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Pharmaceutical Policy in Canada : Reflections on a Shifting Landscape. Steve Morgan, PhD Centre for Health Services and Policy Research University of British Columbia. T H E C O M M O N W E A L T H F U N D. Canadian “Medicareâ€. . . . Canadian Pharmacare.
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Pharmaceutical Policy in Canada:Reflections on a Shifting Landscape Steve Morgan, PhD Centre for Health Services and Policy Research University of British Columbia T H EC O M M O N W E A L T H F U N D
Canadian “Medicare”
The coverage landscape:Under- and Un-insured for Routine Drug Costs Source: Applied Management (2000) "Canadians’ Access to Insurance for Prescription Medicines Volume 2”
The coverage landscape: Under- and Un-insured for Catastrophic Costs Source: Applied Management (2000) "Canadians’ Access to Insurance for Prescription Medicines Volume 2”
The financial landscape Source: CIHI and Statistics Canada
The result, a national pastime… Provincial Inquiries • New Brunswick • Saskatchewan • British Columbia National Inquiries • Romanow • Kirby • National Forum on Health • House of Commons
What has been recommend? • National Standards for Coverage • First-dollarcoverage for vulnerable • Catastrophic coverage for all Canadians • Disease management coverage • National agency/network • Drug regulation • Drug policy • Outcomes and policy research
The financial landscape Source: CIHI and Statistics Canada
The demographic landscape Source: Statistics Canada
Coverage (…progress?) • Provinces agreed to “reasonable coverage” against catastrophic drug costs • At the same time… • BC eliminated seniors plan universal income-based plan • Manitoba increased deductibles under its income-based plan • Ontario backed down on income-based plan (for now)
Drug Cost Control (the good news) • Common Drug Review • Coordinated HTA for new drugs • High standards of evidence (for now) • Provinces retain coverage-decisions • Outcomes-Based Coverage • Now in BC, NS, MB, SK … • Utilization Initiatives • Data NPDUIS • Analysis COMPUS • Provincial Agencies Quebec “Medicines Council”