A key factor in the national pharmacare debate is the public cost, which the Parlia- mentary Budget Office estimated would be $11.2 billion in 2024-25 if the national list of drugs was the same as the list used by the Quebec provincial plan. [...] They included the Royal Commission on Health Services (1964), also known as the Hall Commission; the National Forum on Health (1997); the Commission on the Future of Health Care in Canada (2002), also known as the Romanow commission; the Study on the State of the Health Care System in Canada (2003), also known as the Kirby commission; and, most recently, the Advisory Council on the Implementation. [...] The federal government announced three pharmacare initiatives in its 2019 budget: the creation of the Canadian Drug Agency to assess the effectiveness of new prescription drugs and negotiate prices on behalf of Canadians, the development of a national list of covered drugs (a formulary) and the creation of a national strategy for high-cost drugs for rare diseases. [...] Nota- bly, the overall budget for the plan would have a great deal of flexibility, as the 12 IRPP Insight | February 2024 fi nancial commitment from the federal government would be determined by the initial size of the formulary and the reinsurance threshold. [...] The ultimate size of the formulary would depend on the level of funding provided to the program and how much of the cost is charged to patients.
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