25 Oct Oct 2010: Submission to Fair Drug Prices Review

Monday, 25 October 2010

Towards Fairness – Nova Scotia and Pharmacare
Submission to the Fair Drug Prices Consultation, October 2010
Nova Scotia Citizens’ Health Care Network

The Nova Scotia Citizens’ Health Care Network believes in a universal pharmacare program that provides first-dollar coverage to all Nova Scotians regardless of ability to pay, just like Medicare.  We believe the province has a vital role to play in pushing the federal government to act on pharmacare and should work with other provinces to bring the federal government to the table.

In the interim, the Health Network supports the government’s efforts to reduce costs, both for patients and for the provincial treasury.

We are also pleased that the governments’ plan include public consultation and hope that this will be the plan as this process moves forward.  We participated in a Fair Drug Prices consultation on session on Oct 5.

We also want to draw the government’s attention to the following two reports:

Life Before Pharmacare – A report from the Canadian Health Coalition documenting the need for a National Pharmacare Program.  Based on hearings organized in 2007 and 2008 across the country, including a hearing in Halifax that was attended by the current Health Minister as NDP Health Critic.  The report is available at http://pharmacarenow.ca/wp-content/uploads/2010/01/LifeBeforePharmacare.pdf

The Economic Case for Universal Pharmacare – Released by the Canadian Centre for Policy Alternatives and authored by Professor Marc-Andre Gagnon, the report attempts to demonstrate the savings created by universal pharmacare.  The report is available at http://pharmacarenow.ca/wp-content/uploads/2010/09/Universal-Pharmacare-Report-e.pdf.

For the Health Network, there are 3 key areas when discussing pharmacare – Access, Cost, and Patient Safety.

Recommendations to the Fair Drug Prices for Nova Scotians consultation:

  1. Access
    1. Expand access to prescription drugs by re-investing all monies saved through the Fair Drug Prices process.  Our estimate is that the process should save between $40-$60 million/year on the provincial budget based on numbers provided in the consultation.  This could expand coverage in the Family Pharmacare Program by about 70,000-105,000 Nova Scotians based on the existing program expenses.  Alternatively the money could be used to improve the program itself by reducing co-pays and deductibles. (These numbers are based on numbers provided to us during the consultations on October 5th.  The Department has not confirmed the figures with us since.)
    2. Advocate at the federal level for a national pharmacare program that is cost-shared by the federal government
    3. Cost
      1. Implement a 25% cap on the cost of generics versus brand name drugs, just like in Ontario
      2. Urge the federal government to take action to reform patent laws to make prescription drugs accessible to patients
      3. Support Ontario’s national buyer alliance for bulk-purchasing of prescription drugs
      4. Work with other Atlantic Premiers on Pharmacare and other cost reduction strategies
      5. Investigate potential development of a local, ideally public, generic drug manufacturing industry in the province or region
      6. Patient safety
        1. Ensure decisions about what is included on the provincial formularies continue to be made based on scientific evidence and not political pressure
        2. Review the provincial formularies to ensure the most effective drug products are included and not necessarily the latest or those with minor variations from the original product(s)
        3. Address the need for better prescribing practices among physicians.  This also has potential for cost savings as many patients are on too many medications
        4. Meet with organizations such as the Federation of Community Health Centres and other prescribing groups to ensure the best and most effective prescribing practices are followed
        5. Push the federal government to enforce the ban on direct-to-consumer prescription drug advertising

Additionally, we do not support negotiating behind closed doors with generic drug companies and prefer an open, transparent process that includes new legislation at the completion of this process.

We hope the provincial government will act quickly to ensure Nova Scotians do not pay more for the same generic drugs as patients in other provinces and that the province begins working toward a National Pharmacare Program.