National Pharmacare Program Background:
Canada’s Pharmacare Act, which came into force on October 10, 2024, establishes a national framework to guide efforts to improve the accessibility and affordability of prescription drugs and related products in collaboration with the provinces, territories and Indigenous peoples. s. 5 affirms the Government of Canada’s commitment to maintaining long-term funding and provides that the funding for provinces and territories must be provided primarily through agreements with their respective governments.
On March 20, 2025, the Government of Canada and the Yukon Government executed a national pharmacare bilateral agreement (also referred to as the “bilateral agreement” throughout this PIA (see Appendix C)), which provides up to $9.5 million funding over four years for the provision of universal access to contraceptive and diabetes medications for residents of the Yukon.
The primary objectives of the agreement include:
1. Providing Universal, Single-payer, First-dollar coverage for the list of products that are covered in the Yukon and belong to categories identified in Annex A of the bilateral agreement.
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2. Increase access to insulin pumps and advanced glucose monitors (“AGM”) by expanding eligibility for public coverage of these products, with all expanded coverage subject to existing coverage plans and adjudication rules.
Yukon Insured Health Services Role:
Yukon Insured Health Services (“IHS”) is responsible for the delivery of health care benefits as set out in the Yukon Health Care Insurance Plan (“YHCIP”), including the delivery of the Yukon National Pharmacare Program (“YNPP”) in accordance with the bilateral agreement with the Government of Canada.
Previously, the coverage of diabetes and contraceptive medications in the Yukon was split between territorial drug plans, privat coverage, non-insured benefits, and out of pocket payers. Backed by the Government of Canada funding, the Yukon Government will now cover these medications under the umbrella of a National Pharmacare program for eligible Yukon residents (also referred to as “beneficiaries”).
In 2025, IHS issued a Request for Proposals (2025-7-4646) for the provision of National Pharmacare Claims Adjudication services.
Yukon National Pharmacare Claims Adjudication Service Provider:
Pacific Blue Cross (“PBC”) was the successful vendor for RFP 2025-7-4646 and the Yukon Government awarded the contract for the Yukon National Pharmacare Claims Adjudication services to PBC in 2026.
PBC is a not-for-profit Health Benefits Society based in Burnaby, BC, serving 1 in 3 British Columbians with health, dental, life, disability, and travel coverage through both group and individual plans.
PBC has been adjudicating pharmaceutical claims for over 85 years since their establishment in the 1940s and currently serves approximately 18% of Yukon residents across two dental programs available to residents of the territory, in addition to several Yukon-based small business and individual travel coverage policies.
