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Despite increased incremental cost to the public payer, economy-wide savings can be achieved under a single-payer universal drug plan, new PBO report finds

Ottawa (Ontario), October 12, 2023

The Parliamentary Budget Officer (PBO) today released his estimate of the cost to the public sector (federal and provincial governments combined) for a single-payer universal drug plan over a five-year period effective January 1st, 2024 in response to Parliamentarians’ interest in implementing a pharmacare plan.

The report, Cost Estimate of a Single-payer Universal Drug Plan, is an update of the first estimate, Federal Cost of a National Pharmacare Program, which was published in 2017.

“Our report is based on a national application of the Régie de l'assurance maladie du Québec (RAMQ) drug formulary, with universal access and a standardized copayment scheme implemented by a single payer”, explained Yves Giroux, PBO. “According to our estimates, the additional cost to the public sector is estimated to be $11.2 billion in 2024-2025, increasing to $13.4 billion in 2027-2028”.

There are incremental costs to the public sector resulting from expanding public expenditures to cover the private insurance and out-of-pocket market shares. However, as a result of the increased negotiating power of a single payer, economy-wide savings are expected. “The economy-wide savings on drug expenses generated by a single-payer plan would amount to $1.4 billion in 2024-2025, rising to $2.2 billion in 2027-28.”

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    {"id":"RP-2324-016-S","is_published":"2023-10-12T12:57:06.000000Z","release_date":"2023-10-12T13:00:00.000000Z","title_en":"Cost Estimate of a Single-payer Universal Drug Plan","title_fr":"Estimation des co\u00fbts d\u2019un r\u00e9gime d\u2019assurance-m\u00e9dicaments universel \u00e0 payeur unique","internal_id":"RP-2324-016-S","metadata":{"abstract_en":"This report estimates the total and incremental public cost of a single-payer universal drug plan\u2014 \u201cPharmacare\u201d\u2014over 2023-24 to 2027-28. The estimated cost reflects a national application of Quebec\u2019s R\u00e9gie de l\u2019assurance maladie du Qu\u00e9bec (RAMQ) formulary with universal access and a copayment scheme.","abstract_fr":"Le pr\u00e9sent rapport estime les co\u00fbts publics totaux et diff\u00e9rentiels d\u2019un r\u00e9gime d\u2019assurance-m\u00e9dicaments universel \u00e0 payeur unique \u2013 l\u2019\u00ab\u2009assurance-m\u00e9dicaments\u2009\u00bb \u2013 pour la p\u00e9riode allant de 2023-2024 \u00e0 2027-2028. Le co\u00fbt estim\u00e9 refl\u00e8te une application \u00e0 l\u2019\u00e9chelle nationale de la liste des m\u00e9dicaments assur\u00e9s de la R\u00e9gie de l\u2019assurance maladie du Qu\u00e9bec (RAMQ) avec un acc\u00e8s universel et un r\u00e9gime de contributions.","highlights":[{"content":{"en":"Upon the implementation of a single-payer universal drug plan based on Quebec\u2019s R\u00e9gie de l\u2019assurance maladie du Qu\u00e9bec (RAMQ) formulary\u2014 \u201cPharmacare\u201d\u2014we estimate the incremental cost to the public sector (that is federal and provincial governments combined) to be $11.2 billion in 2024-25, increasing to $13.4 billion in 2027-28.","fr":"Dans le cadre de la mise en \u0153uvre d\u2019un r\u00e9gime d\u2019assurance-m\u00e9dicaments universel \u00e0 payeur unique calqu\u00e9 sur la liste de m\u00e9dicaments assur\u00e9s de la R\u00e9gie de l\u2019assurance maladie du Qu\u00e9bec (RAMQ) \u2013 l\u2019\u00ab\u2009Assurance-m\u00e9dicaments\u2009\u00bb \u2013 nous estimons que le co\u00fbt additionel pour le secteur public (c\u2019est-\u00e0-dire, les gouvernements f\u00e9d\u00e9ral et provinciaux ensemble), serait de 11,2 milliards de dollars en 2024-2025 et augmentera pour s\u2019\u00e9tablir \u00e0 13,4 milliards de dollars en 2027-2028."}},{"content":{"en":"In terms of the economy as a whole, we estimate cost savings on drug expenditures of $1.4 billion in 2024-25, rising to $2.2 billion in 2027-28.","fr":"En ce qui concerne l\u0027\u00e9conomie dans son ensemble, nous estimons que les \u00e9conomies r\u00e9alis\u00e9es sur les d\u00e9penses de m\u00e9dicaments s\u0027\u00e9l\u00e8vent \u00e0 1,4 milliards de dollars en 2024-2025 et augmenteront pour s\u2019\u00e9tablir \u00e0 2,2 milliards de dollars en 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author={Barkova, Lisa and Busby, Carleigh},\n title={Cost Estimate of a Single-payer Universal Drug Plan},\n institution={The Office of the Parliamentary Budget Officer},\n year=2023,\n \n address = \u0022Ottawa, ON\u0022\n}","fr":"@techreport{DPB-RP2324016S,\n author={Barkova, Lisa and Busby, Carleigh},\n title={Estimation des couts d\u2019un r\\\u0027{e}gime d\u2019assurance-m\\\u0027{e}dicaments universel \\`{a} payeur unique},\n institution={Bureau du directeur parlementaire du budget},\n year=2023,\n \n address = \u0022Ottawa, ON\u0022\n}"}}