This week brought sweeping changes in political leadership, renewed commitments to healthcare, and rising international pressure on Canada’s pharmaceutical system. As Prime Minister Mark Carney reshapes his inner circle, his government is also doubling down on pharmacare, while cross-border drug pricing reforms in the U.S. raise red flags for affordability. Here’s what you need to know.
Carney’s Cabinet Reshuffle
Prime Minister Mark Carney announced a cabinet shuffle that reshaped the government’s leadership on trade, transportation, and international diplomacy. Chrystia Freeland stepped down as Minister of Transport and Internal Trade to become Canada’s Special Representative for the Reconstruction of Ukraine, confirming she will not seek re-election and will leave her seat in the House of Commons once her constituency association finalizes the timing, with Liberal MPs Rob Oliphant, Ryan Turnbull, and Jean-Yves Duclos praising her longstanding advocacy for Ukraine and fluency in the Ukrainian language.
Dominic LeBlanc, already President of the King’s Privy Council for Canada and Minister responsible for Canada-U.S. Trade, Intergovernmental Affairs, and One Canadian Economy, will now also serve as Minister of Internal Trade, while Steven MacKinnon, the Leader of the Government in the House of Commons, takes on the role of Minister of Transport.
Pharmacare Plan Under Review as Talks Continue
In a bid to demonstrate continuity, Carney reaffirmed his commitment to national pharmacare, pledging to continue negotiating bilateral pharmacare agreements with provinces and territories that have not yet signed deals, reversing an earlier position that limited the program to pre-election agreements. The government confirmed that the first phase of national pharmacare will provide universal coverage for contraceptives and select diabetes medications, reducing out-of-pocket costs for Canadians.
While provinces like Manitoba, B.C., P.E.I., and Yukon have reached agreements, others remain hesitant. The New Brunswick Health Coalition urged Premier Susan Holt to negotiate a provincial pharmacare agreement with the federal government, highlighting gaps in coverage that leave many residents without essential medications.
Health advocacy groups continue to apply pressure. The Canadian Health Coalition outlined that the Liberals have shifted their pharmacare policy four times since the federal election, drawing criticism for inconsistency and causing uncertainty among advocates. Canadian Doctors for Medicare argue this creates disparities in access to medication, as public protests and campaigns continue, some led by The Council of Canadians, who have openly criticized the federal government’s allocation of funds, pointing out that significant military spending casts a shadow over health priorities like pharmacare.
A committee of experts is scheduled to report by October 10 on potential models for a fully universal pharmacare program, which will inform future federal decisions.
Canada’s Lack of Rare Disease Strategy Draws Criticism
Canada remains the only G7 country without a national strategy for rare diseases.
A report by National Newswatch from the Macdonald-Laurier Institute shares that despite having identified around 11,000 rare diseases that collectively impact up to three million Canadians.
The lack of a formalized national strategy has led to delays in launching new drugs for rare diseases (DRDs). The federal government’s initial attempts to address this issue, such as the National Strategy for DRDs introduced in 2019 with a budget of $1.5 billion over three years, has made slow progress, hindered by the complexity of negotiating bilateral agreements with provinces and territories.
Strategic Marketing Adviser Sanda Markus, SCMP, in a social media post, has shared that families and caregivers of patients with rare neurological diseases such as CHD2, face unexpected challenges and a lack of support.
Advocates emphasize the importance of investing in early, evidence-based interventions and propose policy reforms, including making children’s health a national priority, closing policy gaps, and investing in Indigenous-led solutions
Trump’s Drug Pricing Strategy Poses Threat to Canadian Access
Health Affairs reported that U.S. President Donald Trump’s most favoured nation (MFN) directive targets the U.S. pharmaceutical industry’s “Achilles heel” of international price disparities, demanding that American patients and payers receive the lowest drug prices available in developed countries. While the MFN approach may lower some drug costs, it faces legal limits, may not ensure fair value-based pricing, and is unlikely to create a rational global pricing system.
At the same time, the administration’s tariffs on imports, including medical supplies and pharmaceuticals, risk raising costs for hospitals, potentially driving consolidation and higher out-of-pocket expenses for patients. Experts recommended short-term exemptions for essential medical goods, integrating Health Impact Assessments into trade policy, and strategically expanding domestic production to mitigate these risks and protect public health.
Alice Valder Curran, partner at Hogan Lovells, noted that while the MFN policy’s full impact is still uncertain, the administration’s executive order and communications to major pharma companies are already influencing industry behaviour.
Trump is weighing tariff exemptions for certain “non-patented” pharmaceutical products, including vaccines, cell therapies, and immunological products, as part of his reciprocal tariff scheme. The exemptions, outlined in Annex III of a recent executive order, aim to address domestic demand but would vary depending on trade partner agreements.
At the same time, U.S. Food and Drug Administration (FDA) leaders are moving to eliminate the use of outside advisory committees in drug application reviews, calling them burdensome, though critics warned the change would weaken transparency and limit public scrutiny.
Healthcare Agenda Faces Federal and Provincial Challenges
In an emailed statement to The Hill Times, Health Minister Marjorie Michel’s office said priorities this fall include cutting red tape to speed up access to medicines, supporting researchers, expanding youth mental health services, and strengthening primary care while continuing negotiations on bilateral pharmacare agreements.
Consultants noted the Carney government is retrenching from Trudeau-era health expansions, with spending restraint shifting Ottawa’s focus toward regulation, innovation, and workforce retention. On Facebook, Michel reiterated that as Parliament resumes, she and her colleagues will work to reduce paperwork, support mental health, and strengthen access to primary care.
Conservative health critic MP Dan Mazier said his top priority as Parliament resumes is getting internationally trained doctors working in Canada, stressing the need for a national licensing standard to address the shortage of family physicians and nurses. He also pledged to press the Carney Liberals on canola trade disputes with China, immigration system failures, housing prices, and rising crime.
Meanwhile, the Canadian Medical Association urged Prime Minister Mark Carney’s government to make healthcare a central nation-building priority as MPs return to Ottawa, citing polling that shows 89% of Canadians want better access to universal care. CMA President Dr. Margot Burnell highlighted support for reducing physician paperwork, advancing digital health, and re-tabling key legislation as ways to modernize the system and improve access.
In Newfoundland and Labrador, the provincial election set for October 14 has put the province’s healthcare crisis at the forefront, with issues including long wait times, ER overcrowding, physician and nursing shortages, and weak retention in rural areas.
From the cabinet room to communities, this week highlighted the pressure points of Canadian healthcare policy. As the federal government navigates leadership shifts, pharmacare implementation, and international drug market shocks, the question isn’t just what will change—it’s how quickly the system can adapt.
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