Denis Morrice, Executive Director of the ORA, is very skilled in sharing “tidbits” of relevant industry news! Here is his latest post!
- There is one word for the Canadian Drug landscape: CHANGE!
- The 3As are now 4As: Access, Appropriateness, Affordability, Accountability.
- The cost of new drugs is the driver of the various changes and introduction of various restrictive prior authorization systems, managed care programs, product listing agreements, increase in deductibles, caps, de-listing, etc.
- Explains why the 25 Insurers in Private Plans all have different policies, procedures, and coverage along with issues around transparency. In terms of “choice,” patients and physicians are the last consideration.
- Also explains why more patients are resorting to the public drug programs. Trillium intended to have a streamlined coordination of benefits by the Fall of this year – that is not going to happen. Hopefully it will happen in early 2018.
- 80% of the 7,000 drugs in the pipeline are for the higher cost drugs.
- President Trump says Justin is doing a spectacular, spectacular job. However, Canada is highlighted as a ‘drug problem’. Canada is a huge exporter of drugs to the U.S.
- PMPRB (Patented Medicine Prices Review Board) changes are coming with a focus on lowering drug costs in Canada. The unintended consequences might be that Canada goes on a longer waiting list for new drugs to be launched in Canada. Also an issue that 25% of drugs receiving a positive recommendation from CADTH (Canadian Agency for Drugs and Technologies in Health) are not approved by the pCPA (Pan-Canadian Pharmaceutical Alliance). PMPRBs present reference countries: France, Germany, Italy, Sweden, Switzerland, UK, U.S. The new list: France, Germany, Japan, Sweden, UK, Italy, Australia, Belgium, Spain, Netherlands, Norway, South Korea.
- RWD and RWE are noted as critical activities by all the players at major drug events and many say they are doing it. However, not one mentions comparative data. The OBRI and ORA Informatics Committee now use the term RWCD. There is greater use of the terms: Predictive Data Sets and Predictive Analytics.
- Harmonization: both pCPA and CLHIA (Canadian Life and Health Insurance Association) have agreed to consider across Canada the harmonization of drug Approval and Renewal criteria of RA biologics and biosimilars. – it’s a start.
- OHIP+: the start of efforts for a National Pharmacare program. Ontario’s OHIP+ is for those under 25years. The major issue identified at this time is with rare diseases. OHIP+ will cover the 4,000 plus drugs on the OPDP formulary but many drugs for rare diseases are not on the list. As the Canadian Organization for Rare Diseases states: “it’s an opportunity to get it right”. An interesting comment: A person with Cystic Fibrosis in Canada lives 10 yrs longer than the person with CF in the U.S.
- Drug Shortages are expected to continue for various reasons. One being that many generic drug costs have been pushed down to 18% of brand and some now 15%. The ORA has engaged a P/T Task Team on Drug Shortages (their mission: to identify, prevent, alleviate and resolve drug shortage situations)
- At a recent meeting of regulatory and policy people it was clearly stated a number of times: “it is important to engage clinicians and patients”.
