November 19, 2013
Pan-Canadian Drug Pricing Alliance: How will it unfold?
How ready will you be when PCPA becomes a reality for your brand?
In an evolving regulatory environment, brand pricing and access strategies are continuously being challenged and re-examined to adjust to new government initiatives. This evening’s event was tailored as a group discussion between industry and government stakeholders around the Pan-Canadian Drug Pricing Alliance (PCPA) and to hear new insights from independent research.
This evening’s event was designed as a panel discussion and the panellists included: Walter Robinson, the Vice-President of Government Affairs at Rx&D; Judy McPhee, the Executive Director of Pharmaceutical Services for the Department of Health and Wellness at the Government of Nova Scotia; Ghislain Boudreau, the Vice-President of Public Affairs at Pfizer Canada; and Adrienne Blanchard, a partner at Norton Rose Fulbright.
The moderator for the evening was Bill Dempster, a co-founder of 3Sixty Public Affairs Inc. He began the evening by explaining the origins of PCPA. He mentioned that the ultimate goal of the PCPA is to obtain lower prices for medications for Canadians, because they pay more for drugs than other people worldwide.
Judy McPhee was the first panellist to address the audience. She explained that PCPA is currently led by Ontario and Nova Scotia, but that all provinces participate, except for Quebec. She mentioned that the overall objective of PCPA is to increase the sustainability of drug plans by providing more affordable access to drugs that provide value to the healthcare system. She mentioned that Canadians and governments want consistent access to medications across the country and that pricing needs to be addressed to obtain that consistency. She explained that the pharma industry had been approaching them for product listing agreements (PLAs), but their largest challenge has been the lack of a formal process or governance structure in order to fulfill their mandates. She explained that the PCPA goals are to increase access to drug treatment options, improve consistency across drug listings across the country and reduce the duplication of negotiations and utilization of resources.
The second panellist to speak was Ghislain Boudreau. He felt that the common theme in negotiating with PCPA was that there was too much focus on the short-term cost containment approach and not enough on non-pricing options, such as coverage with evidence, investment opportunities, education programs, and value-added solutions, etc. He felt that the goal was broader than the price-volume concept and that that was an element that needed to be “put back on the table.”
Another panellist, Adrienne Blanchard, pointed out that the PCPA has no legal status, which has implications. It is difficult for parties involved with PCPA to know what the expectations are. She mentioned that there are administrative issues, price issues and business considerations.
After talks from the panellists, the floor was given over to questions from the audience.
The first question related to the process and governance of PCPA. Judy responded to this question candidly, saying that the current process is not perfect, but that PCPA has the desire to make it more formal and structured with more transparency. She did emphasize that she felt that there was no duplicity in their processes with respect to CDR or P-CODER.
The second question from the audience was with respect to leveraging R&D capacity in Canada, instead of focusing on cost containment. Walter Robinson responded to this by saying that there needs to be a “clean and continuous line” from safety to HTA to pricing discussion/negotiation to reimbursement for products. He felt this would allow the process to be as vast as it can be and as safe as it has to be, so that Canadian patients could get access to medications faster and the PCPA could reduce the built-in costs for industry and be fair to governments. Ghislain Boudreau added that looking at medications within the “short-term mould” needed to be reassessed, and that health technology management across the life cycle of products should be reviewed, because this would demonstrate the long-term value of medications.
Another question was raised regarding the issue of the Pan-Canadian pricing process driving prices so low that it may be discouraging companies from bring out new products (including generics). The question to the panel was, “How do you ensure that you don’t get to the point where you don’t drive out competition?” Judy McPhee responded that the PCPA was cognizant of this issue, but she responded that the PCPA currently sees companies coming in with higher prices knowing that they’re going to be negotiated down through the process. She mentioned that brand companies are approaching PCPA daily to cut deals to decrease their price to drive the cost of generics down, particularly when brand medications are reaching end of patent. Judy mentioned that the PCPA process is not designed to drive down the cost of brand medications. She responded to the comment from an audience member that, if a company were to come in with a transparent price at the start of negotiations, they wouldn’t get “knocked down even further”. Judy mentioned that she was aware that this is a perception of PCPA, but she asserted that it wasn’t true.
The question as to where Quebec stands in all of these negotiations was raised and Judy responded that Quebec has not been involved at all in the pricing process. However, she did say that the PCPA would welcome Quebec in all of the PCPA processes. Ghislain added that there is an openness to embark on a PLA with the Quebec government, but he felt that it will take time and that there was a need to put some pressure on them to make this happen.
The last question of the evening was with respect to private payers and whether there is an interest in having them as part of the PCPA process. Judy gave an honest response, saying that, at this time, she didn’t know. Walter responded that there were a number of legal issues surrounding this, and as such, it was a difficult subject to address.
All in all, this evening’s event was a resounding success, as it generated some stimulating and thought-provoking discussion!
Click here to see the article on Pan-Canadian Pricing Alliance in the November issue of the Inside Policy magazine.