Memorandum of Understanding between the Government of Canada and the Government of British Columbia for Universal, Single-Payer, First-Dollar Access to Select Contraception and Diabetes Medications

No Canadian should have to choose between paying for prescription drugs and putting food on the table. Unfortunately, many are still forced to make this impossible decision due to cost. In 2021, over a quarter of British Columbia residents reported not having sufficient insurance to cover the cost of their prescription drugs. That is why the Government of Canada continues to work with provinces, territories and stakeholders to ensure that Canadians have better access to the prescription drugs they need.

To this end, the Government of Canada introduced Bill C-64, An Act Respecting Pharmacare. Once passed, this Act commits the Government of Canada to working collaboratively with provinces and territories towards the step by step implementation of national universal pharmacare. As a first phase, this means negotiating bilateral agreements with willing provinces and territories to provide universal, single-payer, first-dollar coverage for select contraception and diabetes medications.

The Government of Canada and the Government of British Columbia are announcing their intention to work together to improve contraception and diabetes coverage for residents of British Columbia. Once Bill C-64 receives Royal Assent, the Government of British Columbia will enter formal negotiations with the Government of Canada to implement universal, single-payer, first-dollar coverage for select contraception and diabetes medications, as initially identified by the Government of Canada on February 29 (Annex A).

In a historic announcement on April 1, 2023, the province began providing free contraceptives to all residents. In 2023 alone, approximately 188,000 people received free prescription contraception, as well as about 37,000 emergency contraceptives through this nation-leading program. Free prescription contraception has an immeasurably net-positive impact on the most vulnerable people, reduces gender inequality and improves health outcomes for parents and children. According to an Options for Sexual Health study (2010), every $1 spent on access to contraception can save as much as $90 in government spending. 

The Government of British Columbia is committed to continue its progress on pharmacare. The province is intending to provide free treatment of menopausal symptoms with hormone replacement therapy (HRT). Because British Columbia has been a leading jurisdiction in the country for the coverage of contraception medication, the province intends to extend universal, single-payer, first-dollar access, consistent with Bill C-64, to HRT to help support the health of Canadians throughout their lifetime. Additionally, prescription drugs and related products could be added to the lists of contraception and diabetes medications and will be discussed during pharmacare negotiations for universal, single-payer, first-dollar coverage. The benefits of federal pharmacare funding will enable the Government of British Columbia to further enhance its leadership in pharmacare programming for its residents.

Our two governments recognize the importance of collaboration to support the health of the residents of British Columbia and look forward to working together on this important initiative.

Signed on September 12, 2024.

The Honourable Mark Holland Minister of Health Government of Canada

The Honourable Adrian Dix Minister of Health Government of British Columbia