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A Type 1 diabetes advocate from the United States at a Canadian pharmacy after purchasing lower cost insulin in London, Ont., on June 29, 2019.CARLOS OSORIO/Reuters

Federal funding for diabetes medications is one of the sticking points in protracted negotiations over a new federal pharmacare program, which the Liberal minority government promised New Democrats it would create in exchange for their support in the House of Commons.

The Liberals and the NDP have agreed that legislation for a Canada Pharmacare Act, aimed at beginning progress toward a national program for covering the costs of pharmaceuticals, must be tabled by the beginning of March in order to keep the two parties’ supply-and-confidence deal in place.

The deal, signed almost two years ago, has provided stability for Prime Minister Justin Trudeau’s government by guaranteeing it NDP backing. This has given the Liberals certainty that they can avoid an election before 2025. In return, the government agreed to make progress on NDP priorities, including pharmacare.

As talks continued behind the scenes on Wednesday, NDP Leader Jagmeet Singh sought to increase the pressure on the government at a news conference in Toronto, during which he pointed out that the Liberals have not yet agreed to his party’s demand that Ottawa fund all drugs for treating diabetes.

“They’ve not committed fully to diabetes,” Mr. Singh said. “What we’re looking for is real coverage for people that are living with diabetes, real, true coverage. And that’s not yet been committed to.”

The NDP has said the legislation must incorporate a single-payer, universal pharmacare system. The Liberals have expressed concerns publicly about the cost of such a program.

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Under the supply-and-confidence deal, the Liberals did not promise to fund any specific drugs. But the talks now appear to have expanded beyond the initial agreement, to include both diabetes drugs and contraceptives.

Last week, The Globe and Mail first reported that as part of the negotiations with the NDP the federal government is considering covering birth control and diabetes medications, and that the NDP had asked for additional categories of drugs to be covered. The Globe reported that negotiators are discussing how many drugs to cover, and how to determine which drugs qualify.

In December, The Globe also reported that government officials have done various cost analyses as part of the negotiations. At the time, a source said supplying diabetes drugs alone would cost $1-billion annually. The Globe is not identifying the source because they were not authorized to speak publicly on the matter.

At Wednesday’s news conference, Mr. Singh did not offer specifics on what medications were being discussed. He said Mr. Trudeau and the Liberals “know what we want.”

Glenn Thibeault, Diabetes Canada’s executive director of government affairs, said his organization is pleased to hear that political leaders are discussing diabetes medications.

“We look forward to seeing what the details entail, recognizing the importance of individualized diabetes management and the diverse treatment needs of those affected,” he said. “Diabetes costs the health care system $50-million a day.”

The NDP has not revealed its other demands publicly, but it hinted at them in a social media post on Tuesday, in which the party told its followers they shouldn’t have to pay for birth control, insulin, anti-anxiety or cholesterol medications.

Mr. Singh refused to address the other two categories of drugs when pressed on Wednesday, saying he wouldn’t “get into the details of what we’re negotiating.”

Diane Francoeur, the chief executive officer of the Society of Obstetricians and Gynaecologists of Canada, said her organization has met with all parties to discuss access to contraceptives. She said in most provinces there is no coverage for birth control.

Last year, British Columbia became the first province to cover the costs of prescription contraception. The Manitoba government announced it would do the same last fall. Those provinces are the only two with NDP governments.

Dr. Francoeur said women make up 50 per cent of the Canadian population and, on average, have to address the possibility of pregnancy for more than 30 years of their lives.

“Women are putting that on their shoulders and in their wallet all the time,” she said.

The Liberals rely heavily on the NDP in the House of Commons to ensure their broader agenda is passed. New Democrats vote with the government on things such as curtailing debate to force votes, and speeding up the legislative process. That support has become more important as the Conservatives increase their efforts to slow the government’s agenda with procedural manoeuvres.

Mr. Singh has repeatedly said his party will withdraw its help if the Liberals don’t meet its pharmacare demands. To introduce the legislation by March 1, the bill has to be on the order paper by Tuesday at the latest.

Talks between the two parties went through the long weekend. On Wednesday, Mr. Singh sounded optimistic that a deal will be reached. He told reporters there was “positive movement” in the talks but that “we’re not there yet.”

He met with Mr. Trudeau for their quarterly meeting on Feb. 5, but publicly demanded another one to finalize the pharmacare agreement. Mr. Trudeau’s office declined to comment on the request.

Canada is the only country with universal health care that does not also have universal pharmacare. In 2019, former Ontario health minister Eric Hoskins chaired a pharmacare advisory council that recommended Ottawa establish a universal, single-payer, public system for prescription drug coverage.

Last year, the Parliamentary Budget Officer estimated that, once fully implemented, such a program would cost $38.9-billion a year. But given how much is already spent on public health care plans and direct federal drug costs, the incremental additional cost of a universal program was estimated at $13.4-billion.

With a report from Laura Stone

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