Honourable Minister Madeleine Dubé Minister of Health - Changes - Proposed to Prescription Drug Program



 Honourable Minister Madeleine Dubé
Minister of Health

Coalition for Seniors and Nursing Home Residents’ Rights

Changes - Proposed to Prescription Drug Program

Room 155  - Pavillon Léopold-Taillon
         University of Moncton, NB
            November 22, 2011

The Coalition for Seniors and Nursing Home Residents’ Rights represents  more than 56 groups with a make-up of over 98,000 members comprised of individuals and groups who come together to endorse and promote shared principles. Members are drawn from the community and consist of retired seniors, labour, women’s groups, church groups, legions, researchers, and organizations committed to social justice.

The Coalition’s mission is to support affordable and accessible programs that enhance the quality of life for seniors.

In New Brunswick we have more than 55,000 seniors who are receiving the Guaranteed Income Supplement, while only 48,000 participate in the prescription drug plan. Some choose to not participate because of the co-payment amount of $250. Others do not understand the plan; believing that they will have to pay the $250 up front. Others choose not to participate because they don’t believe they will need the plan at the time for various reasons.

 The recent announcement of the proposed change to the prescription drug program for low-income seniors is simply the wrong step to take. Seniors will be making choices by improvising their medication, food and shelter. This will only lead to additional cost to the health care system when these types of decisions are made.

Many seniors tell us, that before their next pension cheque each month, they have to make tough decisions as to whether to go to the food bank or go without. Their current pension does not provide an income that adequately allows seniors to enjoy the luxury of quality food.  This is a reality.

 When we look at a household, a couple who is eligible for the prescription drug program currently pays the co-pay amount of $250 each for a total of $500. The new proposed increase would impact significantly on a household since this would double the amount to $1000.
If we go one step further, seniors living in a special care home retain $135 per month from their pension and pay an average of nine prescriptions per month at a cost of $9.05 per dispensing fee; thus, leaving them $53.55 for personal necessities. The proposed change will take them six months to get to the new cap increase of $500, depriving them of their dignity due to having a short fall in their monthly comfort allowance.

The doubling of the yearly cost for seniors is counter-productive. It will only force seniors to choose between medications they can and can’t afford. The end result, they will become sick and end up needing costly services which will impact on the health care system even more.

We understand the government has some fiscal challenges, just like other jurisdictions in Canada or for that matter in the world; you need to find other solutions, rather than trying to address the problem on the backs of vulnerable seniors who are currently experiencing difficult times.  



Recommendation: One Universal Pharmacare

We encourage the province to work with the federal government for the implementation of a universal Pharmacare Plan. The report on “The Economic Case for Universal Pharmacare” sets out two scenarios for reaching the goal of savings of up to 10.7 billion a year.

A public drug insurance plan should form an integral part of a country’s Pharmaceutical polices. The plan should tie together social programs designed to provide a minimum of well-being for all Canadians. (1)

Scenario one:  Implementing universal Pharmacare and of moderate revision of industrial policies related to drug prices. The current expenditure on prescription drugs are at 25.1 billion.  The report states that having a universal pharmacare plan it would be a net savings with Pharmacare of 4.48 billion.

Scenario Two: Implementing universal Pharmacare with elimination of industrial policies related to drug prices. Cost savings with a universal Pharmacare plan: save on dispending fees, cost savings with rigorous drug review and price negotiations (as in New Zealand), eliminate the monthly deductible and the 15 year patent protection for drugs in Quebec and eliminate multiple private-plans savings from cheaper administration and tax subsidies for these plans.  This would be a net savings with Pharmacare of 10.7 billion.

The report also states that many countries, including France, the UK, Sweden, Australia and New Zealand have universal drug plans and as a result, pay far less for drugs than Canada.  Switzerland, like Canada, pays high prices to support its national pharmaceutical industry, but Switzerland 94% of drugs are paid by public spending as compared to 45% in Canada.
Recommendation: Two Public Auto Insurance

We encourage the government to implement the proposed public automobile insurance model that was estimated to have a net positive impact on the provincial economy.  The report findings stated that the initial displacement of 1,134 people working in New Brunswick’s private sector insurance industry will be partially offset by the creation of 800 new automobile insurance jobs at the Crown Corporation.  One only needs to look at other jurisdictions such as Manitoba where public auto Insurance has been in existence since 1971. It is a model that has worked well.

Creating new jobs for New Brunswick will enhance its abilities to stimulate the economy and be prosperous. More people will return from Alberta to live and work in the province they want to be in. This means more tax dollars and spending by New Brunswickers who want to be home.

The implementation of a Public Auto Insurance Plan as proposed in 2004 would result in an overall increase to the revenues estimated at $3.5 million per year. (2)
Recommendation: Three Tax Structure

We need to return to the level of taxation that individuals and corporations were paying before 2008. The province has been losing millions of dollars each year. This needs to be recuperated.

In 2009-10 it was $143, 5 million, in 2010-11 it was $257.9 million, and in 2011-12 it will be $325.3 million and the same amount the years thereafter. Simplifying the personal income tax structure by replacing the current four-rate system with two tax rates of 9% and 12%; would generate millions of dollars the province has been losing. (3) We do not support an increase in the HST: this will impact on seniors and the working poor.

Recommendation:  Four - New Brunswick Pharmacheck

The New Brunswick Pharmacists' Association has been stressing that the province needs an electronic, real-time prescription monitoring program to help prevent the abuse of prescription drugs and to save health-care dollars. (4)

Drug monitoring is essential for the citizens of New Brunswick.  This discussion has been ongoing since  the early 1990s, when a coroner's jury recommended developing a New Brunswick-wide program following a four-day inquest into the death of a man who died of a prescription drug overdose.

We urge the government to work with the New Brunswick Pharmacheck in collaboration with the NB Pharmacists’ Association to meet the needs of seniors of New Brunswick, “Getting the most from medication.” The pilot program ran from February to December 2010.  We understand the medication review program was well received by the seniors and pharmacists who participated. (4)

Recommendation:  Five   Prescription Drug Co-Payment

That the co-pay premium for seniors 65 and over, who receive the Guaranteed Income Supplement be waived, and that the Pharmacare deductible rate (dispensing fee) not be applicable for seniors receiving Guaranteed Income Supplement.

In Nova Scotia, seniors have their premium waived entirely if they receive the Guaranteed Income Supplement; Quebec and Alberta provide free prescription coverage for seniors 65 and over. (5)(6) (7

In closing, when you give tax breaks to large corporations or raise income tax that will affect those that struggle to make ends meet from cheque to  cheque in order to provide a standard of living for themselves and their families this is unacceptable.

 We do not support the proposed increase in the prescription drug plan for seniors.

Respectfully submitted,

Debbie Ellison, President                                                                 Nelson Vessey, Treasurer
Claire Gay 1st   Vice-President                                                         Kathy Ervin, Secretary
Pat Goobie, 2nd Vice- President                                                     Cecile Cassista, Executive Director



(1)The Economic Case for Universal Pharmacare, Costs and Benefits of publicly funded drug coverage for all Canadians, CCPA,
(2)Final Report on Public automobile Insurance April 2004- Executive Summary http://www.gnb.ca/legis/business/committe[1]es[2]/reports/2004auto/PDF/Full_Report-e.pdf
(3) The Plan to Lower Taxes in New Brunswick, 2009-2012, Department of Finance, page.5
Prescription monitoring
Prescription monitoring
(5)Nova Scotia Seniors' Pharmacare
(6) Alberta Prescription Drug Program Seniors
(7)Quebec Public Plan

5 Coalition for Seniors and Nursing Home Residents’ Rights