I assumed the idea was the play the middle-man only - but keep the individual provinces, etc. in the same role.

I.e., become a bulk buyer & distributor of drugs - but do not take over admin of the plans themselves

That seems WAY EASIER to setup, way less expensive, way less to worry about.  Just get the provinces and canadian plans to buy from the federal govt instead of dealing with the firms directly.  But let them continue to manage the programs

That should only cost say $20M / year to run instead of hundreds of millions but could theoretically achieve the same or maybe even better results.