A government committee's report about setting up a prescription drug plan in New Brunswick was tabled in the legislature on Tuesday, but it is not the catastrophic drug program many New Brunswickers had been hoping for.
The report, presented by Health Minister Ted Flemming, addresses a 2009 pledge under the former Liberal government to set up a plan for uninsured New Brunswickers as part of the poverty reduction initiative.
But it does not directly address Premier David Alward's 2010 election promise to create a catastrophic drug plan "that will fairly subsidize New Brunswickers' drug costs based on their ability to pay."
The committee, chaired by former health minister Dennis Furlong, does, however, suggest legislation could be drafted to create minimum coverage standards for private drug plans that would eliminate the need for catastrophic coverage.
"This legislation should result in improvements to drug coverage so that more financial assistance is provided by private drug plans, and there is less need for a Government Insurance Plan for insured New Brunswickers."
'While I can’t speak to the details of a drug plan that hasn’t been developed yet, I can assure the house that our insurance plan will address all of these scenarios. That’s what we’re committed to doing Mr. Speaker and that is what we’re going to do.' —Health Minister Ted Flemming
However, if that doesn't work, the report suggests plan options for the uninsured outlined in the report could also be adapted to help other New Brunswickers who have insurance but are not fully covered for an illness triggering enormous drug costs.
Individuals or employers could enrol in the proposed insurance plan as supplemental insurance, subject to payment of an appropriate premium.
"However, the implementation of minimum coverage standards (for those with existing drugs plans), mentioned above, should make this unnecessary."
Catastrophic drug coverage ensures that no one is denied access to necessary, high-cost drugs based on where they live, or their ability to pay.
New Brunswick and Prince Edward Island are the only provinces without a program to cover the cost of expensive drugs for people who need them to stay alive or to keep debilitating illnesses at bay.
As a result, some New Brunswickers face annual bills in the five- to six-figure range.
Flemming argued catastrophic drug coverage means different things to different people.
"Some are uninsured and have incomes that make any drug costs catastrophic. Some need one very expensive drug that they just can’t afford. Others are taking a number of low-cost drugs, often to manage a chronic disease, that add up to an amount that they can’t pay at the end of each month," he said.
"All of these situations are catastrophic. And while I can’t speak to the details of a drug plan that hasn’t been developed yet, I can assure the house that our insurance plan will address all of these scenarios.
"That’s what we’re committed to doing Mr. Speaker and that is what we’re going to do," he said, adding he hopes to announce the details of a new plan in the "not too distant future."
But Liberal MLA Donald Arseneault, who is the opposition's health critic, said the report is "far from" what the premier had committed to in terms of catastrophic drug coverage.
Arseneault said he does agree with providing a drug plan for the estimated 150,000 New Brunswickers who are uninsured, but he expressed concerns about the plan being mandatory and whether the premiums people will have to pay will be affordable.
Plan should be mandatory for uninsured
The report, entitled "An Insurance Plan for Prescription Drugs for Uninsured New Brunswickers, recommends the plan should be mandatory for all uninsured New Brunswickers.
"This would allow the costs of prescription drugs to be redistributed across the 70,000 families, so that the prospect of a family facing significant financial hardship would be eliminated for the families participating in the plan," the 107-page report states.
In addition, the plan could be financed primarily by those families through the payment of premiums, the report says.
The committee suggests two options: an annual deductible of $250 for a single person, or $500 for a family, combined with a 20 per cent copayment, subject to a maximum copayment of $30; or no deductible, but with a 30 per cent copayment, subject to a maximum copayment of $30.
The remaining costs would be funded by the government and employers who do not provide drug coverage to some or all of their employees.
There should be no barriers to access, such as medical exams, exclusion of pre-existing conditions, or waiting periods, and no maximum limit on the amount of financial assistance the plan would provide, the committee recommends.
The government should use the same formulary currently used for government-sponsored drug plans to determine which drugs should be eligible under the new plan, it states.
NDP Leader Dominic Cardy described the plan as "a big step forward."
"This plan goes some way towards making sure every New Brunswicker has the coverage they need," he said in a statement.
In response to criticisms of the plan for not including a clear catastrophic drug component, Cardy contends a comprehensive drug plan is better than a stand-alone catastrophic plan.
"This plan should help all New Brunswickers, including those with chronic as well as catastrophic conditions," he said.
"This will help improve the quality of life for thousands of people, help our economy and, most important, make sure no mother or father has to choose between the medicine their child needs and paying the rent."
The NDP will, however, continue to push the Alward government to include new drugs on the provincial formulary, including the cancer drug Avastin, Cardy said.