Health
Pharmacare won’t help Canadians with rare disorders

From the MacDonald Laurier Institute
By Nigel Rawson and John Adams
Canadians with rare disorders will be even worse off if NDP’s parliamentary blackmail works
Last month the federal NDP convention in Hamilton voted unanimously to force the Liberals to introduce a single-payer universal pharmacare program or see the current “confidence-and-supply” deal canceled. Will universal government-run pharmacare benefit Canadians with rare disorders? We fear not.
Canadians with such disorders are already disadvantaged compared with sufferers in other countries. Fewer specialized drugs are launched in Canada than in the United States and Europe. Those that are get approval for marketing about a year, on average, after they do there.
That’s not because Health Canada takes longer to review new medicines. The process takes about the same time in the three places. Rather, delayed approval is likely due to manufacturers submitting later to Health Canada because federal, provincial and territorial hostility towards the industry has made our biopharmaceutical market less attractive.
Approval doesn’t mean government drug plans will pay for a drug, however. Further government-created barriers impact all Canadians, but particularly those with rare disorders who want access to novel drugs for their unmet or poorly met health needs. As a consequence, what gets listed in government drug plans varies widely, leading to a postal code lottery.
In a set of articles published over the summer by the Macdonald-Laurier Institute, we discuss the several obstacles patients and their families face as they try to gain access to new or expensive innovative therapies. They include: the lack of federal incentives for developers to submit new medicines to Health Canada; health technology assessment that is neither accountable, independent nor transparent and makes recommendations about which drugs to cover in public drug plans to governments; and price negotiations between government drug plans and manufacturers.
Even when drug developers clear these government-created barriers, public drug plans are under no obligation to add the approved medicines to their benefit lists. Too often governments focus only on drug costs and ignore the broader benefits effective drugs can bring, not only to the health and well-being of patients and their families, but also to other parts of the health system, to the economy and to society at large. If a new drug reduces doctor or emergency visits or hospitalizations or helps a person get back to work, those benefits typically are ignored by our drug assessment system.
The federal government made matters worse over the past six years by planning to drastically reduce drug prices by regulatory order, not negotiation. This caused considerable uncertainty among developers, resulting in even fewer new drugs being submitted for marketing approval here than in the U.S. and EU.
Proponents plainly want a lowest-common-denominator government-run public plan that would crowd out private plans, which over two-thirds of Canadians currently rely on for drug access.
Despite the federal government committing $1.5 billion over three years to “increase access to, and affordability of, effective drugs for rare diseases to improve the health of patients across Canada,” its initiative is not comprehensive. So far, Canada has neither a government-endorsed national rare disorder strategy nor an Orphan Drug Act providing incentives to developers to launch orphan medicines in Canada. Most other developed countries have both.
Patients’ organizations have stepped in where governments have failed to act and proposed a Canadian strategy that would include incentives and funding to encourage developers to launch drugs in this country and cut through the barriers we have described to provide timely access to the many innovative treatments on the research horizon. For example, access to breakthrough drugs could be allowed as soon as Health Canada says they are safe and effective, even as other administrative boxes are checked and prices negotiated. Other countries use this approach.
Canadians afflicted with any of the 11,000 or so known rare disorders have significant unmet needs. Fewer than five per cent have any treatment beyond symptom relief or palliative care. The last thing these people need is for governments to ration innovative drugs even more than they already do or to force even deeper price cuts from drug developers in order to pay for universal pharmacare that covers only basic medicines.
Canadians with rare disorders almost certainly will be even worse off if the NDP’s parliamentary blackmail works.
Nigel Rawson is an affiliate scholar with the Canadian Health Policy Institute and a senior fellow with the Macdonald-Laurier Institute, as is John Adams, co-founder and CEO of Canadian PKU and Allied Disorders Inc.
Mental Health
Suspect who killed 11 in Vancouver festival attack ID’d

Quick Hit:
Authorities have identified the driver responsible for the devastating attack at Vancouver’s Lapu Lapu Day festival that killed at least 11 and injured dozens more. The suspect, Kai-Ji Adam Lo, 30, had a well-documented history of mental illness, and his family sought help just hours before the tragic event.
Key Details:
- Kai-Ji Adam Lo, 30, was identified as the driver who plowed into a crowd, killing 11 and injuring dozens more.
- Lo’s family sought psychiatric help for him hours before the attack; he was already known to law enforcement.
- Police believe the attack was not terror-related, citing Lo’s extensive mental health struggles.
At least 9 dead in mass casualty event after driver crashes into crowd at Vancouver street festival.
The 30 year old driver was taken into custody by festival goers then arrested.
According to law enforcement “the suspect was known to police for certain circumstances”. pic.twitter.com/slG7LsZNFG
— Kevin Dalton (@TheKevinDalton) April 27, 2025
Diving Deeper:
The city of Vancouver is grappling with unspeakable tragedy following the deadly assault that unfolded during the Lapu Lapu Day festival, a vibrant celebration honoring the Filipino community. Authorities have identified the man behind the wheel as 30-year-old Kai-Ji Adam Lo, who was apprehended at the scene Saturday night.
Lo, whose troubled history with mental illness was well known to local authorities and mental health professionals, faces eight counts of second-degree murder, with additional charges expected as the investigation continues. According to reports, Lo’s family had reached out to a hospital psychiatric ward just hours before the incident, desperately seeking help for him amid his escalating paranoia and delusions. It remains unclear whether any intervention was made in response to the family’s call.
Vancouver Police Chief Steve Rai confirmed that Lo had no interactions with law enforcement immediately prior to the event, but acknowledged that the city is reeling from its “darkest day.” Investigators emphasized that, because of Lo’s mental state, they do not believe the attack was terror-related.
Adding to the complex portrait of the suspect, Lo was mourning profound personal loss. His brother, Alexander Lo, was murdered in January 2024. Following the death, Lo had penned heartbreaking posts online, sharing how his brother’s death and his mother’s subsequent suicide attempt shattered their family.
Tragically, among the 11 killed during Saturday’s carnage was a 5-year-old child. Dozens more were wounded when Lo drove his SUV into the densely packed crowd gathered for the festivities. Lo has since appeared in court and will remain in custody as prosecutors prepare to bring additional charges.
The horror that unfolded in Vancouver serves as a stark reminder of the broader systemic failures surrounding mental health interventions. While Canadian authorities attempt to grapple with the aftermath, this tragedy sadly echoes similar stories in other nations where warnings about individuals in crisis have gone unheeded—with catastrophic results.
Addictions
Four new studies show link between heavy cannabis use, serious health risks

Cannabis products purchased in Ontario and B.C., including gummies, pre-rolled joints, chocolates and dried flower; April 11, 2025. [Photo credit: Alexandra Keeler]
By Alexandra Keeler
New Canadian research shows a connection between heavy cannabis use and dementia, heart attacks, schizophrenia and even death
Six months ago, doctors in Boston began noticing a concerning trend: young patients were showing up in emergency rooms with atypical symptoms and being diagnosed with heart attacks.
“The link between them was that they were heavy cannabis users,” Dr. Ahmed Mahmoud, a cardiovascular researcher and physician in Boston, told Canadian Affairs in an interview.
These frontline observations mirror emerging evidence by Canadian researchers showing heavy cannabis use is associated with significant adverse health impacts, including heart attacks, schizophrenia and dementia.
Sources warn public health measures are not keeping pace with rapid changes to cannabis products as the market is commercialized.
“The irony of this moment is that society’s risk perception of cannabis is at an all-time low, at the exact moment that the substance is probably having increasingly negative health impacts,” said Dr. Daniel Myran, a physician and Canada Research Chair at the University of Ottawa. Myran was lead researcher on three new Canadian studies on cannabis’ negative health impacts.
Legalization
Canada was the first G7 country to create a commercial cannabis market when it legalized the production and sale of cannabis in 2018.
The drug is now widely used in Canada.
In the 2024 Canadian Cannabis Survey, an annual government survey of cannabis trends, 26 per cent of respondents said they used cannabis for non-medical purposes in the past year, up from 22 per cent in 2018. Among youth, that number was 41 per cent.
Health Canada’s website warns that cannabis use can lower blood pressure and raise heart rates, which can increase the risk of a heart attack. But the warnings on cannabis product labels vary. Some mention risks of anxiety or effects on memory and concentration, but make no mention of cardiovascular risks.
The annual cannabis survey also shows a significant percentage of Canadians remain unaware of cannabis’ health risks.
In the survey, only 70 per cent of respondents said they had enough reliable information to make informed decisions about cannabis use. And 50 per cent of respondents said they had not seen any education campaigns or public health messages about cannabis.
At the same time, researchers are finding mounting evidence that cannabis use is associated with health risks.
A 2023 study by researchers at the University of Calgary, the University of Alberta and Alberta Health Services found that adults with cannabis use disorder faced a 60 per cent higher risk of experiencing adverse cardiovascular events — including heart attacks. Cannabis use disorder is marked by the inability to stop using cannabis despite negative consequences, such as work, social, legal or health issues.
Between February and April of this year, three other Canadian studies linked frequent cannabis use to elevated risks of developing schizophrenia, dementia and mortality. These studies were primarily conducted by researchers at the Ottawa Hospital Research Institute and ICES uOttawa (formerly the Institute for Clinical Evaluative Sciences).
“These results suggest that individuals who require hospital-based care for a [cannabis use disorder] may be at increased risk of premature death,” said the study linking cannabis-related hospital visits with increased mortality rates.
The three 2024 studies all examined the impacts of severe cannabis use, suggesting more moderate users may face lower risks. The researchers also cautioned that their research shows a correlation between heavy cannabis use and adverse health effects, but does not establish causality.
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Budtenders
Health experts say they are troubled by the widespread perception that cannabis is entirely benign.
“It has some benefits, it has some side effects,” said Mahmoud, the Boston cardiovascular researcher. “We need to raise awareness about the side effects as well as the benefits.”
Some also expressed concern that the commercialization of cannabis products in Canada has created a race to produce products with elevated levels of THC, the main psychoactive compound that produces a “high.”
THC levels have more than doubled since legalization, yet even products with high THC levels are marketed as harmless.
“The products that are on the market are evolving in ways that are concerning,” Myran said. “Higher THC products are associated with considerably more risk.”
Myran views cannabis decriminalization as a public health success, because it keeps young people out of the criminal justice system and reduces inequities faced by Indigenous and racialized groups.
“[But] I do not think that you need to create a commercial cannabis market or industry in order to achieve those public health benefits,” he said.
Since decriminalization, the provinces have taken different approaches to regulating cannabis. But even in provinces where governments control cannabis distribution, such as New Brunswick and Nova Scotia, products with high THC levels dominate retail shelves and online storefronts.
In Myran’s view, federal and provincial governments should instead be focused on curbing harmful use patterns, rather than promoting cannabis sales.
Ian Culbert, executive director of the Canadian Public Health Association, thinks governments’ financial interest in the cannabis industry creates a conflict of interest.
“[As with] all regulated substances, governments are addicted to the revenue they create,” he said. “But they also have a responsibility to safeguard the well-being of citizens.”
Culbert believes cannabis retailers should be required to educate customers about health risks — just as bartenders are required to undergo Smart Serve training and lottery corporations are required to mitigate risks of gambling addiction.
“Give ‘budtenders’ the training around potential health risks,” he said.
“While cannabis may not be the cause of some of these negative health events … it is the intersection at which an intervention can take place through the transaction of sales. So is there something we can do there that can change the trajectory of a person’s life?”
This article was produced through the Breaking Needles Fellowship Program, which provided a grant to Canadian Affairs, a digital media outlet, to fund journalism exploring addiction and crime in Canada. Articles produced through the Fellowship are co-published by Break The Needle and Canadian Affairs.
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