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With a new government in place, a coalition of social groups and labour unions is renewing calls for a national pharmacare program, saying that paying for essential prescription drugs is a fundamental step in the evolution of medicare.

“Universal first-dollar coverage for cost-effective, safe drugs will save money and lives,” Kathleen Connors, chairwoman of the Canadian Health Coalition, said in a letter to new federal Health Minister Tony Clement.

“Canada has a big drug problem,” she said, citing the $18-billion in annual prescription drug spending and the large number of medical errors related to prescription drugs. (An estimated 12,000 deaths annually are attributed to the misuse and overprescription of drugs in Canada.)

Ms. Connors said prescription drugs are the health expenditure that is growing most quickly, and the way to rein that in is with improved management and use of medication. But, at the same time, a growing number of Canadians are being denied access to medically necessary drug treatments.

“It's time to replace our patchwork, U.S.-style insurance plans that drive up spending and leave millions without access,” Ms. Connors said.

The 28-page report, “More For Less: A National Pharmacare Strategy,” argues that Canadians should have access to all drugs “necessary for healthy living” free of charge, regardless of income or where they live in the country.

The coalition recommends that a national formulary be created that includes drugs that are medically necessary and cost effective. Under the plan, an independent agency would determine what drugs are placed on the list.

Currently, each province has its own drug formulary, but there are attempts to co-ordinate the lists through an agency called the Common Drug Review. Canada also has a federal agency that sets prescription drug prices; it's called the Canadian Patented Medicines Prices Review Board.

The coalition, in its report, criticizes the PMPRM for lacking transparency and for not being discerning enough because it approves so-called me too drugs — medications that do little more than existing ones but usually cost a lot more.

It is equally critical of Health Canada's therapeutic products directorate, which regulates drugs. The coalition says the directorate does not do enough to prevent potentially dangerous drugs from entering the marketplace, and does virtually no follow-up.

The report calls for the creation of an independent agency to monitor and investigate the safety of drugs after they reach the market, one that would be modelled after the Transportation Safety Board.

According to the Canadian Institute for Health Information, about 46 per cent of prescription drug costs in Canada are paid from the public purse, while 34 per cent are paid through private insurance (most of it provided by employers) and 20 per cent out of pocket by individuals.

In its report, the Canadian Health Coalition argues that a national pharmacare plan would reduce costs for provincial health plans, but it would benefit employers even more, extending the “competitive advantage” that medicare already offers.

Currently, Canadian employers spend more than $6.7-billion annually in drug insurance premiums, but 42 per cent of workers are not covered by work-based plans, according to the report.

Linda Silas, president of the Canadian Federation of Nurses Unions, said a well-built national pharmacare program would not be too expensive, as critics of the approach argue. Rather, she said, it would reduce waste and costs.

“The goal is simple: Pay only for what is cost-effective and safe. That would save lives and money,” Ms. Silas said.

Between 1985 and 2004, annual prescription drug costs rose to $18-billion from $2.6-billion.