Embed Size (px)
Citation preview
A PAN-CANADIAN PHARMACEUTICAL ALLIANCE UPDATE – OPTIMIZING THE PROCESS FOR PATIENTSSeptember 1, 2016
2
1. pCPA overview2. Impact on patient access3. How the pCPA process is
evolving and what’s next for pCPA
4. How patients can engage
What we will discuss
3
pCPA objectives• Increase access to
clinically effective and cost-effective drug treatment options
• Improve the consistency of drug funding decisions
• Achieve consistent and lower drug costs
• Reduce duplication and improve use of resources
4
pCPA participants
Federal plans (NIHB etc.)
• Includes all provinces / territories - QC joined in October 2015• Federal plans joined in February 2016
5
Two streams: innovative and generics
Innovative medicines
Negotiate terms for product listing agreements (as of July 31 2016):• Closed / Completed: 112• Underway: 32• No negotiations: 38• P/T negotiations: 13
Generic medicines
Value Price Initiative caps 18 generic medicines at 18% of innovator and applies a tiered pricing framework for all other generic drugs
Co-leads: ON & NS Co-leads: NS & SK
6
pCPA savings
More than $712 million in savings annually
July 2016
Price reductions for 18 generic drugs and negotiated price agreements for 95 brand name drugs (as of April 1, 2016)
7
pCPA process
Existing meds• Therapeutic reviews• Renegotiations of
existing PLAs etc.
New medsCADTH
recommendation
pCPAdeliberation
No negotiations Individual consideration by plansNegotiations
Letter of intent signed
Jurisdictional listings
8
Proposed guiding principles for pCPA process• Holistic: consideration of value from multiple perspectives• Predictable: communication of process, timelines, participation,
decision making • Consistent: consistent process & approach, recognizing unique
nature of negotiations• Transparent: timely and regular public reporting• Efficient & Effective: reduce duplication and align with current
national HTA review • Collaborative and representative: cross-jurisdictional engagement
with stakeholders • Respectful: recognition of different perspectives and needs amongst
stakeholders • Ethical: reflect ethical principles such as validity, veracity and
autonomy • Value-driven: achieving value for the health care system
9
pCPA office
• Established in September 2015• Housed in the Ontario Public Drug Program • Office manager is Imran Ali• Working on developing negotiation guidelines
Mandate: support national negotiations with manufacturers Tasks:
• standardization of templates • multi-channel communications • administrative support and tracking of performance
metrics• capacity building: additional expertise to support
consistency of negotiations across jurisdictions, transparency of process and accountability
pCPA
10
Impact on Patient Access:Trend to higher listing rates and more consistency
BC AB SK MB ON QC NB NS PE NL0
10
20
30
40
50
60
70
80
14
20
25
32
20
33
11
22
6
21
27
5356
71
60 59
7369
54
72
2006 (out of 103 drugs) 2015 (out of 195 drugs)
Source: IMS Brogan; PRA Quarterly; data represents the previous two years of listing decisions
Number of New Medicines Added to Provincial Formularies
(2006 vs. 2015)
Percentage of new medicines reimbursed
(2006 vs. 2015)
BC AB SK MB ON QC NB NS PE NL0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
14%
19%
24%
31%
19%
31%
11%
21%
6%
20%14%
27%29%
36%
31% 30%
37%35%
28%
37%
2006 2015
11
Total Provincial Gov’t Health Expenditures on Prescribed Medicines2006-2013 (Actual) and 2014-2015 (Forecast), $ Billions
Source: CIHI – National Health Expenditure Trends (C Series)
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015$0
$2
$4
$6
$8
$10
$12
$8.17 B$8.67 B
$9.16 B$9.86 B $10.06 B $10.30 B $10.28 B $10.29 B $10.44 B $10.66 B
$ B
illio
ns
% of totalhealth
spending8.5 % 8.4 % 8.2 % 8.3 % 8.0 % 7.9 % 7.6 % 7.5 % 7.3 % 7.4 %
12
pCPA process still evolving• Ongoing negotiation guidelines
consultations• Timelines• Sorting/prioritization• Patient engagement• Biosimilars – new approaches• Class reviews and older products• Performance measures and evaluation of
process• Updated approaches to generic drugs• Memorandum of Understanding across
jurisdictions
13
Themes for discussion
• Is there an increased role for patients at pCPA?• Policy and guideline development• Governance, leadership and accountability• Individual product input?
• pCPA’s impact on cancer treatment access (e.g., new indications)
• Transparency & accountability
14
William (Bill) [email protected] (mobile)
Johanne [email protected] (mobile)
Louise [email protected]
416.457.3179 (mobile)
