SlideShare une entreprise Scribd logo
1  sur  26
Télécharger pour lire hors ligne
What you should know about
drug approval bodies in Canada
101:
The Elevator Length Pitch
Who Pays for Pharmaceuticals in
Canada?
Total 2013 Rx Meds Expenditure
$29.3 B*; 100%
Private Sector Share
$17.1 B; 58.4% of total
Public Sector Share
$12.2 B; 41.6% of total
Other Publicly Funded
Drug Expenditure;
1.1 B; 3.8% of total;
9.0% of public share
Federal Drug Benefit
Plan;
0.6 B; 2.0% of total;
4.9% of public share
Provincial Drug
Benefit Plan;
10.5 B; 35.8% of total;
86.1% of public share
Out-of-Pocket
Contributions;
7.0 B; 23.9% of total;
40.9% of private share
Private Insurers;
10.1 B; 34.5% of total;
59.1% of private share
* Not including medicines dispensed in hospitals
Source: Prescribed Drug Spending in Canada 2012 Report, CIHI
2
In 2014, Canadians spent an estimated $28.8 billion
on prescribed drugs
3
Total Health Expenditure, by Use of Funds, Canada, 2014f
Complex Pathway to Patient Access
Drug Development
Health Canada
Review
Patented Medicine
Prices Review Board
Health Technology
Assessment
Hospitals
Patient Access
Private Drug Plans
pan-Canadian
Pharmaceutical Alliance
4
Provincial Drug
Plans
Health Canada
review
Safety, efficacy,
and
manufacturing
quality
Patented
Medicine Prices
Review Board
(PMPRB) review
Common Drug Review (CDR)
Pan-Canadian Oncology Drug
Review (pCODR)
Local /Regional Review
(For generics and older medications)
and INESSS
Private drug plan health
technology analysis / evaluation –
resources
Public and Private
Drug Benefit Plan
review (budgetary
capacity, plan
characteristics,
determination of
clinical criteria, price
and utilization
negotiations and
reimbursement status
o
r
o
r
o
r
NoC or NoC/c
Max. Avg. Potential
Price (MAPP)
Formulary Listing
Recommendation
Formulary Listing
Decision/Inclusion
Growth in prescribed drug spending has slowed
in both the public and private sectors since 2000
6
Prescribed Drug Spending, Canada, 2000 to 2014f
Inception
of the CDR
Interim
jODR
process
Bill 102 in
Ontario
Beginning
of pCPA
Federal Government Jurisdiction –
Public Plans
Legal Framework
• Canada Health Act and Regulations
• Vanessa’ s Law
• Food and Drugs Act and Regulations
• Patent Act and Regulations
Federal Health Regulatory Agencies
• Health Canada reporting to Minister of Health
– Food and Drugs Act and Regulations
– Vanessa’s Law
• Patented Medicine Prices Review Board
reporting to Minister of Health
– Patent Act and Regulations
Public Jurisdictions in Health
Federal/ Provincial/ Territorial
Canada Health Act
• Federal legislation requiring universal access to doctors and
hospitals
• Treatments prescribed in hospital are also covered
generally
• Hospitals decide what drugs and tests they will cover
• Hospital administered drugs and tests outside that list must
be paid for by patients
Public Drug Coverage
Federal Jurisdiction
The federal government covers:
> federal employees and retirees
> the military
> the RCMP
> First Nations on Reserves ( Non-Insured
Health Benefits )
> inmates in federal penitentiaries
> refugees
Food and Drugs Act
Requires drugs approved for sale in Canada to be safe, effective and of
good quality
Oversight is through Health Canada for :
> drugs- brand and generic
> biologics and biosimilars
> medical devices
> natural and non-prescription health products
> marketed health products
> compliance and enforcement
Clinical trial approval, approval for sale, post market monitoring,
Special Access Programme
Vanessa’s Law
Amended the Food and Drugs Act to include
rules that:
• Strengthen safety oversight
• Improves reporting by health care institutions
of serious adverse drugs reactions and
medical device incidents
Patent Act and Regulations
The Patent Act establishes PMPRB to regulate prices of patented drugs
sold in Canada to ensure that the prices are not excessive
The Regulations include the list or basket of countries to be taken into
account in determining excessive pricing i.e. U.S., Germany, Spain, U.K.,
France , Switzerland, Sweden and the automatic increases annually
based on CPI
Compendium of Policies, Guidelines and Procedures are non-binding
guidance from the PMPRB Board to staff and patentees including the
role of therapeutic benefit and the way to rely on the basket to
determine excessive pricing
Oversight through the Patented Medicine Prices Review Board that
also reports on generic drug price trends
Joint Federal/Provincial/ Territorial
Health Jurisdiction
The Canadian Agency for Drugs and Technologies
in Health (CADTH)
• Not for profit corporation reporting to a Board of
Directors
pan-Canadian Pharmaceutical Alliance (pCPA)
• Created by and reporting to the Council of the
Federation
Public Drug Coverage
Provincial/ Territorial Jurisdiction
Provinces and territories cover:
> eligible people residing in the province
/territory
> inmates in provincial correctional institutions
> First Nations not on reserve
> refugees
> provincial employees and retirees
Coverage is limited to a specific list of drugs, biologics and
diagnostics, specific populations, ages or incomes and
may have deductibles and copays
Role of CADTH
• Recommendation making body to the provinces
and territories about what drugs, biologics,
companion diagnostics are good value to be
covered under public reimbursement processes
• These are a guide only, non-binding
• This is done through a health technology
assessment process
Health Technology Assessment
(HTA)
• Assessment of value to the public drug plans
• Based on an evidence based formula
• If value is determined to be “good “ based on the
formula chosen for measurement, a reimburse or
reimburse with clinical criteria and/or conditions is
made
• If value is not acceptable, a do not reimburse
recommendation is made
Common Drug Review
• Housed within CADTH to reviews new drugs and new indications
for drugs except oncology
• Looks at clinical data, economic analyses, patient perspectives
• Does therapeutic class reviews as well
• Recommendations are made public
• Patient groups may submit information about a specific review
or class review and there are public members on the Canadian
Drug Expert Committee
pan-Canadian Oncology Drug Review
• Housed in CADTH to review new oncology therapies and new
indications
• Looks at clinical data, economic analyses, patient perspectives and
practicalities of implementation in a formal deliberative framework
• Draft recommendation are open for comment before formalized
• Recommendations to reimburse or reimburse with clinical
criteria/and conditions or not to reimburse made to P/T are public
• Patient groups may submit information about a specific review or
class review and there are patient members on the pCODR Expert
Review Committee (pERC)
Institut national d’excellence en santé et en
services sociaux (INESSS) in Québec
• The evaluation process considers five criteria as established
by the Institute’s founding Act: therapeutic value,
reasonableness of price, cost effectiveness, and the
advisability of entering the drug on the list and its impact
on the health and social services system.
• The drug’s therapeutic value is a prerequisite to
consideration of the other four criteria.
• Appraisal is part of a deliberative process involving
clinicians, researchers, ethicists, pharmaco-economists and
citizens.
• Following this deliberation, INESSS communicates its
recommendations to the Minister of Health and Social
Services.
pan-Canadian Pharmaceutical Alliance
(pCPA)
• Housed by the Government of Ontario with an administrative Office
• Leads non- time limited public plan negotiations for drug prices for
all provinces/ territories and federal plans for First Nations and
inmates
• Negotiation details and outcomes including price are not made
public
• Provinces can opt in to negotiations from the outset or not and may
also leave the negotiations at any point
• Ontario and Nova Scotia facilitate patented drugs negotiations with
one province agreeing to lead each negotiation
Provincial /Territorial Jurisdiction
• Determination of public drug coverage in that
province/territory
• Drug budgets
• Cancer agencies
• Issues for consideration are plan sustainability,
budget
Private Drug Coverage
Eligible people may have additional private
coverage:
• through employer sponsored drug plans or
• spousal or family coverage or
• individually purchased drug coverage
This is intended to augment limited public
insurance
• Subject of a CCSN webinar on the website
Conclusions
• Complex
• Multi jurisdictional
• Layered structures
• Unequal across Canada
• Discretionary powers, often not transparent
• Some patient engagement but not always
meaningful
• Not universal coverage either in who is covered
or what is covered
613-898-1871
jmanthorne@survivornet.ca or
mforrest@survivornet.ca
www.survivornet.ca
@survivornetca
Facebook: CanadianSurvivorNet
Pinterest: survivornetwork
1.800.460.5832
kathy@saveyourskin.ca
sabrina@saveyourskin.ca
saveyourskin.ca / sauvetapeau.ca
@saveyourskinfdn @sauvetapeau
Facebook:
@SaveYourSkinFoundation
@SauveTaPeau
1.800.449.6830
ascali@schizophrenia.ca or
eboudreau@schizophrenia.ca
www.schizophrenia.on.ca
@peace_of_minds
Facebook: Schizophrenia Society of
Ontario
Questions?

Contenu connexe

Tendances

regulatory aspects of medical devices in USA
regulatory aspects of medical devices in USAregulatory aspects of medical devices in USA
regulatory aspects of medical devices in USAnavyasribandaru
 
Drug approval process in japan
Drug approval process in japanDrug approval process in japan
Drug approval process in japanManish kumar
 
REGULATORY CONSIDERATIONS IN JAPAN.pptx
REGULATORY CONSIDERATIONS IN JAPAN.pptxREGULATORY CONSIDERATIONS IN JAPAN.pptx
REGULATORY CONSIDERATIONS IN JAPAN.pptxAartiVats5
 
Post Marketing Requirements/Complaince: PMRs and PMCs
Post Marketing Requirements/Complaince: PMRs and PMCsPost Marketing Requirements/Complaince: PMRs and PMCs
Post Marketing Requirements/Complaince: PMRs and PMCsDr. Reena Malik
 
Regulation of medical device in japan
Regulation of medical device in japanRegulation of medical device in japan
Regulation of medical device in japanKrushnaAgnihotri
 
Marketing Authorization Procedure in European Union
Marketing Authorization Procedure in European UnionMarketing Authorization Procedure in European Union
Marketing Authorization Procedure in European UnionDoninder Hooda
 
Plasma master file
Plasma master filePlasma master file
Plasma master fileSridhar S
 
Yuvraj Regmi on Hatch-Waxman Act and Amendments and CFR
Yuvraj Regmi on Hatch-Waxman Act and Amendments and CFRYuvraj Regmi on Hatch-Waxman Act and Amendments and CFR
Yuvraj Regmi on Hatch-Waxman Act and Amendments and CFRYUVRAJ REGMI
 
Auditing of manufacturing facilities by international regulatory agencies ppt
Auditing of manufacturing facilities by international regulatory agencies pptAuditing of manufacturing facilities by international regulatory agencies ppt
Auditing of manufacturing facilities by international regulatory agencies pptTek kaushik
 
GMP for Nutraceuticals .pdf
GMP for Nutraceuticals  .pdfGMP for Nutraceuticals  .pdf
GMP for Nutraceuticals .pdfBhavikaAPatel
 
CLINICAL INVESTIGATION AND EVALUATION OF MEDICAL DEVICES AND.pptx
CLINICAL INVESTIGATION AND EVALUATION OF MEDICAL DEVICES AND.pptxCLINICAL INVESTIGATION AND EVALUATION OF MEDICAL DEVICES AND.pptx
CLINICAL INVESTIGATION AND EVALUATION OF MEDICAL DEVICES AND.pptxFaizanShaikh204666
 
European_Union.ppt.Nikhil[1].pptx
European_Union.ppt.Nikhil[1].pptxEuropean_Union.ppt.Nikhil[1].pptx
European_Union.ppt.Nikhil[1].pptxNikhilBorade5
 
Labeling/Advertising and Promotion, Import/Export, and Enforcement Actions
Labeling/Advertising and Promotion, Import/Export, and Enforcement ActionsLabeling/Advertising and Promotion, Import/Export, and Enforcement Actions
Labeling/Advertising and Promotion, Import/Export, and Enforcement ActionsMichael Swit
 
Investigational new drug application
Investigational new drug application Investigational new drug application
Investigational new drug application Kirsha K S
 
Clinical Research Regulation in European Union
Clinical Research Regulation in European Union Clinical Research Regulation in European Union
Clinical Research Regulation in European Union ShantanuThakre3
 

Tendances (20)

regulatory aspects of medical devices in USA
regulatory aspects of medical devices in USAregulatory aspects of medical devices in USA
regulatory aspects of medical devices in USA
 
Drug approval process in japan
Drug approval process in japanDrug approval process in japan
Drug approval process in japan
 
REGULATORY CONSIDERATIONS IN JAPAN.pptx
REGULATORY CONSIDERATIONS IN JAPAN.pptxREGULATORY CONSIDERATIONS IN JAPAN.pptx
REGULATORY CONSIDERATIONS IN JAPAN.pptx
 
Post Marketing Requirements/Complaince: PMRs and PMCs
Post Marketing Requirements/Complaince: PMRs and PMCsPost Marketing Requirements/Complaince: PMRs and PMCs
Post Marketing Requirements/Complaince: PMRs and PMCs
 
Regulation of medical device in japan
Regulation of medical device in japanRegulation of medical device in japan
Regulation of medical device in japan
 
Marketing Authorization Procedure in European Union
Marketing Authorization Procedure in European UnionMarketing Authorization Procedure in European Union
Marketing Authorization Procedure in European Union
 
Plasma master file
Plasma master filePlasma master file
Plasma master file
 
Yuvraj Regmi on Hatch-Waxman Act and Amendments and CFR
Yuvraj Regmi on Hatch-Waxman Act and Amendments and CFRYuvraj Regmi on Hatch-Waxman Act and Amendments and CFR
Yuvraj Regmi on Hatch-Waxman Act and Amendments and CFR
 
How Prescription Drugs are Approved in Canada
How Prescription Drugs are Approved in CanadaHow Prescription Drugs are Approved in Canada
How Prescription Drugs are Approved in Canada
 
Auditing of manufacturing facilities by international regulatory agencies ppt
Auditing of manufacturing facilities by international regulatory agencies pptAuditing of manufacturing facilities by international regulatory agencies ppt
Auditing of manufacturing facilities by international regulatory agencies ppt
 
Hatch waxman act
Hatch waxman actHatch waxman act
Hatch waxman act
 
GMP for Nutraceuticals .pdf
GMP for Nutraceuticals  .pdfGMP for Nutraceuticals  .pdf
GMP for Nutraceuticals .pdf
 
CLINICAL INVESTIGATION AND EVALUATION OF MEDICAL DEVICES AND.pptx
CLINICAL INVESTIGATION AND EVALUATION OF MEDICAL DEVICES AND.pptxCLINICAL INVESTIGATION AND EVALUATION OF MEDICAL DEVICES AND.pptx
CLINICAL INVESTIGATION AND EVALUATION OF MEDICAL DEVICES AND.pptx
 
Fda guidance for pharmaceutical post marketing reporting professor pirouzi
Fda guidance for pharmaceutical post marketing reporting   professor pirouziFda guidance for pharmaceutical post marketing reporting   professor pirouzi
Fda guidance for pharmaceutical post marketing reporting professor pirouzi
 
European_Union.ppt.Nikhil[1].pptx
European_Union.ppt.Nikhil[1].pptxEuropean_Union.ppt.Nikhil[1].pptx
European_Union.ppt.Nikhil[1].pptx
 
Labeling/Advertising and Promotion, Import/Export, and Enforcement Actions
Labeling/Advertising and Promotion, Import/Export, and Enforcement ActionsLabeling/Advertising and Promotion, Import/Export, and Enforcement Actions
Labeling/Advertising and Promotion, Import/Export, and Enforcement Actions
 
GHTF
GHTFGHTF
GHTF
 
Investigational new drug application
Investigational new drug application Investigational new drug application
Investigational new drug application
 
Clinical Research Regulation in European Union
Clinical Research Regulation in European Union Clinical Research Regulation in European Union
Clinical Research Regulation in European Union
 
Nsf standard
Nsf standardNsf standard
Nsf standard
 

En vedette

Is this Your Challenge
Is this Your ChallengeIs this Your Challenge
Is this Your ChallengeCara Lacey
 
Canada Market Access Briefing
Canada Market Access BriefingCanada Market Access Briefing
Canada Market Access BriefingMichael Jacobson
 
10 Biggest Market Access Mistakes
10 Biggest Market Access Mistakes10 Biggest Market Access Mistakes
10 Biggest Market Access MistakesCara Lacey
 
Patient support programmes within medicines optimisation – the pros and cons
Patient support programmes within medicines optimisation – the pros and consPatient support programmes within medicines optimisation – the pros and cons
Patient support programmes within medicines optimisation – the pros and consPM Society
 
Leveraging Patient Support Programs in Biologic-Biosimilar Competitive Landscape
Leveraging Patient Support Programs in Biologic-Biosimilar Competitive LandscapeLeveraging Patient Support Programs in Biologic-Biosimilar Competitive Landscape
Leveraging Patient Support Programs in Biologic-Biosimilar Competitive LandscapeAlex Xiaoguang Zhu
 
Patient adherence – what’s the problem?
Patient adherence – what’s the problem?Patient adherence – what’s the problem?
Patient adherence – what’s the problem?PM Society
 

En vedette (10)

Is this Your Challenge
Is this Your ChallengeIs this Your Challenge
Is this Your Challenge
 
Canada Market Access Briefing
Canada Market Access BriefingCanada Market Access Briefing
Canada Market Access Briefing
 
10 Biggest Market Access Mistakes
10 Biggest Market Access Mistakes10 Biggest Market Access Mistakes
10 Biggest Market Access Mistakes
 
Drug Access Navigation - An Insider's Perspective
Drug Access Navigation - An Insider's PerspectiveDrug Access Navigation - An Insider's Perspective
Drug Access Navigation - An Insider's Perspective
 
Bone Health in Cancer - Dr. Sandy Sehdev
Bone Health in Cancer - Dr. Sandy SehdevBone Health in Cancer - Dr. Sandy Sehdev
Bone Health in Cancer - Dr. Sandy Sehdev
 
Patient support programmes within medicines optimisation – the pros and cons
Patient support programmes within medicines optimisation – the pros and consPatient support programmes within medicines optimisation – the pros and cons
Patient support programmes within medicines optimisation – the pros and cons
 
Leveraging Patient Support Programs in Biologic-Biosimilar Competitive Landscape
Leveraging Patient Support Programs in Biologic-Biosimilar Competitive LandscapeLeveraging Patient Support Programs in Biologic-Biosimilar Competitive Landscape
Leveraging Patient Support Programs in Biologic-Biosimilar Competitive Landscape
 
CADTH - Why it is important, and what now?
CADTH - Why it is important, and what now?CADTH - Why it is important, and what now?
CADTH - Why it is important, and what now?
 
Patient adherence – what’s the problem?
Patient adherence – what’s the problem?Patient adherence – what’s the problem?
Patient adherence – what’s the problem?
 
New Diagnostics Guiding Oncology Treatment Decisions
New Diagnostics Guiding Oncology Treatment DecisionsNew Diagnostics Guiding Oncology Treatment Decisions
New Diagnostics Guiding Oncology Treatment Decisions
 

Similaire à Drug Approval Bodies in Canada 101: The Elevator Length Pitch

Health Technology Assessment: Comparison between UK and Canada Processes by D...
Health Technology Assessment: Comparison between UK and Canada Processes by D...Health Technology Assessment: Comparison between UK and Canada Processes by D...
Health Technology Assessment: Comparison between UK and Canada Processes by D...Dr. Tayaba Khan
 
Private Insurance Plans - Do they have a future in Canada?
Private Insurance Plans - Do they have a future in Canada?Private Insurance Plans - Do they have a future in Canada?
Private Insurance Plans - Do they have a future in Canada?Canadian Cancer Survivor Network
 
Federal pharmaceutical pricing reform: What do patients think?
Federal pharmaceutical pricing reform: What do patients think?Federal pharmaceutical pricing reform: What do patients think?
Federal pharmaceutical pricing reform: What do patients think?Canadian Cancer Survivor Network
 
Application for New Drug Discovery (NDD) according to USFDA guidelines
Application for New Drug Discovery (NDD) according to USFDA guidelines Application for New Drug Discovery (NDD) according to USFDA guidelines
Application for New Drug Discovery (NDD) according to USFDA guidelines Bharathiar university
 
CCSN Advocacy Webinar #2
CCSN Advocacy Webinar #2CCSN Advocacy Webinar #2
CCSN Advocacy Webinar #2Tiffany Glover
 
Lunchtime Seminar with Paula Lorgelly - 14 December 2015
Lunchtime Seminar with Paula Lorgelly - 14 December 2015Lunchtime Seminar with Paula Lorgelly - 14 December 2015
Lunchtime Seminar with Paula Lorgelly - 14 December 2015Office of Health Economics
 
Rx15 pharma tues_330_burns
Rx15 pharma tues_330_burnsRx15 pharma tues_330_burns
Rx15 pharma tues_330_burnsOPUNITE
 
Bringing Rare Disease Drugs to Canada Opportunities, Challenges, and More Cha...
Bringing Rare Disease Drugs to Canada Opportunities, Challenges, and More Cha...Bringing Rare Disease Drugs to Canada Opportunities, Challenges, and More Cha...
Bringing Rare Disease Drugs to Canada Opportunities, Challenges, and More Cha...Canadian Cancer Survivor Network
 
regulatory approval process of drug, cosmetic and herbals in canada
regulatory approval process of drug, cosmetic and herbals  in canada regulatory approval process of drug, cosmetic and herbals  in canada
regulatory approval process of drug, cosmetic and herbals in canada Richa Patel
 
Canada’s Orphan Drug Regulatory Framework: What Health Canada is doing now an...
Canada’s Orphan Drug Regulatory Framework: What Health Canada is doing now an...Canada’s Orphan Drug Regulatory Framework: What Health Canada is doing now an...
Canada’s Orphan Drug Regulatory Framework: What Health Canada is doing now an...Canadian Organization for Rare Disorders
 
How patient groups can have more say in the drug approval process
How patient groups can have more say in the drug approval processHow patient groups can have more say in the drug approval process
How patient groups can have more say in the drug approval processCanadian Cancer Survivor Network
 
Rx15 tpp tues_1230_allen-emptage
Rx15 tpp tues_1230_allen-emptageRx15 tpp tues_1230_allen-emptage
Rx15 tpp tues_1230_allen-emptageOPUNITE
 
Veena Sanjay Katoriya
Veena Sanjay KatoriyaVeena Sanjay Katoriya
Veena Sanjay KatoriyaVEENA18
 

Similaire à Drug Approval Bodies in Canada 101: The Elevator Length Pitch (20)

The Mad, Fairytale World of Drug Approval in Canada
The Mad, Fairytale World of Drug Approval in CanadaThe Mad, Fairytale World of Drug Approval in Canada
The Mad, Fairytale World of Drug Approval in Canada
 
Pharmacare - Caveat Emptor (Let the Buyer Beware)
Pharmacare - Caveat Emptor (Let the Buyer Beware)Pharmacare - Caveat Emptor (Let the Buyer Beware)
Pharmacare - Caveat Emptor (Let the Buyer Beware)
 
Health Technology Assessment: Comparison between UK and Canada Processes by D...
Health Technology Assessment: Comparison between UK and Canada Processes by D...Health Technology Assessment: Comparison between UK and Canada Processes by D...
Health Technology Assessment: Comparison between UK and Canada Processes by D...
 
Private Insurance Plans - Do they have a future in Canada?
Private Insurance Plans - Do they have a future in Canada?Private Insurance Plans - Do they have a future in Canada?
Private Insurance Plans - Do they have a future in Canada?
 
Cathy parker the orphan drug framework
Cathy parker the orphan drug frameworkCathy parker the orphan drug framework
Cathy parker the orphan drug framework
 
Federal pharmaceutical pricing reform: What do patients think?
Federal pharmaceutical pricing reform: What do patients think?Federal pharmaceutical pricing reform: What do patients think?
Federal pharmaceutical pricing reform: What do patients think?
 
Orphan Drugs
Orphan DrugsOrphan Drugs
Orphan Drugs
 
Panel D: CORD 2018 Fall Conference Nov 8: Day 1
Panel D: CORD 2018 Fall Conference Nov 8: Day 1Panel D: CORD 2018 Fall Conference Nov 8: Day 1
Panel D: CORD 2018 Fall Conference Nov 8: Day 1
 
Application for New Drug Discovery (NDD) according to USFDA guidelines
Application for New Drug Discovery (NDD) according to USFDA guidelines Application for New Drug Discovery (NDD) according to USFDA guidelines
Application for New Drug Discovery (NDD) according to USFDA guidelines
 
CCSN Advocacy Webinar #2
CCSN Advocacy Webinar #2CCSN Advocacy Webinar #2
CCSN Advocacy Webinar #2
 
Lunchtime Seminar with Paula Lorgelly - 14 December 2015
Lunchtime Seminar with Paula Lorgelly - 14 December 2015Lunchtime Seminar with Paula Lorgelly - 14 December 2015
Lunchtime Seminar with Paula Lorgelly - 14 December 2015
 
Rx15 pharma tues_330_burns
Rx15 pharma tues_330_burnsRx15 pharma tues_330_burns
Rx15 pharma tues_330_burns
 
Maureen smith patient submissionspresentation.m smith.nov2015
Maureen smith patient submissionspresentation.m smith.nov2015Maureen smith patient submissionspresentation.m smith.nov2015
Maureen smith patient submissionspresentation.m smith.nov2015
 
Bringing Rare Disease Drugs to Canada Opportunities, Challenges, and More Cha...
Bringing Rare Disease Drugs to Canada Opportunities, Challenges, and More Cha...Bringing Rare Disease Drugs to Canada Opportunities, Challenges, and More Cha...
Bringing Rare Disease Drugs to Canada Opportunities, Challenges, and More Cha...
 
regulatory approval process of drug, cosmetic and herbals in canada
regulatory approval process of drug, cosmetic and herbals  in canada regulatory approval process of drug, cosmetic and herbals  in canada
regulatory approval process of drug, cosmetic and herbals in canada
 
Canada’s Orphan Drug Regulatory Framework: What Health Canada is doing now an...
Canada’s Orphan Drug Regulatory Framework: What Health Canada is doing now an...Canada’s Orphan Drug Regulatory Framework: What Health Canada is doing now an...
Canada’s Orphan Drug Regulatory Framework: What Health Canada is doing now an...
 
How patient groups can have more say in the drug approval process
How patient groups can have more say in the drug approval processHow patient groups can have more say in the drug approval process
How patient groups can have more say in the drug approval process
 
Rx15 tpp tues_1230_allen-emptage
Rx15 tpp tues_1230_allen-emptageRx15 tpp tues_1230_allen-emptage
Rx15 tpp tues_1230_allen-emptage
 
Veena Sanjay Katoriya
Veena Sanjay KatoriyaVeena Sanjay Katoriya
Veena Sanjay Katoriya
 
OTC and budget.pdf
OTC and budget.pdfOTC and budget.pdf
OTC and budget.pdf
 

Plus de Canadian Cancer Survivor Network

CCSN Webinar Patient Input into HTA Decision Making Oct 5 2023.pptx
CCSN Webinar Patient Input into HTA Decision Making Oct 5 2023.pptxCCSN Webinar Patient Input into HTA Decision Making Oct 5 2023.pptx
CCSN Webinar Patient Input into HTA Decision Making Oct 5 2023.pptxCanadian Cancer Survivor Network
 
CCSN Presentation Getting Your Gut What It Needs A Post Cancer Treatment Guid...
CCSN Presentation Getting Your Gut What It Needs A Post Cancer Treatment Guid...CCSN Presentation Getting Your Gut What It Needs A Post Cancer Treatment Guid...
CCSN Presentation Getting Your Gut What It Needs A Post Cancer Treatment Guid...Canadian Cancer Survivor Network
 
Young Adult Cancer Canada & the 8 Things You Need to Know About Cancer in the...
Young Adult Cancer Canada & the 8 Things You Need to Know About Cancer in the...Young Adult Cancer Canada & the 8 Things You Need to Know About Cancer in the...
Young Adult Cancer Canada & the 8 Things You Need to Know About Cancer in the...Canadian Cancer Survivor Network
 

Plus de Canadian Cancer Survivor Network (20)

CBoC_IMC_Time to Patient Presentation_CCSN.pdf
CBoC_IMC_Time to Patient Presentation_CCSN.pdfCBoC_IMC_Time to Patient Presentation_CCSN.pdf
CBoC_IMC_Time to Patient Presentation_CCSN.pdf
 
Pancreatic Cancer an Overview - CCSN 2024-02-29
Pancreatic Cancer an Overview - CCSN 2024-02-29Pancreatic Cancer an Overview - CCSN 2024-02-29
Pancreatic Cancer an Overview - CCSN 2024-02-29
 
Bulk Importation MSSC Presentation 2024-02-final .pdf
Bulk Importation MSSC Presentation 2024-02-final .pdfBulk Importation MSSC Presentation 2024-02-final .pdf
Bulk Importation MSSC Presentation 2024-02-final .pdf
 
CCSN Webinar 2023 2023 11 Diet for PEP.pdf
CCSN Webinar 2023 2023 11 Diet for PEP.pdfCCSN Webinar 2023 2023 11 Diet for PEP.pdf
CCSN Webinar 2023 2023 11 Diet for PEP.pdf
 
CCSN Webinar - EAOCRC FINAL [Autosaved].pptx
CCSN Webinar - EAOCRC FINAL [Autosaved].pptxCCSN Webinar - EAOCRC FINAL [Autosaved].pptx
CCSN Webinar - EAOCRC FINAL [Autosaved].pptx
 
CCSN David Ma Nov 9 2023 final.pptx
CCSN David Ma Nov 9 2023 final.pptxCCSN David Ma Nov 9 2023 final.pptx
CCSN David Ma Nov 9 2023 final.pptx
 
CCSN_Husereau_2_Nov.pdf
CCSN_Husereau_2_Nov.pdfCCSN_Husereau_2_Nov.pdf
CCSN_Husereau_2_Nov.pdf
 
CCSN Breast Screening for Women in the 40s(1).pptx
CCSN Breast Screening for Women in the 40s(1).pptxCCSN Breast Screening for Women in the 40s(1).pptx
CCSN Breast Screening for Women in the 40s(1).pptx
 
CCSN Webinar Patient Input into HTA Decision Making Oct 5 2023.pptx
CCSN Webinar Patient Input into HTA Decision Making Oct 5 2023.pptxCCSN Webinar Patient Input into HTA Decision Making Oct 5 2023.pptx
CCSN Webinar Patient Input into HTA Decision Making Oct 5 2023.pptx
 
AsbestosPresentation-PCNforCCSN-Final-Sept28.pdf
AsbestosPresentation-PCNforCCSN-Final-Sept28.pdfAsbestosPresentation-PCNforCCSN-Final-Sept28.pdf
AsbestosPresentation-PCNforCCSN-Final-Sept28.pdf
 
CCSN EUPROMS.pptx
CCSN EUPROMS.pptxCCSN EUPROMS.pptx
CCSN EUPROMS.pptx
 
survivornettalkCancerandWorkP.pdf
survivornettalkCancerandWorkP.pdfsurvivornettalkCancerandWorkP.pdf
survivornettalkCancerandWorkP.pdf
 
CCSN Long Covid FINAL.pptx
CCSN Long Covid FINAL.pptxCCSN Long Covid FINAL.pptx
CCSN Long Covid FINAL.pptx
 
CCSN Presentation Getting Your Gut What It Needs A Post Cancer Treatment Guid...
CCSN Presentation Getting Your Gut What It Needs A Post Cancer Treatment Guid...CCSN Presentation Getting Your Gut What It Needs A Post Cancer Treatment Guid...
CCSN Presentation Getting Your Gut What It Needs A Post Cancer Treatment Guid...
 
CCSN Powerpoint Template_planningfornewreality.pptx
CCSN Powerpoint Template_planningfornewreality.pptxCCSN Powerpoint Template_planningfornewreality.pptx
CCSN Powerpoint Template_planningfornewreality.pptx
 
SayaniAmbreen_SocialInequalitiesANDCancer_April2023.pdf
SayaniAmbreen_SocialInequalitiesANDCancer_April2023.pdfSayaniAmbreen_SocialInequalitiesANDCancer_April2023.pdf
SayaniAmbreen_SocialInequalitiesANDCancer_April2023.pdf
 
CS2FS What to expect from Advisors.pptx
CS2FS What to expect from Advisors.pptxCS2FS What to expect from Advisors.pptx
CS2FS What to expect from Advisors.pptx
 
Update on Cancer Meds Review and Approval 23Mar2023.pptx
Update on Cancer Meds Review and Approval 23Mar2023.pptxUpdate on Cancer Meds Review and Approval 23Mar2023.pptx
Update on Cancer Meds Review and Approval 23Mar2023.pptx
 
Young Adult Cancer Canada & the 8 Things You Need to Know About Cancer in the...
Young Adult Cancer Canada & the 8 Things You Need to Know About Cancer in the...Young Adult Cancer Canada & the 8 Things You Need to Know About Cancer in the...
Young Adult Cancer Canada & the 8 Things You Need to Know About Cancer in the...
 
Equity_oriented_LCS_CCSN_Nov2022.pdf
Equity_oriented_LCS_CCSN_Nov2022.pdfEquity_oriented_LCS_CCSN_Nov2022.pdf
Equity_oriented_LCS_CCSN_Nov2022.pdf
 

Dernier

Children who live with Grandparents are really lucky
Children who live with Grandparents are really luckyChildren who live with Grandparents are really lucky
Children who live with Grandparents are really luckySERUDS INDIA
 
Water can create peace or spark conflict.
Water can create peace or spark conflict.Water can create peace or spark conflict.
Water can create peace or spark conflict.Christina Parmionova
 
Millions of Homeless Children in kurnool
Millions of Homeless Children in kurnoolMillions of Homeless Children in kurnool
Millions of Homeless Children in kurnoolSERUDS INDIA
 
Item # 4 - Appointment of new PW Director
Item # 4 - Appointment of new PW DirectorItem # 4 - Appointment of new PW Director
Item # 4 - Appointment of new PW Directorahcitycouncil
 
2024: The FAR, Federal Acquisition Regulations - Part 17
2024: The FAR, Federal Acquisition Regulations - Part 172024: The FAR, Federal Acquisition Regulations - Part 17
2024: The FAR, Federal Acquisition Regulations - Part 17JSchaus & Associates
 
2024: The FAR, Federal Acquisition Regulations - Part 16
2024: The FAR, Federal Acquisition Regulations - Part 162024: The FAR, Federal Acquisition Regulations - Part 16
2024: The FAR, Federal Acquisition Regulations - Part 16JSchaus & Associates
 
Yes!? We can end TB - World Tuberculosis Day 2024.
Yes!? We can end TB - World Tuberculosis Day 2024.Yes!? We can end TB - World Tuberculosis Day 2024.
Yes!? We can end TB - World Tuberculosis Day 2024.Christina Parmionova
 
PPT Item # 2 -- Announcements Powerpoint
PPT Item # 2 -- Announcements PowerpointPPT Item # 2 -- Announcements Powerpoint
PPT Item # 2 -- Announcements Powerpointahcitycouncil
 
What is Politics by Andrew Heywood - Introduction to Politics
What is Politics by Andrew Heywood - Introduction to PoliticsWhat is Politics by Andrew Heywood - Introduction to Politics
What is Politics by Andrew Heywood - Introduction to Politicsabisamharim
 
Leveraging Water for Peace - World Water Day 2024
Leveraging Water for Peace - World Water Day 2024Leveraging Water for Peace - World Water Day 2024
Leveraging Water for Peace - World Water Day 2024Christina Parmionova
 
Project Synthesis - Markus Schneider - Humane Future Lab
Project Synthesis - Markus Schneider - Humane Future LabProject Synthesis - Markus Schneider - Humane Future Lab
Project Synthesis - Markus Schneider - Humane Future LabMarkus Schneider
 
B-SAN Annual Report July 2022 - June 2023
B-SAN Annual Report July 2022 - June 2023B-SAN Annual Report July 2022 - June 2023
B-SAN Annual Report July 2022 - June 2023B-SCAN
 
DB9_BTR_Webinar_Slidedeck_20230320 (1).pptx
DB9_BTR_Webinar_Slidedeck_20230320 (1).pptxDB9_BTR_Webinar_Slidedeck_20230320 (1).pptx
DB9_BTR_Webinar_Slidedeck_20230320 (1).pptxNAP Global Network
 
india sanitation coalition Swachata Abhiyan ​.pdf
india sanitation coalition Swachata Abhiyan ​.pdfindia sanitation coalition Swachata Abhiyan ​.pdf
india sanitation coalition Swachata Abhiyan ​.pdfcoalitionindiasanita
 
My Burning Issue: "War in Ukraine" Cycle 54
My Burning Issue: "War in Ukraine" Cycle 54My Burning Issue: "War in Ukraine" Cycle 54
My Burning Issue: "War in Ukraine" Cycle 54mmazurak
 
Hub Design Inspiration Graphics for inspiration
Hub Design Inspiration Graphics for inspirationHub Design Inspiration Graphics for inspiration
Hub Design Inspiration Graphics for inspirationStephen Abram
 
Presentation of the European Youth Foundation
Presentation of the European Youth FoundationPresentation of the European Youth Foundation
Presentation of the European Youth FoundationEuropeanYouthFoundation
 
PPT Item # 5-6 218 Canyon Drive replat prop.
PPT Item # 5-6 218 Canyon Drive replat prop.PPT Item # 5-6 218 Canyon Drive replat prop.
PPT Item # 5-6 218 Canyon Drive replat prop.ahcitycouncil
 
Parents can give charity ideas for kids.
Parents can give charity ideas for kids.Parents can give charity ideas for kids.
Parents can give charity ideas for kids.SERUDS INDIA
 
Passive Interactive Programming and Surveys 2.pptx
Passive Interactive Programming and Surveys 2.pptxPassive Interactive Programming and Surveys 2.pptx
Passive Interactive Programming and Surveys 2.pptxStephen Abram
 

Dernier (20)

Children who live with Grandparents are really lucky
Children who live with Grandparents are really luckyChildren who live with Grandparents are really lucky
Children who live with Grandparents are really lucky
 
Water can create peace or spark conflict.
Water can create peace or spark conflict.Water can create peace or spark conflict.
Water can create peace or spark conflict.
 
Millions of Homeless Children in kurnool
Millions of Homeless Children in kurnoolMillions of Homeless Children in kurnool
Millions of Homeless Children in kurnool
 
Item # 4 - Appointment of new PW Director
Item # 4 - Appointment of new PW DirectorItem # 4 - Appointment of new PW Director
Item # 4 - Appointment of new PW Director
 
2024: The FAR, Federal Acquisition Regulations - Part 17
2024: The FAR, Federal Acquisition Regulations - Part 172024: The FAR, Federal Acquisition Regulations - Part 17
2024: The FAR, Federal Acquisition Regulations - Part 17
 
2024: The FAR, Federal Acquisition Regulations - Part 16
2024: The FAR, Federal Acquisition Regulations - Part 162024: The FAR, Federal Acquisition Regulations - Part 16
2024: The FAR, Federal Acquisition Regulations - Part 16
 
Yes!? We can end TB - World Tuberculosis Day 2024.
Yes!? We can end TB - World Tuberculosis Day 2024.Yes!? We can end TB - World Tuberculosis Day 2024.
Yes!? We can end TB - World Tuberculosis Day 2024.
 
PPT Item # 2 -- Announcements Powerpoint
PPT Item # 2 -- Announcements PowerpointPPT Item # 2 -- Announcements Powerpoint
PPT Item # 2 -- Announcements Powerpoint
 
What is Politics by Andrew Heywood - Introduction to Politics
What is Politics by Andrew Heywood - Introduction to PoliticsWhat is Politics by Andrew Heywood - Introduction to Politics
What is Politics by Andrew Heywood - Introduction to Politics
 
Leveraging Water for Peace - World Water Day 2024
Leveraging Water for Peace - World Water Day 2024Leveraging Water for Peace - World Water Day 2024
Leveraging Water for Peace - World Water Day 2024
 
Project Synthesis - Markus Schneider - Humane Future Lab
Project Synthesis - Markus Schneider - Humane Future LabProject Synthesis - Markus Schneider - Humane Future Lab
Project Synthesis - Markus Schneider - Humane Future Lab
 
B-SAN Annual Report July 2022 - June 2023
B-SAN Annual Report July 2022 - June 2023B-SAN Annual Report July 2022 - June 2023
B-SAN Annual Report July 2022 - June 2023
 
DB9_BTR_Webinar_Slidedeck_20230320 (1).pptx
DB9_BTR_Webinar_Slidedeck_20230320 (1).pptxDB9_BTR_Webinar_Slidedeck_20230320 (1).pptx
DB9_BTR_Webinar_Slidedeck_20230320 (1).pptx
 
india sanitation coalition Swachata Abhiyan ​.pdf
india sanitation coalition Swachata Abhiyan ​.pdfindia sanitation coalition Swachata Abhiyan ​.pdf
india sanitation coalition Swachata Abhiyan ​.pdf
 
My Burning Issue: "War in Ukraine" Cycle 54
My Burning Issue: "War in Ukraine" Cycle 54My Burning Issue: "War in Ukraine" Cycle 54
My Burning Issue: "War in Ukraine" Cycle 54
 
Hub Design Inspiration Graphics for inspiration
Hub Design Inspiration Graphics for inspirationHub Design Inspiration Graphics for inspiration
Hub Design Inspiration Graphics for inspiration
 
Presentation of the European Youth Foundation
Presentation of the European Youth FoundationPresentation of the European Youth Foundation
Presentation of the European Youth Foundation
 
PPT Item # 5-6 218 Canyon Drive replat prop.
PPT Item # 5-6 218 Canyon Drive replat prop.PPT Item # 5-6 218 Canyon Drive replat prop.
PPT Item # 5-6 218 Canyon Drive replat prop.
 
Parents can give charity ideas for kids.
Parents can give charity ideas for kids.Parents can give charity ideas for kids.
Parents can give charity ideas for kids.
 
Passive Interactive Programming and Surveys 2.pptx
Passive Interactive Programming and Surveys 2.pptxPassive Interactive Programming and Surveys 2.pptx
Passive Interactive Programming and Surveys 2.pptx
 

Drug Approval Bodies in Canada 101: The Elevator Length Pitch

  • 1. What you should know about drug approval bodies in Canada 101: The Elevator Length Pitch
  • 2. Who Pays for Pharmaceuticals in Canada? Total 2013 Rx Meds Expenditure $29.3 B*; 100% Private Sector Share $17.1 B; 58.4% of total Public Sector Share $12.2 B; 41.6% of total Other Publicly Funded Drug Expenditure; 1.1 B; 3.8% of total; 9.0% of public share Federal Drug Benefit Plan; 0.6 B; 2.0% of total; 4.9% of public share Provincial Drug Benefit Plan; 10.5 B; 35.8% of total; 86.1% of public share Out-of-Pocket Contributions; 7.0 B; 23.9% of total; 40.9% of private share Private Insurers; 10.1 B; 34.5% of total; 59.1% of private share * Not including medicines dispensed in hospitals Source: Prescribed Drug Spending in Canada 2012 Report, CIHI 2
  • 3. In 2014, Canadians spent an estimated $28.8 billion on prescribed drugs 3 Total Health Expenditure, by Use of Funds, Canada, 2014f
  • 4. Complex Pathway to Patient Access Drug Development Health Canada Review Patented Medicine Prices Review Board Health Technology Assessment Hospitals Patient Access Private Drug Plans pan-Canadian Pharmaceutical Alliance 4 Provincial Drug Plans
  • 5. Health Canada review Safety, efficacy, and manufacturing quality Patented Medicine Prices Review Board (PMPRB) review Common Drug Review (CDR) Pan-Canadian Oncology Drug Review (pCODR) Local /Regional Review (For generics and older medications) and INESSS Private drug plan health technology analysis / evaluation – resources Public and Private Drug Benefit Plan review (budgetary capacity, plan characteristics, determination of clinical criteria, price and utilization negotiations and reimbursement status o r o r o r NoC or NoC/c Max. Avg. Potential Price (MAPP) Formulary Listing Recommendation Formulary Listing Decision/Inclusion
  • 6. Growth in prescribed drug spending has slowed in both the public and private sectors since 2000 6 Prescribed Drug Spending, Canada, 2000 to 2014f Inception of the CDR Interim jODR process Bill 102 in Ontario Beginning of pCPA
  • 7. Federal Government Jurisdiction – Public Plans Legal Framework • Canada Health Act and Regulations • Vanessa’ s Law • Food and Drugs Act and Regulations • Patent Act and Regulations
  • 8. Federal Health Regulatory Agencies • Health Canada reporting to Minister of Health – Food and Drugs Act and Regulations – Vanessa’s Law • Patented Medicine Prices Review Board reporting to Minister of Health – Patent Act and Regulations
  • 9. Public Jurisdictions in Health Federal/ Provincial/ Territorial Canada Health Act • Federal legislation requiring universal access to doctors and hospitals • Treatments prescribed in hospital are also covered generally • Hospitals decide what drugs and tests they will cover • Hospital administered drugs and tests outside that list must be paid for by patients
  • 10. Public Drug Coverage Federal Jurisdiction The federal government covers: > federal employees and retirees > the military > the RCMP > First Nations on Reserves ( Non-Insured Health Benefits ) > inmates in federal penitentiaries > refugees
  • 11. Food and Drugs Act Requires drugs approved for sale in Canada to be safe, effective and of good quality Oversight is through Health Canada for : > drugs- brand and generic > biologics and biosimilars > medical devices > natural and non-prescription health products > marketed health products > compliance and enforcement Clinical trial approval, approval for sale, post market monitoring, Special Access Programme
  • 12. Vanessa’s Law Amended the Food and Drugs Act to include rules that: • Strengthen safety oversight • Improves reporting by health care institutions of serious adverse drugs reactions and medical device incidents
  • 13. Patent Act and Regulations The Patent Act establishes PMPRB to regulate prices of patented drugs sold in Canada to ensure that the prices are not excessive The Regulations include the list or basket of countries to be taken into account in determining excessive pricing i.e. U.S., Germany, Spain, U.K., France , Switzerland, Sweden and the automatic increases annually based on CPI Compendium of Policies, Guidelines and Procedures are non-binding guidance from the PMPRB Board to staff and patentees including the role of therapeutic benefit and the way to rely on the basket to determine excessive pricing Oversight through the Patented Medicine Prices Review Board that also reports on generic drug price trends
  • 14. Joint Federal/Provincial/ Territorial Health Jurisdiction The Canadian Agency for Drugs and Technologies in Health (CADTH) • Not for profit corporation reporting to a Board of Directors pan-Canadian Pharmaceutical Alliance (pCPA) • Created by and reporting to the Council of the Federation
  • 15. Public Drug Coverage Provincial/ Territorial Jurisdiction Provinces and territories cover: > eligible people residing in the province /territory > inmates in provincial correctional institutions > First Nations not on reserve > refugees > provincial employees and retirees Coverage is limited to a specific list of drugs, biologics and diagnostics, specific populations, ages or incomes and may have deductibles and copays
  • 16. Role of CADTH • Recommendation making body to the provinces and territories about what drugs, biologics, companion diagnostics are good value to be covered under public reimbursement processes • These are a guide only, non-binding • This is done through a health technology assessment process
  • 17. Health Technology Assessment (HTA) • Assessment of value to the public drug plans • Based on an evidence based formula • If value is determined to be “good “ based on the formula chosen for measurement, a reimburse or reimburse with clinical criteria and/or conditions is made • If value is not acceptable, a do not reimburse recommendation is made
  • 18. Common Drug Review • Housed within CADTH to reviews new drugs and new indications for drugs except oncology • Looks at clinical data, economic analyses, patient perspectives • Does therapeutic class reviews as well • Recommendations are made public • Patient groups may submit information about a specific review or class review and there are public members on the Canadian Drug Expert Committee
  • 19. pan-Canadian Oncology Drug Review • Housed in CADTH to review new oncology therapies and new indications • Looks at clinical data, economic analyses, patient perspectives and practicalities of implementation in a formal deliberative framework • Draft recommendation are open for comment before formalized • Recommendations to reimburse or reimburse with clinical criteria/and conditions or not to reimburse made to P/T are public • Patient groups may submit information about a specific review or class review and there are patient members on the pCODR Expert Review Committee (pERC)
  • 20. Institut national d’excellence en santé et en services sociaux (INESSS) in Québec • The evaluation process considers five criteria as established by the Institute’s founding Act: therapeutic value, reasonableness of price, cost effectiveness, and the advisability of entering the drug on the list and its impact on the health and social services system. • The drug’s therapeutic value is a prerequisite to consideration of the other four criteria. • Appraisal is part of a deliberative process involving clinicians, researchers, ethicists, pharmaco-economists and citizens. • Following this deliberation, INESSS communicates its recommendations to the Minister of Health and Social Services.
  • 21. pan-Canadian Pharmaceutical Alliance (pCPA) • Housed by the Government of Ontario with an administrative Office • Leads non- time limited public plan negotiations for drug prices for all provinces/ territories and federal plans for First Nations and inmates • Negotiation details and outcomes including price are not made public • Provinces can opt in to negotiations from the outset or not and may also leave the negotiations at any point • Ontario and Nova Scotia facilitate patented drugs negotiations with one province agreeing to lead each negotiation
  • 22. Provincial /Territorial Jurisdiction • Determination of public drug coverage in that province/territory • Drug budgets • Cancer agencies • Issues for consideration are plan sustainability, budget
  • 23. Private Drug Coverage Eligible people may have additional private coverage: • through employer sponsored drug plans or • spousal or family coverage or • individually purchased drug coverage This is intended to augment limited public insurance • Subject of a CCSN webinar on the website
  • 24. Conclusions • Complex • Multi jurisdictional • Layered structures • Unequal across Canada • Discretionary powers, often not transparent • Some patient engagement but not always meaningful • Not universal coverage either in who is covered or what is covered
  • 25. 613-898-1871 jmanthorne@survivornet.ca or mforrest@survivornet.ca www.survivornet.ca @survivornetca Facebook: CanadianSurvivorNet Pinterest: survivornetwork 1.800.460.5832 kathy@saveyourskin.ca sabrina@saveyourskin.ca saveyourskin.ca / sauvetapeau.ca @saveyourskinfdn @sauvetapeau Facebook: @SaveYourSkinFoundation @SauveTaPeau 1.800.449.6830 ascali@schizophrenia.ca or eboudreau@schizophrenia.ca www.schizophrenia.on.ca @peace_of_minds Facebook: Schizophrenia Society of Ontario

Notes de l'éditeur

  1. Notes f: Forecast. $ billions; percentage share of total health expenditure. Source National Health Expenditure Database, 2014, Canadian Institute for Health Information.
  2. Notes Questions to answer: how many freedom of information requests in Ontario since 2006, How many onco products declined by CDR before jODR, state of deficits in Canada in 2013 vs in 2003. f: Forecast. Rx Drug: Prescribed drug. Source National Health Expenditure Database, 2014, Canadian Institute for Health Information.