Free prescription drugs for anyone under 25, a first of its kind, Liberals say

New plan will come into effect January 2018 and fully cover 4,400 drugs

By Laura Fraser, CBC News
Posted: Apr 27, 2017 4:21 PM ET
Last Updated: Apr 28, 2017 5:28 AM ET

All Ontario children and adults younger than 25 will have their full prescription drug costs covered by a new provincial program, regardless of family income or whether they already have private insurance. 

This expanded drug coverage will cost a projected $465 million per year.

Currently, the Ontario Drug Plan (ODP) covers prescription drug costs for approximately 900,000 families on social assistance and another three million seniors.

The new program will roll out Jan. 1, 2018 — and will cover 4,400 drugs for the province’s four million children and young adults. The medications are the same already included in the ODP, which includes treatment for acute and chronic illness, as well as certain pediatric cancers.

How it affects insurance premiums

What this means for the insurance industry — and whether it will reduce family premiums — is unclear.

Health department staff said that while they’ve had discussions with those in the industry, they couldn’t say whether there had been a commitment to change premiums but hope the savings will be passed on to families.

Under the plan, neither children nor young adults would have to go through their or their parent’s private insurer for coverage first. And because the provincial program would be free, patients wouldn’t be on the hook for co-payment or dispensary fees, unlike with private coverage.

When asked why the “OHIP+: Children and Youth Pharmacare” plan would apply to those who already have coverage, Finance Minister Charles Sousa said the province wanted people to have equal access to medication.  “Even with those who have plans, they still have co-pays and deductibles and that’s a significant expense on them,” he said. “You want an income test and we’re not doing that.”

He also noted that the changing nature of work has seen people working contract jobs, something that has created a drop in the number of people who earn employee health benefits.

What it means for patients

Dr. Danielle Martin, a family doctor and the VP of Medical Affairs and Health System Solutions at Women’s College, described the expansion as a “huge improvement” to the current system.

In her practice, she said she’s experienced “many heartbreaking moments” when families are uncertain they can pay for puffers or insulin for their children – or when young women aren’t sure how to pay for birth control pills.  This type of program is critical to the long-term health of the province’s patients and its health-care system because those people unable to afford medication to manage chronic conditions, (like high blood pressure or diabetes), may eventually suffer the consequences — such as stroke, vision loss, heart attacks — which can be deadly for patients and require expensive costly hospital care.