PHARMACEUTICAL POLICY CONSULTATION PAPER
On December 16, 2004, the province of Quebec released a Drug Policy Report with recommendations in four major areas: (i) access to medication, (ii) reasonable pricing, (iii) optimal drug utilization, and (iv) ongoing support for the pharmaceutical industry. The report includes thirty-four ministerial suggestions within these four areas.
Key Points
Access to Medication
Continue to review listed drugs on the basis of scientific analysis
Reduce time to listing of new products as well as administrative complexities with exceptional drug classes in order to ensure timely access
Improve ease of modifications to the Formulary primarily to introduce price changes, and for new applications especially for generics
Improve management of exceptional status drugs by the RAMQ (I.e. access to the formulary over the Internet)
Redefine/clarify the rules for medication reimbursement
Reasonable Pricing
End the policy of not allowing price increases on listed medication* to ensure that Quebec pays equal and fair prices on medication
Negotiate agreements on prices (to be approved by the government of Quebec and the manufacturers)
Impose a ceiling price for generic drugs as well as a profit margin of a maximum of 6% for wholesalers to ensure equity
Optimal Utilization of Medication
Develop and implement different methods to make better use of new technologies
Advance projects that will allow: (a) the pharmacist to have a greater impact on a patients drug utilization, and (b) the review and creation of improved strategies for non-compliance (some measures will not be applied until changes in certain regulations regarding patient privacy are made)
Initiate a consumer education campaign regarding optimal drug utilization
Enforce the use of the code of marketing practices by manufacturers
Require pharmacists to invoice the RAMQ according to the drugs actual acquisition price
Ongoing Pharmaceutical Industry Support
Unite government health policies with industry policies in order to preserve industry support by:
o continuing the use of BAP 15
o reducing risks associated with medication use (I.e. forthcoming evidence)
o creating a permanent forum to reunite government and industry
*A policy has been in place since 1994 that did not allow the prices of listed medications to increase, however in spite of this policy a growth in costs to the RGAM had been observed. For the past ten years, increases on prices were accepted only for exceptional cases, meanwhile the Consumer Price Index increased by 20%.
