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The Pharmacare Act has passed third reading. Here’s what comes next.

We are another step closer to Canadians getting access to life-saving medicines with their provincial health cards, rather than their credit cards.

Yesterday, the Pharmacare Act (Bill C-64) passed third reading in the House of Commons, despite Conservative attempts to obstruct the legislation. The legislation passed with only a few minor amendments, which means the universal, single-payer framework remains intact – though so do ambiguities about what happens when the program expands beyond contraceptives, insulin, and other diabetes drugs. It is now headed to the Senate, which will review the bill before it becomes law.

At the Standing Committee on Health’s hearings on Bill C-64, federal Health minister Mark Holland said the list of drugs to be initially covered represents an “absolute minimum,” and the government is open to adding to it based on negotiations with provinces and recommendations from experts. As patient activists working with the Council of Canadians have pointed out, the list needs to be expanded to offer truly comprehensive coverage for diabetes drugs.

Overall, the Pharmacare Act represents an important and long-overdue advance for public health care in Canada. It speaks to the core Canadian value that people should be able access health care based on need, not on their ability to pay. Prescription drugs shouldn’t be treated any differently.

Credit is due in large part to the tireless efforts of our chapters, supporters, and allies who have been organizing for pharmacare. At the hearings at the Standing Committee on Health, the NDP’s Peter Julian recognized how important this work has been for moving pharmacare forward:

“I certainly want to thank the many organizations that have brought this into being: the Canadian Health Coalition, the Canadian Labour Congress, the Canadian Federation of Nurses Unions, the Council of Canadians and so many other groups that have been pushing for years for this start of universal pharmacare. It’s a historic day.”

Since the pharmacare bill was first introduced at the end of February, Council of Canadians supporters sent more than 1,300 messages to federal MPs calling for the legislation to be fast-tracked. When the Standing Committee on Health reviewed the bill, we submitted a brief emphasizing the importance of expanding coverage beyond diabetes drugs and contraceptives, under the same universal, single-payer framework. And we exposed the pharmaceutical and insurance industry ties of many witnesses called to testify before the committee.

Make no mistake: the passage of Bill C-64 is a defeat for Big Pharma and its allies. While the program is starting small, the framework of the Pharmacare Act opens the way for a fully public, single-payer pharmacare system that will lower drug prices and ensure everyone has access to the medicines they need. After years of government inaction, this is a huge accomplishment.

We can’t rest on our laurels, however.

Once the bill gets through the Senate, negotiations between federal, provincial and territorial governments will start. Rolling out the program will require bilateral agreements to fund the expansion of existing public drug coverage to make diabetes drugs and contraceptives free for everyone. While many provinces (British Columbia, Manitoba, Prince Edward Island, Newfoundland and Labrador) have indicated they are supportive of pharmacare, others are on the fence (Ontario, Nova Scotia) or outright hostile (Alberta and Quebec) to the program.

Corporate opponents of pharmacare see these negotiations as a key opportunity to stall pharmacare’s roll out or to subvert it to their own ends. In the days after the Pharmacare Act was introduced, there was a spate of pharmaceutical company lobbyist registrations at the provincial level. Insurance industry lobbyists are turning their focus to influencing federal-provincial negotiations, too.

We know what their playbook will be. They will furiously lobby provincial governments to either refuse to participate or to weasel their way out of the single-payer framework that threatens their profits. They will try to get pharma-funded “patient advocates” and other compromised actors to sit on the Committee of Experts tasked with giving advice on how to expand the program. And they will use allied think tanks and the Conservative Party to amplify their disinformation, claiming that pharmacare is unaffordable, unnecessary, and a threat to people’s existing drug coverage, as they did at the Standing Committee on Health’s hearings on Bill C-64.

But we are developing a playbook of our own, to counter Big Pharma’s disinformation and to ensure that as many Canadians as possible are getting free diabetes drugs and contraceptives before the next federal election. We have had some amazing discussions with allies across the country, including many reproductive justice and women’s health organizations that are fired up about getting pharmacare rolled out as soon as possible.


We have passed a crucial milestone in the fight for pharmacare. Together, we can make pharmacare a reality and ensure that no one in Canada is left behind.