Issue link: http://clhia.uberflip.com/i/406567
The paper covers the entire life cycle of the drug market in Canada starting from how drugs are approved for sale and priced, through to the purchase and reimbursement of drug costs. At each stage, it makes important, actionable recommendations to address the weaknesses of our current system. The ultimate goal from a policy perspective must be to ensure that Canadians have access to the drugs they need without undue financial hardship as a result of prescription drug costs. All the recommendations in the paper are important and need to be addressed over the medium term. As a priority, however, the paper argues that fundamental reform is required of the Patented Medicines Prices Review Board's mandate and practices in order to reduce drug prices for all Canadians. It also recommends that, as a priority, discussions start on creating a common, national minimum formulary as a means to reduce complexity in the system and that governments lead a discussion to work towards the creation of a new, collaborative, end-to- end approval and funding regime for orphan drugs. The new orphan drug regime will ensure that Canada has both a robust process to approve orphan drugs from a safety and effectiveness perspective and a plan for how to fund orphan drugs so that Canadians will be able to access them once approved. While fundamental reform is pursued, the paper suggests that shorter term and more tactical reform also be implemented. As a priority, the paper recommends that provinces start to automatically list generic drugs once they have been approved as bio-equivalent with the brand drug. This will eliminate the current lag in listing new generics and will immediately generate savings for all Canadians. The paper also recommends that, as a priority, governments implement improved processes to reduce the complexity in the system so that individuals can smoothly transition between public and private coverage and that a monitoring framework for off-label prescribing be developed to address concerns over patient safety and cost escalation.