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The federal pharmacare plan will increase government spending by $1.9-billion over five years, according to new findings from the Parliamentary Budget Officer.

The PBO, a non-partisan agent of Parliament, examined costs associated with the implementation of Bill C-64. The legislation, tabled in February, proposes providing single-payer coverage for contraceptives and diabetes medications.

The office’s estimate is higher than costing in the recently tabled federal budget, which was $1.5-billion over five years. The fiscal blueprint said that the federal government’s intent is to work with provinces and territories to “provide universal, single-payer coverage for a number of contraception and diabetes medications.”

In the report released on Wednesday, the PBO said its estimate assumes that “any medications that are currently covered by provincial and territorial governments, as well as private insurance providers, will remain covered on the same terms.”

The tabling of pharmacare legislation earlier this year ended months of talks between the Liberals and the NDP, who have been working together as part of a supply-and-confidence agreement. The NDP supports Prime Minister Justin Trudeau’s minority government in exchange for a Liberal commitment to act on NDP priority issues in an arrangement designed to be in place until the fall of 2025.

Health Minister Mark Holland’s office did not directly comment on the PBO report when asked on Wednesday.

“Our primary focus is on passing C-64 legislation so that we can begin the important work to negotiate and sign agreements with provinces and territories that will lay out the precise needs of each jurisdiction,” Ministry of Health spokesman Jeff Woodland said in a statement.

Steven Staples, national director of policy and advocacy at the Canadian Health Coalition, said the report does not account for money that may be saved as more provinces and territories finalize bilateral agreements with the federal government. Mr. Staples’s organization advocates for the improvement of universal public health care in Canada and supports national pharmacare.

Under a single-payer pharmacare system, pharmaceutical purchases for provinces and territories will happen at once, meaning the government will have the bargaining power to negotiate lower prices, Mr. Staples said.

The PBO estimate is within “a similar ballpark” as the money set aside in the budget, he added.

“I don’t think [the PBO estimate] is scary at all,” Mr. Staples said. “What’s scary is the number of Canadians who aren’t able to access medication because they can’t afford it.”

Statistics Canada reported that in 2021, about one fifth of Canadians said they did not have insurance to cover any of the cost of prescription medications in a 12-month period. One in 10 Canadians reported not adhering to their prescription, such as by skipping doses or delaying filling prescriptions, because of cost.

Franco Terrazzano, the federal director of the Canadian Taxpayers Federation, said Wednesday that he is concerned about the estimated cost for pharmacare. He said he hoped the federal government would take measures to prove to taxpayers it could be fiscally responsible.

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