“Our government remains focused on empowering Canadians—by lowering costs, expanding opportunity, and protecting the vital social programs Canadians rely on, from child care to dental care to pharmacare.”
Those were the words of the federal government in the November 2025 budget.
Fast forward to spring 2026.
From the Spring Economic Update, it appears that there will be no new federal funding for additional pharmacare deals. With the bilateral health funding dropping from $4.3 billion in 2025-26 to $3.1 billion in 2027-28, it seems that the federal government doesn’t see a future for national pharmacare.
This is disappointing, considering the progress that has been made advancing pharmacare in Canada. The Pharmacare Act was passed in 2024, and under the Trudeau Liberal government, the federal government signed four bilateral agreements with British Columbia, Manitoba, P.E.I., and the Yukon.
If the federal government walks away from pharmacare, it puts at risk ongoing funding that has only recently been committed. In 2025-26, the federal government contributed $88.1 million to support these provinces and one territory in the expansion of public coverage of diabetes medications and contraception for all residents. The federal pharmacare contribution is expected to increase to $269.6 million by 2028-29.
But after 2029?
It appears that the federal government is killing any hope of national pharmacare before it even got off the ground.
In April, P.E.I.’s health minister revealed that Ottawa will be cutting $29 million in health care funding to the province over the next three years.
After P.E.I. raised public concerns, Newfoundland and Labrador’s health minister said, “the door was closed on our province.”
The federal government appears poised to allow existing bilateral funding agreements to expire without renewal, translating into cuts for existing provincial health care services, including funding for diabetes medications and contraceptives, which was negotiated with these three provinces and one territory. And if those jurisdictions want to maintain the existing universal coverage for diabetes medications and contraceptives, they will have to fill the funding gap created by the federal government.
Out-of-pocket drug costs add to the cost of living crisis
In 2023, Canadian residents spent $8 billion on out-of-pocket prescription drugs. Another $15.8 billion was spent on drugs through private insurance plans.
Cost-related medication non-adherence, as it is referred to in the research, remains a pressing concern in Canada. Estimates from 16 studies of non-adherence range from five to 10 per cent of the population that is not able to follow medical recommendations for prescription drug therapy due to inability to pay.
The factors predicting non-adherence include “high out-of-pocket spending, low income or financial flexibility, lack of drug insurance, younger age, and poorer health.” Cost-related medication non-adherence is two to five times higher in Canada than comparable countries with universal pharmacare.
Even still, these studies may underestimate the extent to which Canadian residents are unable to afford medications. Survey evidence has shown that upwards of one in five people in Canada have not taken prescribed medication because it was too expensive.
The evidence hasn’t changed: pharmacare benefits population health and health care
Since the federal government has walked back its commitment to build out national pharmacare in Canada, the evidence about its benefits has not changed.
Numerous governmental reports have recommended Canada move to a system of universal, publicly funded, single-payer pharmacare, including the 2018 parliamentary committee report Pharmacare Now, 2019 National Advisory Council report on the implementation of national pharmacare, and the 2025 Final Report of the National Pharmacare Committee of Experts.
National pharmacare is estimated to benefit population health by ensuring that patients can receive the treatment they require and manage health conditions and chronic diseases. The benefits also accrue for the health care system as individuals: when able to access prescription drugs, people are less likely to end up in emergency departments or inpatient care because their medical conditions go unmanaged.
The economic benefits of national pharmacare are clear. The 2019 report, A Prescription for Canada, estimated that by 2027, with a comprehensive formulary of drugs, Canada would spend $5 billion less on prescription drugs while at the same time improving access for all. These are substantial cost savings, which could help reduce the financial pressures facing people across the country.—and improve their health.
National pharmacare can help address widening inequality and cost of living pressures, but we need the federal government to recommit to this nation-building project.
