Little Italy’s Nav Persaud makes the case for free meds

By Nicole Stoffman

This article is the first in a series about local residents making a difference in our community. These unsung heroes were brought to the Gleaner’s attention by MPP Jessica Bell, who honoured them at her Annual Community Celebration, in December of 2019.

Dr. Nav Persaud had a problem: his diabetes patients weren’t getting better because they couldn’t afford medication. 

“Even though the rights for insulin were sold for a dollar by Banting and Best with the idea that everyone should have access to them, in Canada the type of job you have determines if you have access to medicines,” says Persaud, the Palmerston-Little Italy resident and outspoken advocate for National Pharmacare.

Dr. Persaud, who is a staff physician in the Department of Family and Community Medicine at St. Michael’s Hospital, started keeping a supply of medications on hand to give for free to patients with chronic illnesses. Still, the issue of inequitable drug coverage weighed on him and his team.

“Ultimately, we realized that there are millions of people in Canada facing this problem, and so we wanted to do something that could inform a public policy change that would help everyone.” 

That something was the CLEAN Meds study. The 2016-17 study provided almost 800 people with free access to more than 125 medicines. Free access improved participants’ health in more ways than one. Not only were their illnesses better managed, but those receiving free medicine were 53% more likely to afford rent and food than those in the control group who did not.

The study was supported by the Canadian Institutes for Health Research, the Province of Ontario, the Canada Research Chairs program, and the St Michael’s Hospital Foundation.

Some study participants, as well as members of the community guidance panel who helped to design the study, were Annex residents. According to a 2016 Statistics Canada survey, 7.5 million Canadians lack or have inadequate drug coverage. 

Canada is the only high-income country in the world with free Medicare but not free medicine. Instead, we have a mixed system of private and public insurance, while many pay for medicines out of pocket. The exception is Quebec, which provides prescription drug coverage to everyone in the province. 

Advocates of maintaining the current system argue that most Canadians are covered in some form or another. Indeed, the majority of the CLEAN Meds participants had insurance but could not afford the co-payments or deductibles. 

According to a 2016 UBC-led study, almost 1 million Canadians find themselves in a similar situation, and elect to spend less on food and heating costs in order to afford their medications.

Interestingly, not all CLEAN Meds participants were the working poor. Some had incomes of up to $70,000 yet lacked adequate drug coverage because they had larger households, or very expensive medication. 

“It’s important for people to understand and recognize that every day, they are passing people in the street who can’t afford medicines, including lifesaving ones,” notes Dr. Persaud.

Much of the debate around National Pharmacare in Canada centres on cost. The Parliamentary Budget Officer calculated it would save 4.2 billion a year in spending on drugs, but the government’s Advisory Council reported it could cost taxpayers $15.3 billion. The Green Party estimated it would cost 26.7 billion. 

Even these estimates represent a savings considering Canadians paid $28.5 billion on medications in 2015, making our drug spending per capita the third highest among industrialized countries, according to an OECD study. 

Dr. Persaud, who is also a Canada Research Chair in Health Justice, prefers to focus on the kind of society we want to live in. Do we want our factory workers, taxi drivers, entrepreneurs, and artists to have access to life-saving treatment, if necessary? 

“The reality is that saying to people that this is going to save billions of dollars isn’t very persuasive, and it’s not actually the most important issue,” he explains. 

“We all live in this city and country together, and it’s very clear that Canadians support our publicly-funded health care system, and it’s very obvious that the publicly-funded healthcare system should include medicines.”

“Many times I’ve seen people come back with the same problems that don’t get any better,” adds Dr. Persaud. “Ultimately, you get a phone call that they are in the hospital. You start thinking that you wish there was something we could have done sooner.”