Question Period Note: PHARMACARE

Guided by the recommendations of the Advisory Council on the Implementation of National Pharmacare, the Government of Canada announced concrete steps as part of Budget 2019 toward the implementation of national pharmacare. These include the creation of a Canada Drug Agency, taking steps toward the development of a national formulary, and creating a national strategy for high-cost drugs for rare diseases.

In August 2019, the Government of Canada also announced the final amendments to the Patented Medicines Regulations. The most significant reforms to the regulations since their introduction in 1987, these amendments lay the groundwork for national pharmacare by giving the Patented Medicine Prices Review Board the tools to protect Canadians from excessive prices and making patented medicines more affordable.

• When does the Government intend to implement a national pharmacare program?

• No Canadian should have to choose between paying for prescription drugs and putting food on the table.

• That is why Budget 2019 announced the next critical steps towards the implementation of national pharmacare. These include working with provinces, territories and stakeholders on the creation of a Canadian Drug Agency, taking steps toward the development of a national formulary, and creating a national strategy for high-cost drugs for rare diseases.

• As we said during the campaign, we are committed to taking the critical next steps to implement national universal pharmacare so all Canadians have the drug coverage they need at an affordable cost.

If pressed on pharmacare
• Building on the historic changes our Government has already made to reduce drug prices, we will continue to work with provincial and territorial governments and other key partners to enable all Canadians to get and afford the medicines they need.

Advisory Council on the Implementation of National Pharmacare
• In Budget 2018, the Government announced the creation of an Advisory Council on the Implementation of National Pharmacare, chaired by Dr. Eric Hoskins. Over the summer and fall of 2018, the Council engaged with Canadians, patients, provincial, territorial and Indigenous leaders, health care experts, and stakeholders. The Council’s stakeholder engagement included regional roundtables, town halls, an online questionnaire, and the opportunity to provide written submissions. The Council released an interim report in March 2019 and on June 12, 2019, the Council’s final report was tabled in Parliament.

Budget 2019 Commitments
• Guided by the initial recommendations in the Council’s interim report, Budget 2019 announced federal investments to move forward on three foundational elements of national pharmacare:
o Creation of a Canada Drug Agency to take a coordinated approach towards assessing effectiveness and negotiating drug prices;
o As part of the work of the Agency, development of a national formulary to promote more consistent coverage across the country; and,
o Creation of a national strategy for high-cost drugs for rare diseases to help Canadians get better access to the effective treatments they need.

• Budget 2019 proposes to provide Health Canada with $35 million over four years, starting in 2019-20, to establish a Transition Office to support the creation of a Canada Drug Agency and national formulary. It also proposes to invest up to $1 billion over two years, starting in 2022-23, with up to $500 million per year ongoing, to help Canadians with rare diseases access the drugs they need.

Modernization of the Patented Medicines Regulations
• The Government has recently modernized the Patented Medicines Regulations to ensure the Patented Medicine Prices Review Board (PMPRB) has the tools and information to fulfill its mandate to protect Canadian consumers from excessive prices of patented medicines. These reforms include three main elements:
o Providing the PMPRB with additional price regulatory factors that consider the price of patented medicines relative to their value and impact on the Canadian health care system;
o Requiring patentees to report Canadian price information that is net of all adjustments (e.g. rebates, discounts), so that the PMPRB is informed of actual market prices in Canada; and,
o Revising the PMPRB7 “basket” of comparator countries, to include markets with comparable consumer protection priorities, economic wealth and medicine markets as Canada. Specifically, the list of countries has been updated to remove the U.S. and Switzerland, and to add Australia, Belgium, Japan, the Netherlands, Norway, and Spain (now the “PMPRB11”).

P/T Perspectives on Pharmacare
• In July 2019, Canadian Premiers stressed that any national pharmacare program should not penalize jurisdictions for investments made to improve drug coverage for its citizens. They also reaffirmed that participation in any national pharmacare program must be voluntary and that discussions with the federal government on pharmacare should be guided by the following four principles: (1) the need to focus on removing cost barriers, (2) that program development should be based on evidence about potential benefits, risks and costs, (3) that P/T governments must retain responsibility for the design and delivery of public drug coverage, and (4) that federal funding should be long-term, adequate, secure, flexible and take into account present and future cost pressures.

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