On April 13, 2016, the Federal government's Standing Committee on Health (HESA) held its 6th meeting of the parliamentary term and its first discussion of National Pharmacare. The committee provided 40 minutes for witnesses (10 minutes for each) to present before the committee. These presentations were followed by a question/answer session.
The witnesses were:
- Department of Health (DOH) – Abby Hoffman, Scott Doidge
- Canadian Institute for Health Information (CIHI) – Brent Diverty, Michael Gaucher
- Patented Medicine Prices Review Board (PMPRB) – Tanya Potashnik, Guillaume Couillard
- Canadian Agency for Drugs and Technologies in Health (CADTH) – Brian O’Rourke
The initial statements were primarily background information on the organizations, but some of the following points were also raised:
- The DOH indicated that between 10% -20% of people are uninsured or underinsured
- The DOH highlighted 2 potential routes for Pharmacare: including prescription drugs as a service under Canada Health Act (CHA); or adapt the existing model to fill the current gaps
- CIHI is prepared to support the committee with cost evaluations of different policies but may require more data to do so
- The PMPRB is involved in a case where the argument is being made that price ceilings are unconstitutional
- The PMPRB is also working on adapting their legal framework and are releasing a discussion paper on the Guidelines in the coming months
- CADTH is prepared to contribute to and possibly manage a national formulary
The committee members questioned the witnesses and communicated a sensitivity to issues of accessibility, high drug costs, costs relative to other countries, and impacts on the Canadian market. Several of their questions were left unanswered due to a lack of data.
Two specific questions of note:
Q – How will the recent trade agreement’s provisions surrounding patent extension impact the market?
A – (Hoffman) The generic industry is looking into how this will affect the market. A maximum extension of 2 years is possible but will be less in reality, and the effect on costs is unknown.
Q – Who would manage a national formulary?
A – (O’Rourke) CADTH would be willing to manage the national formulary.
One committee member posed several questions about international comparisons citing the Pharmacare 2020 report. Ms. Hoffman responded that the sourced savings were improbably high.
The next meeting of the committee is scheduled for Monday, April 18, 2016.
If you are interested in being notified about future meetings on this topic, please register here: http://www.parl.gc.ca/Committees/en/HESA/Meetings.
Contributed by Arvind Mani, Director of Market Access and Policy Research, Gannon Rogers, Pharmaceutical Policy Research Assistant and Avery Hughes, Pricing and Reimbursement Analyst at PDCI Market Access Inc.