Thread by @IvaCheung

Who else will be at the #YVR community dialogue session on national pharmacare tonight? 🙋🏻

Two years ago I attended the public consultation for federal disability legislation. Even though it took a long-ass time for the Accessible Canada Act to be proposed afterward, the consultation itself was one of the most memorable and edifying events I've ever attended.

That consultation—and the one tonight—never would have happened under the Conservatives. Every day I'm grateful that Harper's not PM anymore. The prospect of being back under the Cons terrifies me, but it's a real possibility 'cause Trudeau didn't follow through on #ERRE.

👆 Oh, and if you're not going to the community dialogue tonight, you can still send the gov't your thoughts here: canada.ca/en/health-cana…

I'm back from the community dialogue on #pharmacare, and I'd like to tweet about some of the things I heard tonight, so please mute that hashtag if you DGAF.

First, @DrEricHoskins gave context by drawing attention to the word "implementation" in the name of the "Advisory Council on the Implementation of National Pharmacare." He says we've had lots of studies, reports, recommendations over 50 years. Now we have to *act*. #pharmacare

The advisory council was first mentioned in the spring budget. They want to be the architects of a model that will best serve Canadians. They aim to submit their report to Parliament next spring. Then it'll be up to the gov't to run with it. #pharmacare

.@DrEricHoskins said that ~2 million Canadians aren't able to access the medications they need. ~1 million Canadians sacrifice heat or food to pay for their medications. #pharmacare

Right now there's a lot of support for national #pharmacare—from grassroots organizations, the labour movement, academics, healthcare providers, businesses—so we should take advantage of this support to get it done.

People were invited to speak for 2 minutes each; once every 5 speakers or so, the council members would respond with some comments. They urged people who didn't get a chance to speak to participate using the online consultation portal: letstalkhealth.ca/pharmacare #pharmacare

I won't go through all of the comments, but I'll mention some highlights:
1. There was broad consensus among people in the room that a #pharmacare program should be universal, single payer, paid for via taxation.

2. There was also broad support for a national formulary but a bit of disagreement over the finer details of what drugs should be covered. A person with a daughter with a rare disease wanted a very open formulary. #pharmacare

Some were very supportive of the work of BC's Therapeutics Initiative, but there was one dissenter who said her community had been ill-served by them. #pharmacare

3. One person wanted more research done by non-pharma scientists at universities, which they thought may encourage development of drugs that were beneficial rather than more me-too drugs. #pharmacare

4. An epidemiologist in the room wanted to make sure there was long-term monitoring of adverse effects of the drugs on the formulary. There was also quite a bit of discussion about polypharmacy and deprescribing initiatives. #pharmacare

John Wright, who had been deputy minister of health and deputy minister of finance in Saskatchewan, said that in 2006–2007, the premiers of each province and territory called on their health ministers to discuss developing a national formulary… #pharmacare

…taking into account pricing, catastrophic drug coverage, real-world effectiveness, and rare diseases. Wright said the health ministers got about 90% there but the last 10% was the toughest. But the perception that provinces don't want to cooperate is overblown. #pharmacare

Here's some more information on that ministerial task force: scics.ca/en/product-pro… #pharmacare

The advisory council—and some community members—identified the lack of political will as the biggest barrier. They encouraged all of us to stay engaged after the session: talk to our elected officials, talk to our family and friends, keep the pressure up. #pharmacare

I've lost track of my numbering. Sorry. Anyway, there was talk about the economic benefits. Some community members wanted the council to make sure they modelled not only the benefits of single-payer buying power of drugs… #pharmacare

…but also the economic benefits of preventing complications, crises, rehospitalizations. The savings from these should be a huge selling point. One person said her treatment let her contribute to her family's child care needs, saving them money, too. #pharmacare

An antipoverty advocate suggested the council emphasize #pharmacare as a poverty-reduction strategy.

What got me a bit weepy was @DrEricHoskins saying that this initiative was a nation-building exercise. Many in the room probably had coverage, but we want to make sure all Canadians do. We're rightly proud of medicare, and this is our chance to take it a step further. #pharmacare

So there you have it: if you want #pharmacare, participate in the consultation online or in person, and make your support for pharmacare known to your elected officials—nationally, provincially, and even locally. letstalkhealth.ca/pharmacare