Are insurance companies trying to ‘strong arm’ New Brunswick into rejecting pharmacare?

Health Minister John Dornan told public health care activists this week that the health insurance industry may respond to pharmacare in New Brunswick by eliminating private coverage for Ozempic — a medication commonly used to help lower blood sugar levels for people with Type-2 diabetes — leaving the province with a multi-million dollar gap in coverage, since Ottawa doesn’t currently cover that medication. 

Dornan made the comments on Monday in a meeting with activists from the NB Health Coalition, according to three people who were in attendance.

“What we understand is that [insurance companies] are threatening to not cover Ozempic for private plan holders, which would force the provincial government to shoulder that burden,” said Steven Staples, a policy analyst with the Canadian Health Coalition, who was part of the group that met with the Health Minister.

Two other people who were at the meeting — Chris Watson, president of the NB Federation of Labour, and Lisa Allen, president of CUPE Local 1199 — confirmed that account.

The provincial government currently provides limited public coverage for Ozempic, but so far it’s not among the diabetes treatments that Ottawa covers as part of its pharmacare deals with provinces and territories.

If insurance companies removed Ozempic coverage from private plans, it could significantly increase the number of people seeking coverage from New Brunswick, Dornan indicated in his meeting with activists. He said it would amount to $60 million in additional costs, though he didn’t indicate the period of time covered by that amount, according to Staples.

Staples said the Health Minister’s comments reflect efforts by industry to force the government into rejecting a universal pharmacare. “The insurance companies are trying to strong-arm the government to stay out of the diabetes medication area,” Staples said.

Government spokespersons didn’t respond to several requests for interviews with the Health Minister this week, and provincial government spokesperson Bruce MacFarlane said he was unable to confirm any details from Monday’s meeting.

The provincial government instead issued a vaguely-worded statement attributed to Dornan indicating that Ottawa’s plan isn’t “aligned” with New Brunswick’s current drug plan.

“We continue to be interested in finding a solution with Ottawa on diabetes support aligned with supporting accessibility and affordability of our existing programs without disrupting the stability of coverage people rely on today,” the statement said, in part.

The meeting came just days after Prime Minister Mark Carney told reporters that his government intends to follow-through with pharmacare deals covering diabetes treatments and contraceptives in every province and territory.

The response from New Brunswick’s Liberal government under Premier Susan Holt — who promised free contraceptives in their 2024 election platform — has so far been lukewarm.

“While we support the principle of national pharmacare, the current federal proposal does not align with New Brunswick’s well-established and effective system,” the province said in a statement reported by the Telegraph-Journal this week.

In July, Health Minister John Dornan told the NB Media Co-op that an offer from the feds wasn’t enough to cover the cost of pharmacare and that “New Brunswickers are already relatively well covered.”

But New Brunswick’s drug coverage has been roundly criticized by diabetes patients and public health advocates who cite widespread hardship among low-income people forced to choose between groceries, rent, and live-sustaining treatments.

The New Brunswick Drug Plan is a means-tested system with premiums and copayments based on annual family income. For example, a person with an annual income of $27,000 would pay more than $100 monthly in premiums and up to $17.90 for each prescription, according to provincial government data.

The NB Health Coalition held a virtual media conference on Monday morning to call for a pharmacare commitment from the Holt government.

Jean-Claude Basque, co-chair of the NB Health Coalition, said that activists planned to meet with multiple provincial Cabinet ministers “to impress on them the urgency to sign an agreement” as part of a three-week lobbying campaign.

New Brunswick resident Scott MacMillan described how his daughter was airlifted to hospital when she was diagnosed with Type-1 diabetes as a toddler.

“She was fighting for her life and nearly died when she was 15 months old due to diabetes,” he said. “This was a moment that we realized that Canada’s healthcare system is truly not universal,” he said. Life-sustaining treatments for Type-1 diabetes can cost upwards of $18,000 per year, he added.

Other speakers on Monday included Sophie Lavoie of Reproductive Justice NB, who called the coverage offered under the new national pharmacare plan “an absolute minimum.” She noted that the current lack of universal coverage in New Brunswick contributes to issues including unwanted pregnancies and costly hospitalizations.

One in ten people go without their medication in Canada due to high prices, according to the Canadian Health Coalition, which is campaigning alongside its New Brunswick counterpart.

Advocates often note that Canada is the only country in the world with a universal health care system but no universal coverage for medication outside of hospitals. Low-income people tend to lack private insurance and are more likely to forgo medications because of cost.

Three provinces and one territory — Manitoba, B.C., P.E.I. and Yukon — have signed pharmacare agreements with Ottawa since the Pharmacare Act became law last year.

David Gordon Koch is a journalist with the NB Media Co-op. This reporting has been made possible in part by the Government of Canada, administered by the Canadian Association of Community Television Stations and Users (CACTUS).

Full disclosure: NB Media Co-op coordinating editor Tracy Glynn is the national director of projects and operations of the Canadian Health Coalition. Sophie M. Lavoie of Reproductive Justice NB is also a member of the NB Media Co-op’s editorial board.