Today is the day that Ontario’s new pharmacare program dubbed OHIP+ for Children and Youth begins with more than 4,400 prescription drug products becoming free for all Ontario babies, children and youth aged 24 years or younger. It’s the biggest expansion of medicare in this province since the creation of medicare itself. OHIP+ will now publicly fund drug coverage for over 4 million Ontario children and youth automatically at an estimated cost of $465 million per year. There will be no need to enroll prior as only a valid health card number is required along with a valid prescription from a doctor or nurse practitioner when filling a prescription at any pharmacy in Ontario. There will be no upfront costs, no dispensing fee or co-payment or annual deductible to be paid.
Ontario’s OHIP+ plan extends to all 4,400 medications covered currently by the Ontario Drug Benefit program which is the current flagship for Ontario funded public drug plans. The Ontario Drug Benefit program currently benefits almost 4 million seniors and social-assistance recipients and includes the following prescribed medications that will now be provided at no cost for Children and Youth:
- antibiotics to treat infections
- inhalers for asthma
- various insulins, oral diabetic medications and diabetes test strips
- epinephrine auto-injectors (e.g. EPIPENs®)
- drugs to treat arthritis, epilepsy and other chronic conditions
- medications to treat mental health conditions (e.g. antidepressants)
- attention deficit hyperactivity disorder (ADHD) drugs
- drugs to treat some childhood cancers and other rare conditions
- birth control
The Ontario OHIP+ website provides a data base that can be searched for covered drugs
The OHIP+ program was initiated to take away the perceived financial barriers for families as an estimated 1 of every 10 families don’t fill their prescription medications because they simply can’t afford them. Additionally, many youth between the ages of 18-24 in particular don’t have benefits or jobs to support medication costs. An estimated one in four of those between the ages of 25 and 64 do not have drug insurance according to Health Quality Ontario.
OHIP+ will be the first payer for eligible drug products if you have private drug coverage, are covered under the Trillium Drug Program or happen to be a student covered under a university/college plan. OHIP+ coverage will cease on an individual’s 25th birthday.
Overall, OHIP+ is a key $465 million step toward universal drug care, something found in many developed countries, but not Canada. Many also see this initiative as a political move for this year’s provincial election despite the fact that opposition parties appear supportive of this initaitive and indeed have only criticized it for not going far enough. Indeed, that’s the real question, why are public drog programs now available for those under age 25 and for those over 65, but not for those in the middle? The underlying principle of universal medicare as structured in other developed countries is about not denying essential health care because of an inability to pay. But given the way drugs are or are not funded in Canada, that principle behind universal health care is not being upheld. Let’s hope that Pharmacare for youth is the next step in extending pharmacare for all across Ontario.
For more information on the Ontario OHIP+ program you can check out the new website for details.
