Ottawa must advance a national plan to strengthen health and economic stability
Doug Roth
As we start the new year, Canada’s pharmacare plan stands at a crossroads. Will we deliver universal access to prescription drugs or keep a patchwork system that leaves millions at risk?
Right now, access depends on where you live, not on your needs. That’s not equitable nor was it what Canadians were promised.
The federal government must move quickly to finalize agreements with every province and territory to deliver a truly national program.
In September, Prime Minister Carney announced that he would finalize pharmacare bilateral agreements “as quickly and as equitably as possible,” calling the deals “clear commitments” that will be kept. Advocates, including Heart & Stroke, are calling on the government to follow through.
Progress is underway, but gaps remain.
So far, Manitoba, PEI, BC and Yukon have signed onto the plan, which currently provides coverage for diabetes medication and contraceptives. This first phase sets the stage for a universal, single-payer system that could soon cover other essential medicines for chronic and life-threatening conditions.
The federal government committed $1.5 billion in 2024 to launch this initiative, but to date, only $928 million has been directed to the first four partners. The good news is that means there is enough funding left over to add New Brunswick, Nova Scotia and Newfoundland & Labrador to the plan now – a cost-neutral move that would expand access immediately.
Extending participation to the remaining provinces and territories should be the next priority so that Canadians nationwide can see the full benefits. Pressure is growing across the country as provinces without deals feel the strain.
Health advocates, including Canadian Doctors for Medicare, have joined forces with elected representatives in Ontario to call on their provincial government to sign an agreement with Ottawa. Every day of delay means thousands of Ontarians – and many others across Canada – go without the medicines they need to stay healthy.
Delay will force more Canadians into dangerous trade-offs between health and finance. And that’s not hypothetical – it’s happening 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 medications. Nearly one-quarter say they split pills, skip doses or don’t fill prescriptions because of cost.
These choices have serious health effects and lasting impacts on people’s lives. What’s more, Canada is the only western country with universal healthcare that still excludes comprehensive pharmacare, a reminder that this approach is not groundbreaking but a proven model that works.
The arguments for a national plan are there.
Health Canada’s expert committee recently confirmed that prescription drugs aren’t a luxury –they’re essential for fairness, health, and national identity, and they make financial sense. These principles echo the Canada Health Act, which guarantees equal access to care.
The federal government’s fall budget signaled commitment to vital social programs like pharmacare, but words aren’t enough.
Today’s economic climate combined with rising costs does not justify hesitation; it makes the need for action undeniable. An unstable job market means health benefits vanish when work ends, leaving families vulnerable.
Global supply chain disruptions and shifting U.S. trade policies threaten higher drug prices. And as of 2026, seniors – the group most likely to need multiple medications – officially make up one-fifth of the Canadian population.
All of this points to one truth: pharmacare isn’t optional.
When people can’t afford medications, preventable complications, including crises caused by uncontrolled blood pressure or heart disease, often send them to emergency rooms, adding strain to already stretched services.
Canadians understand this and overwhelmingly support strengthening our access to care. A Canadian Medical Association survey found that 89 per cent believe improving access to universal care should be a top priority for building a stronger country.
This isn’t just about health; it’s about economic security and national resilience.
Amid global uncertainty and threats to Canadian sovereignty, pharmacare is key to protecting both health and stability.
At its core, universal pharmacare isn’t just policy, it’s about people. What happens now will determine whether Canadians can focus on healthy lives instead of worrying about prescriptions they can’t afford.
Pharmacare is health care. This is our chance to deliver what Canadians have waited far too long for and ensure no one is left behind.
Doug Roth is CEO of Heart & Stroke.
