National Pharmacare Launching in B.C.

Coverage for certain items through national pharmacare will be launching in B.C. effective March 1, 2026.

As background, in late 2024, the federal government’s Bill C-64: Pharmacare Act, received royal assent and came into force.This act provided the foundational principles in establishing a national pharmacare program, and defined the first phase of national pharmacare: a focus on contraception and diabetes treatment coverages.

British Columbia was one of the first provinces to express interest in partnering to launch this first phase of national pharmacare, signing an agreement with the federal government in early 2025 for funding of $670 million over three years.

The agreement will come into effect on March 1, 2026 and will cover the following items (as per the Government of BC website):

Diabetes Medications: Insulins, Metformin, Glyburide, Gliclazide, Dapagliflozin, Empagliflozin and empagliflozin with metformin, Saxagliptin and linagliptin, Pioglitazone

Menopausal Hormone Therapies: Oral micronized progesterone, Vaginal estrogen, Topical estrogen and estrogen/progesterone (gels & patches), Oral estradiol, Oral conjugated estrogen, Oral medroxyprogesterone

This was implemented in place of support for contraceptives since BC already implemented its own contraceptives program in 2023.

Coverage under national pharmacare will be provided automatically with plan members not needing to register.It was also noted that certain diabetes-related devices and supplies will be covered effective April 1, 2026, but no further details have yet been provided.

Actual coverage will vary by drug with some being fully covered and others being only partially covered.The Government of B.C. website does reference low cost alternative (LCA) pricing such that drugs at lower costs such as generics will likely have higher coverage levels.

Our Thoughts

We expect this change to be net positive for plan sponsors as it will shift costs for a number of common drugs towards national pharmacare.Further, while several of these drugs were already partially covered through BC MSP, some will now be fully covered through national pharmacare.

That said, the exact impact of this change on plans would be difficult to determine for a few reasons:

BC MSP applies an annual deductible based on family income, which varies by member such that actual impacts will vary across membership.

Member behavior will play a factor.To the extent that the group benefit plan offers coverage for a broader set of drugs than national pharmacare, members may elect to go with an alternative drug and rely on coverage under the group benefit plan.

For plans that typically align their formulary to BC MSP, a discussion should be had with your benefit plan provider to understand how the existing formulary will align to national pharmacare both at launch and going forward.

To the extent that the formulary does not align to national pharmacare, plan sponsors will likely want to consider the potential impacts (e.g., as new drugs enter the market that are not covered through national pharmacare) to ensure this aligns to the plan sponsor’s intent.

Lastly, we look forward to understanding the which diabetes-related devices and supplies will be included as this could further reduce the plan sponsor burden depending on the items covered.We expect further details to be released in the next several weeks.

Jojy Oommen
Partner