As public relations consultants, we are often engaged to build narratives that effectively communicate the position of our clients, especially during times of change. This could not be truer than in the Canadian healthcare industry – one that is highly regulated and includes a multitude of stakeholders. The Canadian healthcare sector faces much change in the coming months including proposed reforms to the Patented Medicine Prices Review Board (PMPRB) guidelines, the potential of a national pharmacare plan, multiple changes in treatments listed on provincial formularies, and the evolving scope of practice for many healthcare practitioners. These have the potential to alter the Canadian healthcare landscape, as we know it.
Several NATIONAL and AXON colleagues recently attended an Ontario Pharmaceutical Marketing Association session, led by Heather McDonald, VP of Market Access and Government Affairs at Bayer Canada, on potential drug pricing reform in Canada and the value of innovation. Here’s what we learned:
Biggest proposed changes by PMPRB:
Updating the PMPRB-7: In Canada, PMPRB’s mandate is to ensure that drug prices are not “excessive”. One way it does this is by comparing a drug’s price in Canada to seven other countries around the world, including Switzerland, the USA, France, the UK, Germany, Italy and Sweden, ensuring that a drug in Canada cannot be priced higher than the median price of that same drug in those seven countries. The proposed changes include removing the USA and Switzerland from the list and updating the list of countries to 12 to include Australia, Belgium, France, Germany, Italy, Japan, the Netherlands, Norway, South Korea, Spain, Sweden, and the United Kingdom (i.e. the “PMPRB12”). The removal of the USA and Switzerland from the list, two countries that often have higher prices for patented drugs than those in Canada, is expected to bring the median price down and thus lower the price that a company can price their treatment at in Canada.
New price determination factors: New factors impacting the price of a drug will be considered based on health technology assessment (HTA), market size, pharmaeconomics, etc.
Confidential rebates disclosure: Innovative companies (patentees) will now be required to disclose confidential rebates made to third parties (ex. payors).
Pharmacare 2020 – a national public drug plan:
The “Pharmacare 2020” proposal would establish a single-payer system in Canada and provide universal coverage of select prescription medicines, deemed medically necessary for Canadians. Stemming from an initiative of the Pharmaceutical Policy Research Collaboration, a CIHR/Health Canada Emerging Team on Equity in Access to Necessary Medicines (2009–2014), the plan is a culmination of research from academics, health professionals, policy-makers, and public interest groups. However, this plan raises many questions, yet to be answered:
- Which prescription medicines will be covered and how will they be evaluated for inclusion?
- Will patients have access to different treatment options?
- Will individuals have the ability to maintain their private health insurance? What will be the role of private health insurers?
- Would taxpayers be on the hook to pay for the national pharmacare plan?
There’s no shortage of opinion on the potential changes. They will have a massive impact on the Canadian healthcare industry and may indicate that Canada is going to be a more challenging place for innovative companies to operate. While many different groups have a stake in these changes –– one thing is clear. All stakeholders must consider the needs of patients, placing them at the centre of their decisions.
Whether working with patients, advocacy groups, pharmaceutical companies, government, academia, research or trade, your team at NATIONAL and AXON are here to help guide you through this change. Reach out to one of our healthcare experts today.
And, for those inspired to share your views with the Government of Canada’s Advisory Council on the Implementation of National Pharmacare, you can have your say by visiting letstalkhealth.ca before September 28, 2018.