Thank you, Chair.

Through you, I want to thank the committee for inviting me to testify today.

For the more than four million people living with diabetes in Canada, access to affordable medications and devices is critical. In fact, the out-of-pocket costs of things like medications, devices and supplies can be as high as $18,000 per year if individuals are solely reliant on public coverage. I will, therefore, focus my remarks on two areas: the implementation and funding provided for diabetes medications under Canada's new national pharmacare program, and the need for investments to support the national diabetes device access fund.

As we know, earlier this month, Bill C-64 received royal assent, creating the framework for a national pharmacare program, which is a good first step. However, many of Diabetes Canada's concerns remain unresolved. During the parliamentary debate on Bill C-64, Diabetes Canada emphasized that the best approach to establishing a national pharmacare program would be to initially focus on helping people who lack adequate coverage for their prescribed treatment regimes and to ensure there are no disruptions to their private coverage. We recommended the inclusion of a provision very similar to the dental care legislation to clarify that a federal pharmacare program will not jeopardize the current system. We remain concerned about the potential unintended consequences of the legislation.

We have also raised concerns with the current draft formulary for diabetes medications, as they do not align with Diabetes Canada's clinical practice guidelines, also called CPGs, which are developed to inform general patterns of care and public policy. Diabetes is a complex condition that has a constantly expanding list of new therapies and medications, and those medications and therapies should be available and covered as options of care.

Within the legislation that has passed, the Minister of Health is now required to direct Canada's Drug Agency to compile a list of essential medicines that will inform the national formulary. As such, Diabetes Canada continues to call for an immediate expansion and update of the background formulary to reflect the CPGs so that people living with diabetes can access the medications they need to support their best possible health outcomes.

We are also calling for an increase to the baseline funding to ensure that the program meets the needs of persons living in Canada with diabetes. If the program is truly a single-payer universal system, then the initial budget 2024 allocation of $1.5 billion over five years, which covers both diabetes and contraception medications, will not provide a sufficient basis of funding for this program to operate properly.

Let me explain: The estimated yearly cost of diabetes medications, as assessed by the private health insurance industry, is over $1.6 billion per year, and in 2023, public spending on diabetes medications was $1.8 billion, which is close to $3.5 billion per year just for diabetes medications alone.

Beyond pharmacare, I also want to speak about the importance of establishing a national diabetes device fund, which the government committed to last February. One-quarter of the people living with diabetes have reported that the additional cost of diabetes devices affects their adherence to their prescribed treatment regimes, which has significant risks to their short- and long-term health. Over the past few years, Diabetes Canada has worked with many provinces and territories to expand affordable access to diabetes devices. We are proud of this work to increase access and are keen to see further expansion of these programs.

However, since last February, we have seen what I would describe as stasis as provinces and territories await further details from the federal government about the device access program before further expanding their programs. That is why it's critical that the government urgently provide more details on its intentions with respect to a federal device and equipment access program as quickly as possible.

Personally, as someone who lives with type 2 diabetes, I know how dramatically my device has improved my quality of life and ability to manage and control my diabetes effectively. The use of devices and equipment that helps individuals manage their diabetes also contributes to a broader savings in the health care system. We also believe further savings could be seen across the country if there is further action undertaken to implement the federal framework for diabetes in Canada.

In closing, by providing that common policy direction through the framework for multisectoral stakeholders, as well as provincial and territorial governments, we can identify gaps in current approaches, avoid duplicating efforts and provide opportunities for monitoring and reporting on progress. Those six framework components would not only improve the quality of life for those four million people in Canada living with diabetes, but save the system dollars.

Therefore, I look forward to working with members of this committee to ensure that the upcoming budget reflects these realities for people living with diabetes in Canada.

I look forward to your questions.

Thank you, Chair.