Please share this video with anyone who may be interested! Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR In this webinar: ● Update on the fast-evolving pCPA ● pCPA's impact on patient access to new, innovative treatments ● Thoughts from CCSN's Louise Binder on how pCPA can involve patients in the decision making process View the video: https://youtu.be/rd08iLHqKQM Follow our social media accounts: Twitter - https://twitter.com/survivornetca Facebook - https://www.facebook.com/CanadianSurvivorNet Pinterest - https://www.pinterest.com/survivornetwork YouTube - https://www.youtube.com/user/Survivornetca

1. A PAN-CANADIAN
PHARMACEUTICALALLIANCE
UPDATE – OPTIMIZING THE
PROCESS FOR PATIENTS
September 1, 2016

2. 1. pCPA overview
2. Impact on patient access
3. How the pCPA process is
evolving and what’s next for
pCPA
4. How patients can engage
What we will discuss
2

3. pCPA objectives
• Increase access to
clinically effective and
cost-effective drug
treatment options
• Improve the
consistency of drug
funding decisions
• Achieve consistent and
lower drug costs
• Reduce duplication and
improve use of resources
3

4. pCPA participants
Federal plans
(NIHB etc.)
• Includes all provinces / territories - QC joined in October 2015
• Federal plans joined in February 2016
4

5. Two streams: innovative and generics
Innovative medicines
Negotiate terms for product
listing agreements (as of July
31 2016):
• Closed / Completed: 112
• Underway: 32
• No negotiations: 38
• P/T negotiations: 13
Generic medicines
Value Price Initiative caps
18 generic medicines at
18% of innovator and
applies a tiered pricing
framework for all other
generic drugs
Co-leads: ON & NS Co-leads: NS & SK
5

6. pCPA savings
More than $712 million in savings
annually
July 2016
6
Price reductions for 18 generic drugs and
negotiated price agreements for 95 brand
name drugs (as of April 1, 2016)

7. pCPA
process
Existing meds
• Therapeutic reviews
• Renegotiations of
existing PLAs etc.
New meds
CADTH
recommendation
pCPA
deliberation
No negotiations
Individual
consideration by plans
Negotiations
Letter of intent signed
Jurisdictional listings
7

8. Proposed guiding principles for pCPA process
• Holistic: consideration of value from multiple perspectives
• Predictable: communication of process, timelines,
participation, decision making
• Consistent: consistent process & approach, recognizing
unique nature of negotiations
• Transparent: timely and regular public reporting
• Efficient & Effective: reduce duplication and align with
current national HTA review
• Collaborative and representative: cross-jurisdictional
engagement with stakeholders
• Respectful: recognition of different perspectives and needs
amongst stakeholders
• Ethical: reflect ethical principles such as validity, veracity and
autonomy
• Value-driven: achieving value for the health care system
8

9. pCPA office
• Established in September 2015
• Housed in the Ontario Public Drug Program
• Office manager is Imran Ali
• Working on developing negotiation guidelines
Mandate: support national negotiations with manufacturers
Tasks:
• standardization of templates
• multi-channel communications
• administrative support and tracking of performance
metrics
• capacity building: additional expertise to support
consistency of negotiations across jurisdictions,
transparency of process and accountability
9

10. Impact on Patient Access:
Trend to higher listing rates and more consistency
14
20
25
32
20
33
11
22
6
21
27
53
56
71
60 59
73
69
54
72
0
10
20
30
40
50
60
70
80
BC AB SK MB ON QC NB NS PE NL
2006 (out of 103 drugs) 2015 (out of 195 drugs)
Source: IMS Brogan; PRA Quarterly; data represents the previous two years of listing decisions
Number of New Medicines
Added to Provincial Formularies
(2006 vs. 2015)
Percentage of new
medicines reimbursed
(2006 vs. 2015)
14%
19%
24%
31%
19%
31%
11%
21%
6%
20%14%
27%
29%
36%
31%
30%
37%
35%
28%
37%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
BC AB SK MB ON QC NB NS PE NL
2006 2015
10

11. Total Provincial Gov’t Health Expenditures on Prescribed Medicines
2006-2013 (Actual) and 2014-2015 (Forecast), $ Billions
Source: CIHI – National Health Expenditure Trends (C Series)
$8.17 B
$8.67 B
$9.16 B
$9.86 B $10.06 B $10.30 B $10.28 B $10.29 B $10.44 B $10.66 B
$0
$2
$4
$6
$8
$10
$12
2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
$Billions
% of total
health
spending
8.5 % 8.4 % 8.2 % 8.3 % 8.0 % 7.9 % 7.6 % 7.5 % 7.3 % 7.4 %
11

12. pCPA process still evolving
• Ongoing negotiation guidelines
consultations
• Timelines
• Sorting/prioritization
• Patient engagement
• Biosimilars – new approaches
• Class reviews and older products
• Performance measures and evaluation of
process
• Updated approaches to generic drugs
• Memorandum of Understanding across
jurisdictions
12

13. Themes for discussion
• Is there an increased role for patients at
pCPA?
• Policy and guideline development
• Governance, leadership and accountability
• Individual product input?
• pCPA’s impact on cancer treatment
access (e.g., new indications)
• Transparency & accountability
13

14. William (Bill) Dempster
wdempster@3sixtypublicaffairs.com
613.614.0283 (mobile)
Johanne Chambers
jchambers@3sixtypublicaffairs.com
613.799.3092 (mobile)
Louise Binder
louise.binder@rogers.com
416.457.3179 (mobile)
14