Comparison of drug coverage in Canada before and after the establishment of the pan-Canadian Pharmaceutical Alliance

Abstract

ObjectivesThis study was conducted to determine whether establishment of the pan-Canadian Pharmaceutical Alliance (pCPA) was associated with significant changes in drug listing decisions across Canada.Analysis and resultsThis study included drug indications that received a Common Drug Review or pan-Canadian Oncology Drug Review listing recommendation within 3 years before (‘pre-PCPA era’ group; n=79) and 3 years after (‘PCPA era’ group; n=91) the pCPA was established in August 2010. At the time of this study (30 April 2014), nine pCPA-participating jurisdictions had listed 35–59% of drug indications in the pre-pCPA era group and a nearly identical range, 36–59%, in the pCPA era group. Within the pCPA-era group, 31 drug indications (34%) had completed pCPA negotiations (‘pCPA negotiation’ subgroup); the jurisdictions had listed 39–77% of these drug indications. Comparison of the pCPA era group to the pre-pCPA era group indicated that the proportion listed did not change significantly in any jurisdiction, and time-to-listing increased significantly in New Brunswick and decreased significantly in Alberta, Manitoba, and Ontario. When the pCPA negotiation subgroup was compared to the pre-pCPA era group, the proportion listed increased significantly in British Columbia, Saskatchewan, Manitoba and Newfoundland and Labrador, and time-to-listing increased significantly in New Brunswick and Nova Scotia and decreased significantly in Manitoba and Ontario. A sensitivity analysis suggested more favourable results regarding the pCPA's impact.ConclusionsWhile the pCPA might have had a varied effect on time-to-listing, this study's primary analysis did not observe a significant impact on the overall proportion of new drug indications listed across jurisdictions. This may be due to the fact that, at the time of this study, only a limited number of drug indications had completed pCPA negotiations. This study provides a framework for future evaluations of the pCPA's impact as it continues to evolve.

Restrictions for reimbursement of direct-acting antiviral treatment for hepatitis C virus infection in Canada: a descriptive study

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“…Under the Council of the Federation, the provinces discussed collective health policies, one outcome being the establishment of the Pan‐Canadian Pricing Alliance (pCPA) in 2010. The goals of the pCPA are lower drug costs and consistent pricing across provinces, increased drug treatment options, and more consistent drug coverage across Canada (Milliken et al ). Within a year, the pCPA had negotiated ten contracts, with 17 negotiations in progress (Husereau et al : 889).…”

Pan-Canadian Pharmaceutical Alliance (pCPA): Timelines Analysis and Policy Implications

“…Ontario and Nova Scotia governments tend to take the lead in this process in the context of innovative drugs, while Saskatchewan and Nova Scotia governments lead the process for generics (Council of the Federation, 2014a). If an agreement is reached, a LOI is signed by both the manufacturer and the pCPA, and each participating jurisdiction will subsequently decide whether and when to fund the drug through its own public drug plan under terms agreed to in a confidential product-listing agreement with the manufacturer (Council of the Federation, 2014a; Milliken et al, 2015).…”

“…The proportion of drugs listed that had a completed pCPA negotiation went up in all provinces, excluding Prince Edward Island where it remained the same. Interestingly, only Manitoba saw both a significant reduction in timelines and significant increase in the proportion of listings (Milliken et al, 2015).…”