Winnipeg Free Press - ONLINE EDITION

Canadians denied drug pricing information

  • Print

OAKVILLE — Yet another patient appears on Global TV News unable to get an expensive prescription drug reimbursed by the Ontario provincial government, and the minister of health and long-term care responds that "the provinces and territories are working together to negotiate with manufacturers to get the best possible prices for drugs."

What no one gets to know is precisely how that’s happening or how quickly, leaving us all in the dark about access to a vital component of modern medical care.

Ontario Health Minister Deb Matthews was referring to what has become the Pan-Canadian Pricing Alliance, an initiative announced in the summer of 2010 to negotiate prices with pharmaceutical companies. According to presentations given by bureaucrats from the Ontario Public Drug Plan, the PCPA’s objectives are to increase access to drugs; improve the consistency of drug listing decisions across Canada; capitalize on combined buying power of jurisdictions; achieve consistent and lower pricing of drugs; and reduce duplication in provincial negotiations. Prices for 20 to 30 drugs are said to have been negotiated. No information is available to the public, however, about these negotiations or their outcomes.

The process lacks transparency — there is no information on a governance structure, there are no reports on the negotiations and not even a website. Nothing is publicly available from the work of the consulting company hired in February of 2013 to develop a governance structure to facilitate PCPA negotiations and provide greater transparency either. The Canadian Security Intelligence Service has more transparency than the PCPA.

The process of getting a new prescription drug approved for marketing and reimbursement by provincial drug plans is a long and tortuous one in Canada. A drug is reviewed by branches of the federal and provincial governments as well as a multiplicity of agencies such as the Canadian Agency for Drugs and Technologies in Health, the Pan-Canadian Oncology Drug Review, the Patented Medicines Prices Review Board, and the Pharmaceutical Advertising Advisory Board. Significant delays in the process have been reported for years. The little that is known about the PCPA process does not bode well for improving the timeliness of prescription drug access in Canada.

Here’s what we do know: Before the PCPA process for negotiation about a drug begins, provinces and territories must declare whether or not they intend to join in the negotiation. For new drugs, all jurisdictions tend to participate, but they are not required to do so — they may already have an agreement with the manufacturer. Participating in the negotiation implies that, if an agreement is reached and a letter of intent signed, the drug will be listed in any subsequent product licensing agreement at the agreed price and with the agreed listing criteria specified in the letter.

But provinces and territories are not mandated to list a drug that has been successfully negotiated through the PCPA process, so the PCPA does not guarantee an eventual listing agreement in all provinces and territories. Each jurisdiction is also free to negotiate further price or other concessions from the manufacturer before a product licensing agreement is signed. These appear to negate the PCPA’s objectives of consistency of listing decisions and reduction of duplication in provincial negotiations.

In addition, there is presently no timeline or performance standard for the PCPA or the subsequent provincial negotiations, and no formal process to prioritize important, potentially life-saving drugs.

New drugs can have a meaningful impact on the wellbeing and survival of those stricken with illness. Not surprisingly then, patients want access to them, or at least information about progress in provincial negotiations. At the very least, they should easily be able to find out what drugs are being reviewed and how long that process is expected to take. Even better, reasons for drugs not being reimbursed should be given to them, as should explanations for why these lengthy delays before funding approval are required.

Canadian drug approval and reimbursement processes generally lack transparency and the PCPA is no exception. When Canadian patients are denied access to an expensive new drug, especially if it is reimbursed in other provinces, it is at least inadequate for a minister of health to simply state that negotiations are in process. The PCPA was established nearly four years ago. It is time for transparency regarding the process and outcomes of the system.

 

Nigel Rawson is a pharmacoepidemiologist, pharmaceutical policy researcher, and president of Eastlake Research Group in Oakville, Ontario.

 

— troymedia.com

Fact Check

Fact Check

Have you found an error, or know of something we’ve missed in one of our stories?
Please use the form below and let us know.

* Required
  • Please post the headline of the story or the title of the video with the error.

  • Please post exactly what was wrong with the story.

  • Please indicate your source for the correct information.

  • Yes

    No

  • This will only be used to contact you if we have a question about your submission, it will not be used to identify you or be published.

  • Cancel

Having problems with the form?

Contact Us Directly
  • Print

You can comment on most stories on winnipegfreepress.com. You can also agree or disagree with other comments. All you need to do is be a Winnipeg Free Press print or e-edition subscriber to join the conversation and give your feedback.

You can comment on most stories on winnipegfreepress.com. You can also agree or disagree with other comments. All you need to do is be a Winnipeg Free Press print or e-edition subscriber to join the conversation and give your feedback.

Have Your Say

New to commenting? Check out our Frequently Asked Questions.

Have Your Say

Comments are open to Winnipeg Free Press print or e-edition subscribers only. why?

Have Your Say

Comments are open to Winnipeg Free Press Subscribers only. why?

The Winnipeg Free Press does not necessarily endorse any of the views posted. By submitting your comment, you agree to our Terms and Conditions. These terms were revised effective April 16, 2010.

letters

Make text: Larger | Smaller

LATEST VIDEO

Wpg_Police_discuss_Red_River_search

View more like this

Photo Store Gallery

  • Young goslings are growing up quickly near Cresent Lake in Portage La Prairie, Manitoba- See Bryksa 30 Day goose project- Day 11- May 15, 2012   (JOE BRYKSA / WINNIPEG FREE PRESS)
  • Challenges of Life- Goose Goslings jump over railway tracks to catch up to their parents at the Canadian Pacific Railway terminalon Keewatin St in Winnipeg Thursday morning. The young goslings seem to normally hatch in the truck yard a few weeks before others in town- Standup photo- ( Day 4 of Bryksa’s 30 day goose project) - Apr 30, 2012   (JOE BRYKSA / WINNIPEG FREE PRESS)

View More Gallery Photos

Poll

Do you think food-security issues are an important topic to address during this mayoral campaign?

View Results

View Related Story

Ads by Google