BC Government on the Verge of Drug Policy Reform

On the verge of a BC Government announcement on a new policy on generic medication pricing and a Long Term Pharmacy Agreement, the Better Pharmacare Coalition (BPC) is mobilizing its two million members to ensure Government keeps its promise that patient interests and input are reflected in the new BC PharmaCare drug review process. As part of its mobilization, the BPC has developed a toolkit of information resources available online at www.betterpharmacare.org.

"The upcoming announcement about the reduction of generic medication pricing and the Long Term Pharmacy Agreement is the first significant test of the BC Government’s commitment to ensure that patients are a ‘paramount priority’ as stated in the Pharmaceutical Task Force recommendations in May 2008," says Cheryl Koehn, Chair, Better Pharmacare Coalition. "Through our ‘Fixing BC PharmaCare: Putting Patients First’ campaign, BC patients, their families and friends can help to ensure the interests of patients are the Government’s key guiding focus as it begins its overhaul of the BC PharmaCare drug review process."

Canadian patients and drug plans pay the second highest prices for off-brand or generic medications among developed countries after the United States. Currently, patients in BC pay some of the highest prices for generic medications in Canada. Under the current system, generic medication manufacturers also make significant profits without investing in research for new medications. The BC Government identified this problem and committed to legislating lower prices for generic medications within six months of fully accepting the Pharmaceutical Task Force recommendations.

The BPC has recommended to Government that the new cost of generic medications be no more than 30 per cent of brand name medication costs to benefit British Columbians living with acute and chronic diseases.

In April 2010, the BPC position was reinforced when the Ontario Government announced it would reduce the rising cost of generic medications by banning the practice whereby generic medication manufacturers pay "professional allowances" to pharmacies to stock and sell their products. Ontario has been paying 50 per cent of the brand name price for generics but wants to reduce that amount to 25 per cent.

"Over the past two years the BPC, along with leading academics and stakeholder groups, has been consulting with Government on the Pharmaceutical Task Force implementation process, and has consistently recommended they negotiate generic medication price reductions and reinvest those savings into additional Health Canada-approved brand name medications listings on the BC PharmaCare drug reimbursement formulary," states Koehn.

The BPC is also concerned that the business model that allows for "professional allowances" or rebates generic medication manufacturers pay to pharmacies leads to a perceived or actual conflict of interest when remuneration is based solely on adapting prescriptions or making a therapeutic substitution. In that case, rather than making treatment decisions based on strictly physicians’ assessments and the individual needs of patients, pharmacists may have an added incentive to switch or adapt patients’ medications so they can be financially remunerated.

Rennie Hoffman, BPC steering committee member and Executive Director of the Mood Disorders Association of BC, states: "Working in the mental illness field, we recognize that pharmacists are an important member of a patient’s healthcare team, but they are not physicians and do not have clinical knowledge about an individual patient’s detailed health history to determine whether a prescription should be changed."

Koehn concludes: "After two years of consulting on the Pharmaceutical Task Force recommendations implementation, the BPC is now measuring the Government’s commitment to make patients a ‘paramount priority’ by actions, not words. After its announcement of a new generic medication pricing policy and the Long Term Pharmacy Agreement, we expect the next step for Government will be to implement a new patient review module reflective of the exhaustive input they have received from the BPC, and other patient organizations, in parallel with the other elements of the new drug review process as promised by the BC Ministry of Health Services."