A Roadmap to a Rational Pharmacare Policy in Canada

"For over two decades, the Canadian Federation of Nurses Unions (CFNU) has been advocating for a national pharmacare plan. Now, as the costs of prescription drugs continue to rise, putting pressures on a health care system that is already stretched to the limit, the CFNU is gaining some new allies. There is a growing consensus that prescription drug policies require reform. Advocates for reform include the C.D. Howe Institute (a well-known public policy think tank), the Canadian Life and Health Insurance Association, provincial and territorial governments, as well as patient advocates from coast-to-coast. A Roadmap to a Rational Pharmacare Policy calls for governments, insurers, policy makers, and pharmaceutical companies to recognize that the present hybrid system we are using to fund prescription drug purchases isn't working. As the title of this report indicates, Dr. Gagnon offers a roadmap to a rational drug policy so that Canada can move into the 21st century, alongside its OECD counterparts. He suggests that governments need to seize the initiative and take advantage of the emerging consensus on the need for reform, and offers a series of a pragmatic, achievable steps that can be taken now to turn policy into practice."--Message from the CFN

CETA and pharmaceuticals: Impact of the trade agreement between Europe and Canada on the costs of prescription drugs

On a per capita basis, Canadian drug costs are already the second highest in the world after the United States and are among the fastest rising in the Organization for Economic Co-Operation and Development. The Comprehensive Economic and Trade Agreement (CETA) between the European Union (EU) and Canada will further exacerbate the rise in costs by:. • Committing Canada to creating a new system of patent term restoration thereby delaying entry of generic medicines by up to two years;. • Locking in Canada's current term of data protection, and creating barriers for future governments wanting to reverse it;. • Implementing a new right of appeal under the patent linkage system that will create further delays for the entry of generics.CETA will only affect intellectual property rights in Canada-not the EU. This analysis estimates that CETA's provisions will increase Canadian drug costs by between 6.2% and 12.9% starting in 2023. The Canadian government committed to compensating provinces for the rise in costs for their public drug plans. Importantly, this means that people paying out-of-pocket for their drugs or receiving them through private insurance, will be charged twice: once through higher drug costs and once more through their federal taxes.As drug costs continue to grow, there are limited options available for provincial/territorial governments: restrict the choice of medicines in public drug plans; transfer costs to patients who typically are either elderly or sick; or take money from other places in the health system, and threaten the viability of Canada's single payer system. CETA will therefore negatively impact the ability of Canada to offer quality health care

Merger mania: Mergers and acquisitions in the generic drug sector from 1995 to 2016

Background: Drug shortages and increasing generic drug prices are associated with low levels of competition. Mergers and acquisitions impact the level of competition. Record merger and acquisition activity was reported for the pharmaceutical sector in 2014/15, yet information on mergers and acquisitions in the generic drug sector are absent from the literature. This information is necessary to understand if and how such mergers and acquisitions can be a factor in drug shortages and increasing prices. Methods: Data on completed merger and acquisition deals that had a generic drug company being taken over (i.e. 'target') were extracted from Bloomberg Finance L.P. The number and announced value of deals are presented globally, for the United States, and globally excluding the United States annually from 1995 to 2016 in United States dollars. Results: Generic drug companies comprised 9.3% of the value of all deals with pharmaceutical targets occurring from 1995 to 2016. Globally, in 1995 there were no deals, in 2014 there were 22 deals worth $1.86 billion, in 2015 there were 34 deals totalling$33.56 billion, and in 2016 there were 42 deals worth in excess of $44 billion. This substantial increase was partially attributed to Teva's 2016 acquisition of Allergan's generic drug business. The surge in mergers and acquisitions for 2015/16 was driven by deals in the United States, where they represented 89.7% of the dollar value of deals in those years. Conclusions: The recent blitz in mergers and acquisitions signals that the generic drug industry is undergoing a transformation, especially in the United States. This restructuring can negatively affect the level of competition that might impact prices and shortages for some products, emphasizing the importance of updating regulations and procurement policies

Drug shortages: Searching for a cure

Shortages of prescription generic drugs have recently made headlines in Canada and elsewhere. The causes and possible solutions for these shortages are still unclear. With the failure of "market forces," has the time come to establish a Crown corporation to ensure the supply of essential drugs