Health committee  That, unfortunately, I don't know off the top of my head.

Health committee  I'm sorry. Lisa tells me that we have the numbers, so I'll probably let her speak.

Health committee  The numbers that Lisa mentioned are the expenditures that are currently being covered by public, private and out-of-pocket expenditures. For the drugs under Bill C-64— contraceptives and diabetes—it's about $5.7 billion. Assuming that all these expenditures would be covered by the federal government, that's how much it would cost.

Health committee  Everybody needs these expensive drugs, unfortunately, but it's true that while generic drugs tend to be a relatively small portion of all prescriptions, they are a much higher portion of total expenditures. You're right that when new drugs come onto the market, they tend to be much more expensive than generic drugs, as I'm sure Mr.

Health committee  Yes, we took into account inflation, past inflation as well as our projections for future inflation.

Health committee  No, we did not include any provinces potentially reducing coverage for diabetes and contraceptives.

Health committee  It is indeed a risk, as is the case if some employers decide to reduce their coverage, knowing that there is a public plan that would cover their employees.

Health committee  Well, I wouldn't say we have no clue, but there's quite a bit of uncertainty regarding the costing of such a plan, given the potential for public plans and private plans to off-load some of their responsibilities onto the public plan.

Health committee  Sure. You're probably referring to our October 2023 report, where we costed a Canada-wide single-payer universal plan that would cover most drugs. In that case, we assumed that the bargaining power of the federal government would allow the single payer—well, I say “the federal government”, but it could be individual provinces.

Health committee  The short answer to your question is no. The mandate of my office is to provide costing and cost estimates. We rarely do cost-benefit analysis for that very reason, unless we're specifically mandated to do that through a very focused request. Generally, we don't do that.

Health committee  Possibly. Based on our understanding of Bill C‑64 and the technical documents included with the first portion, there's a list of drugs that will be covered. There may be other types of contraceptives or diabetes drugs, but they wouldn't be covered. There may also be a behavioural effect such as substitution.

Health committee  No. I don't know if Ms. Barkova would like to add anything.

Health committee  The costs that we referred to in our October 2013 report are the aggregate expenditures on public drug plans. They are expected to increase. That's the cost of the drugs that would be covered under a national pharmacare program.

Health committee  If the committee wants this, we can consider the possibility of doing this work, as long as the available data is thorough enough. Regardless, we could certainly come up with a good approximation, if the committee asked for it.

Health committee  Based on a hypothetical scenario where the government provides a large percentage of the funding for a national program and progressively decreases its share over time, for example by not indexing its contribution or through a reduction, as we have seen in the past, the provinces would inevitably need to make difficult choices.