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Centre for H EALTH S ERVICES AND P OLICY R ESEARCH 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 Slide 2 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH Canadian Medicare Slide 3 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH Canadian Pharmacare Slide 4 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH The coverage landscape: Under- and Un-insured for Routine Drug Costs Source: Applied Management (2000) "Canadians Access to Insurance for Prescription Medicines Volume 2 Slide 5 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH The coverage landscape: Under- and Un-insured for Catastrophic Costs Source: Applied Management (2000) "Canadians Access to Insurance for Prescription Medicines Volume 2 Slide 6 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH The financial landscape Source: CIHI and Statistics Canada Slide 7 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH The result, a national pastime Provincial Inquiries New Brunswick Saskatchewan British Columbia National Inquiries Romanow Kirby National Forum on Health House of Commons Slide 8 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH What has been recommend? National Standards for Coverage First-dollar coverage for vulnerable Catastrophic coverage for all Canadians Disease management coverage National agency/network Drug regulation Drug policy Outcomes and policy research Slide 9 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH What are policy makers seeing? Slide 10 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH The Shifting Landscape? Slide 11 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH The financial landscape Source: CIHI and Statistics Canada Slide 12 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH The demographic landscape Source: Statistics Canada Slide 13 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH What are policy makers doing? Slide 14 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH 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) Slide 15 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH 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 Slide 16 Centre for H EALTH S ERVICES AND P OLICY R ESEARCH Thank you