HESA Committee Report

SUPPLEMENTARY REPORT OF THE NEW DEMOCRATIC PARTY OF CANADA

A Diabetes Strategy for Canada

Canada’s New Democrats strongly believe that the federal government must do more to support Canadians living with diabetes, particularly those who incur significant out-of-pocket costs as a result of this chronic disease.

Canada has one of the highest prevalence rates of diabetes among the Organisation for Economic Co-operation and Development, with more than 3 million people (or 9.4 percent of the population) having either type 1 or type 2 diabetes.

On March 21, 2017, the House of Commons Standing Committee on Health agreed to study diabetes strategies in Canada and other jurisdictions. Over the course of six meetings, the committee heard from 32 witnesses and received 12 briefs from Canadians living with diabetes, advocacy organizations and health care professionals.

Canada’s New Democrats support the Committee’s eleven recommendations, which are intended to help the Government of Canada find better ways to prevent people from getting type 2 diabetes and provide more support to people living with diabetes.

However, in order to ensure that every Canadian living with diabetes can access the medications, devices and supplies they need to manage their disease, the New Democratic Party of Canada is also calling for the immediate implementation of a universal, comprehensive and public pharmacare program, as recommended by the House of Commons Standing Committee on Health in its report entitled Pharmacare Now: Prescription Medicine Coverage For All Canadians. According to the Parliamentary Budget Officer, by implementing such a program, we would save $4.2 billion dollars a year, while extending coverage to every single Canadian.

In 1921, Dr. Frederick Banting, Charles Best, James Collip and their supervisor, James Macleod, discovered insulin in a University of Toronto lab. This discovery revolutionized the treatment of diabetes worldwide and remains among the most celebrated medical discoveries in Canadian history. Yet today, many Canadians living with diabetes are unable to afford the medications, devices and supplies they need. As Dave Prowten, President and Chief Executive Officer, Juvenile Diabetes Research Foundation Canada, told the Committee, “It would be a missed opportunity, on the eve of the 100th anniversary of the discovery of insulin in Canada, if the various types of insulin were not included among drugs covered under pharmacare.”

At present, an estimated 10 to 20 percent of Canada’s population - between 3.5 and 7 million Canadians – do not have sufficient coverage to access the prescription medications they need when they need them. According to Diabetes Action Canada:

One‐third of working Canadians have no drug benefit insurance. For these individuals, taking medications, especially lifelong treatment of diabetes and preventions of its complications (blindness, lower limb amputations, kidney disease) is difficult because of high costs. Patients may reduce their adherence to medications, may delay renewing their prescriptions, or may forgo needed therapy entirely. Indeed, one quarter of Canadian households report cost‐related non‐adherence to prescription drugs.

A recent report from the Canadian Federation of Nurses Unions found that 57 percent of Canadians with diabetes reported failing to adhere to their prescribed therapies due to affordability issues related to medications, devices and supplies. This cost-related non-adherence can lead to avoidable complications and mortality. According to Juvenile Diabetes Research Foundation Canada, “A population based study in Ontario that tracked 600,000 patients found that roughly 830 young and middle-aged patients die each year from lack of access to insulin.” On the other hand, according to a brief submitted jointly by the 100 Campaign, Santé Diabète, T1 International and Universities Allied for Essential Medicines, as many as 5000 deaths in Ontario alone could have been prevented by universal drug coverage for people with diabetes.

Throughout the Committee’s study, Canadians living with diabetes shared personal accounts of their struggles to manage the chronic disease. These witnesses repeatedly emphasized the need for a universal, comprehensive and public pharmacare program to ensure that all Canadians living with diabetes can access the medications, devices and supplies they need.

Victor Lepik, a British Columbian who has lived with type 1 diabetes for more than 30 years, told the Committee that, “Now that I'm retired and living out in B.C., it has just become so obvious that we need a universal health care program, not just for me but for everyone, and especially for diabetics.” Mr. Lepik emphasized that, in order to help prevent complications and provide people with diabetes with practical solutions to improve their lives, we need a federally funded pharmacare program that is open to all, regardless of age or income.

Charlene Lavergne from Oshawa, Ontario has been living with type 1.5 or type 2 diabetes for over 43 years. When asked what universal pharmacare would mean for her personally, Ms. Lavergne responded that,

I'm 63. It would mean that I could look forward to seeing my four granddaughters and I could live with less anxiety and less stress. I would know that it was there for me. I wouldn't have to scramble. I wouldn't have to just about sell my socks for stuff. Having the right insulin too; that's the key. I need to have the right insulin, not the cheapest stuff on the market. Basically it would give me hope, and it would give me a little bit more cash so I could eat.

Ms. Lavergne also underlined the fact that her story is not an isolated one in Canada. She cautioned the Committee that Canadians living with diabetes can’t wait any longer for a plan from the federal government.

No Canadian should ever have to choose between buying medication or food. That’s why Canada’s New Democrats believe there is an urgent need for a national approach to pharmacare that would ensure all Canadians have access to the medications they need when they need them. This must include coverage for diabetes devices and supplies such as test strips, syringes, insulin pumps and continuous glucose monitors.

On clinical, ethical, and economic grounds, universal, comprehensive and public drug coverage has been recommended by royal commissions, national fora, Parliamentary committees, and citizen reference panels dating as far back as the 1940s. Further delays to the implementation of universal, comprehensive and public pharmacare in Canada are unjustified and unacceptable. Canadians living with diabetes can’t afford to wait for relief. They need urgent action from their federal government.

They need pharmacare now.

Canada’s New Democrats therefore recommend:

That the reimbursement of diabetes-related medications, supplies and equipment be included as part of a universal, comprehensive and public pharmacare program established by the Government of Canada, in collaboration with the provinces and territories, through amendments to the Canada Health Act, as recommended by the House of Commons Standing Committee on Health in its report entitled Pharmacare Now: Prescription Medicine Coverage For All Canadians.