Health minister wants more time for pharmacare deals, but NDP health critic says they can be signed in the ‘next few days’

The fate of Canada’s pharmacare plan—for which not a single province has signed on—is unclear as Parliament remains prorogued with the possibility of a spring election to follow.

Part of the plan requires provinces and territories to sign bilateral agreements in order to receive their share of the $1.5-billion that has been set aside to help the jurisdictions cover a list of diabetes medications and contraception. 

But three months after Bill C-64, Pharmacare Act, received royal assent, Health Minister Mark Holland (Ajax, Ont.) has not announced a formal agreement with any province or territory. 

“I can tell you, if I’m given to October, I’ll get all the pharmacare deals, and I believe that,” said Holland during a press conference on Jan. 10. October is when a general election is scheduled to take place if his government does not lose a confidence vote before then. 

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The health minister’s comments, made during a press conference in Saskatoon, were in response to Hill Times Health’s questions about his timeline for completing negotiations for two sets of bilateral agreements in light of a possible spring election. A campaign would occur if the Liberal government loses a confidence vote after Parliament returns on March 24.  

“I think having that time is important, and I’m hopeful that it’s there, but I’ll make use of any time I’m given,” Holland added.  

The minister and Health Canada are currently negotiating bilateral deals for rare disease medicines and for pharmacare. 

Four provinces have signed on for money for rare disease drugs. Holland was in Saskatoon on Jan. 10 to announce that the Saskatchewan government was on board. British Columbia, Newfoundland and Labrador, and Alberta have also signed on. That leaves nine provinces and territories without deals in place. 

Holland said he is “sprinting” to complete the deals.

“We have these agreements that are so important on drugs for rare diseases–it’s essential that we get them all done. I’m feeling very good that there’ll be a number of more, and I’m very hopeful that we can get them all done. On pharmacare, this is going to be up to Parliament,” Holland said, referring to the possibility that the Liberals may be voted down this spring. 

He also pushed for a continuation of Parliament in its current form, saying, “Shouldn’t we use the time we’re given as parliamentarians to get things done?” 

But NDP health critic Peter Julian (New Westminster—Burnaby, B.C.) called Holland’s comments a “red herring.” The development of a pharmacare program was one of the main components of the supply-and-confidence agreement, which resulted in the NDP supporting the federal Liberals during confidence votes between March 2022 and September 2024.

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“All the tools are already in place. There are provinces that have already indicated they want to sign on, [with] B.C. and Manitoba being two examples of that,” Julian said in a phone interview with Hill Times Health on Jan. 13. “The money’s already been approved, the bill has already passed, so there can be no excuse for delay. These bills can be signed within the matter of the next few days, and it’s simply a matter of political will.”

He added that the signing of the agreements will save the lives of Canadians who cannot afford their diabetes medications and devices. 

Julian said that the federal Liberals should look to how medicare in Canada came to be in the 1960s as an example of how to proceed. 

“When we originally put in place universal health care, conservative provinces opposed it, but within three years, every single province had either changed its mind, or the people of that province had changed their government,” he said. 

“And so I think the reality is [that] moving ahead with the provinces that aren’t putting obstacles in place will create space where the people of the remaining provinces that have conservative governments will want to sign on, as well.”  

Julian also said that his party has not changed its stance that it will vote down the Liberal government following the next non-confidence motion. 

NDP leader Jagmeet Singh (Burnaby South, B.C.) said multiple times during a Jan. 6 press conference that his party would not support the Liberals during the next confidence vote. Conservative Leader Pierre Poilievre (Carleton, Ont.) and Bloc Québécois Leader Yves-François Blanchet (Beloeil—Chambly, Que.) have also said they would vote down the government. That could happen within days of Parliament’s return on March 24. Prorogation sets the stage for a new parliamentary session that must start with a throne speech, which is subject to a vote of confidence. 

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If the Liberals lose the next confidence vote, the government will fall and a federal election campaign will begin.

Julian said that if the NDP were in government, “these agreements would be signed every day, and we would be moving ahead to provide that medication.”

Hill Times Health reached out to Poilievre’s office by text and email on Jan. 13 and Jan. 14 to ask if the Conservatives would continue negotiations for bilateral agreements for pharmacare and rare disease medicines if they were to form government this year. Hill Times Health did not receive a response prior to the publication of this article. 

The Conservative Party did not support Bill C-64 when it was making its way through the House of Commons. The party as a whole voted against the pharmacare bill at second and third readings. 

The bilateral deals for pharmacare are one component of the proposed national pharmacare program. Bill C-64 includes references to the development of a list of essential medicines for a national formulary, a national bulk purchasing strategy for drugs, an appropriate use strategy for drugs and a report from an expert committee outlining recommendations for how to move forward with a national and universal program. Each of those components is supposed to be ready on or before Oct. 10, 2025, which is the one-year anniversary of the bill’s royal assent.