both health and stability.
At its core, universal pharmacare is about people, not just policy. What happens now will determine whether Canadians can focus on healthy living instead of worrying about unpaid prescriptions.
Pharmacare is healthcare. This is our chance to achieve what Canadians have long desired and to ensure that no one is left behind.
Doug Roth is the CEO of Heart & Stroke.