Expanding Canadian medicare to include a pharmaceutical benefit: Lessons from Israel

There’s an ongoing debate in Canada about whether to expand medicare to include a pharmaceutical benefit for everyone. The potential health benefits would be significant but there are always concerns about affordability. 

Israel provides an interesting case study. Its national health insurance benefits package includes a comprehensive pharmaceutical benefit. Its per capita pharmaceutical spending is also well below Canada’s and the Organization for Economic Co-operation and Development’s (OECD’s) average. 

This paper highlights seven strategies that Israel has employed to constrain pharmaceutical spending: 

1. Prioritizing new technologies, subject to a global budget constraint
2. Using regulations and market power to secure fair and reasonable prices
3. Establishing an efficient pharmaceutical distribution system
4. Promoting effective prescribing behaviours
5. Avoiding the artificial inflation of consumer demand
6. Striking an appropriate balance between respect for IP rights, access, and cost containment
7. Developing a shared societal understanding of the value and limits of pharmaceutical spending

Review this paper to learn whether these strategies can be adapted to the Canadian context so we can overcome concerns that have impeded the adoption of a national pharmaceutical program.

Read as published in Health Economics, Policy and Law Volume 13, Special Issue 3-4 (SPECIAL ISSUE: Canadian Medicare: Historical Reflections, Future Directions)