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1
EXAMINING THE IBM
REPORT ON THE pCPA
Presentation for CCSN
February 5, 2015
2
Draft v1
December 31, 2013
Draft v2
February...
3
1. pCPA Overview
2. The IBM Report
3. Update
4. Impacts on Patient Access
Outline
4
pCPA Overview
pCPA Overview - Description
The pan-Canadian Pharmaceutical
Alliance (pCPA) is an initiative to
facilitate the conduct of ...
pCPA Overview – Parallel Processes
6
Innovative medicines
Negotiate product listing
agreements (PLAs)
• Closed / Completed...
pCPA Overview – Innovative Process
7
Source: pan-Canadian Drugs Negotiations Report
pCPA overivew The IBM report Update Im...
pCPA Challenges
• Patient concerns
• No seat at the table
• Patient voices may help clarify, expedite, provide additional ...
pCPA Challenges
Other stakeholders
• Industry:
• Lack of transparency re timelines, pCPA process, and specific
criteria
• ...
pCPA Stakeholders
10
• Provincial and Territorial drug program branches
• Provincial cancer agencies (CAPCA)
• Manufacture...
11
The IBM report
IBM Report - Mandate
• Mandate. Recommend options for:
• Innovative medicines: a permanent model
• Generic medicines: achi...
IBM Report – Findings
Canada’s system is unique:
no existing model to import
Guiding Principles:
• Holistic
• Predictable
...
IBM Report – Findings
Common themes
• pCPA goals (incl. non-price goals) are
acceptable
• Single negotiation better than m...
IBM Report – General Recommendations
• Name change from “pricing” to “pharmaceutical”
• Improve communications:
• Negotiat...
IBM Report – Governance Recommendations
• Governance model: Five potential options – secretariat
recommended
• Secretariat...
17
Update
Update
• Decision to establish secretariat announced on September 30, 2014.
• Secretariat will be physically located with ...
19
Impacts on
patient access
Impacts on patient access
• Process longer BUT new medications that would not
otherwise be listed are being reimbursed
• M...
Thank you!
Gerry Jeffcott
gjeffcott@3sixtypublicaffairs.com
613.851.1602 (mobile)
Rachael Manion
rmanion@3sixtypublicaffai...
Canadian Cancer Survivor Network
Contact Info
Canadian Cancer Survivor Network
1750 Courtwood Crescent, Suite 210
Ottawa, ...
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The IBM report on the pCPA

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The IBM report on the pCPA

  1. 1. The webinar will begin shortly! 1
  2. 2. EXAMINING THE IBM REPORT ON THE pCPA Presentation for CCSN February 5, 2015 2 Draft v1 December 31, 2013 Draft v2 February 18, 2014 Draft v3 February 24, 2014 Final version March 22, 2014
  3. 3. 3 1. pCPA Overview 2. The IBM Report 3. Update 4. Impacts on Patient Access Outline
  4. 4. 4 pCPA Overview
  5. 5. pCPA Overview - Description The pan-Canadian Pharmaceutical Alliance (pCPA) is an initiative to facilitate the conduct of joint negotiations for pharmaceuticals being considered for reimbursement through participating public drug plans. 5 PARTICIPANTS • British Columbia • Alberta • Saskatchewan • Manitoba • Ontario • New Brunswick • Nova Scotia • Prince Edward Island • Newfoundland & Labrador • Yukon • Quebec Objectives: • Capitalize on the combined purchasing power of public drug plans across multiple jurisdictions • Improve the consistency of medication listing decisions across the country • Achieve consistent pricing and lower costs • Increase access to treatment options, and • Reduce duplication of negotiations and improve how resources are used pCPA overivew The IBM report Update Impacts on patient access
  6. 6. pCPA Overview – Parallel Processes 6 Innovative medicines Negotiate product listing agreements (PLAs) • Closed / Completed: 49 • Underway: 18 • No negotiations: 23 • P/T negotiaions: 9 Generic medicines Value Price Initiative caps generic medicines at 18% of innovative medicine • 2013: six generic medicines (cholesterol, depression, high blood pressure, GI) • 2014: four additional medicines • 2015: plans to cap additional four • 2016: plans to cap another four pCPA pCPA overivew The IBM report Update Impacts on patient access
  7. 7. pCPA Overview – Innovative Process 7 Source: pan-Canadian Drugs Negotiations Report pCPA overivew The IBM report Update Impacts on patient access
  8. 8. pCPA Challenges • Patient concerns • No seat at the table • Patient voices may help clarify, expedite, provide additional perspectives and lead to co-creation of metrics • Outcomes: • Every product should be listed if LOI is signed • Timeliness: • Clarity around timelines of negotiations needed • Use Special Access Programme while medication under negotiation • Concurrent processes preferred to consecutive processes • Patient experiences: • Patient submissions should be considered • Consider other aspects of value to patients (e.g., different delivery systems) • Health system impacts • also important (e.g., fewer doctor visits) – not just price • Guaranteed supply 8 pCPA overivew The IBM report Update Impacts on patient access
  9. 9. pCPA Challenges Other stakeholders • Industry: • Lack of transparency re timelines, pCPA process, and specific criteria • Overall economic impact should be considered as “value” • pCODR as model of collaboration with industry and patient groups • Provincial implementation after LOI signed inconsistent and unclear • Rare diseases: Consider nominating one province with expertise / program (Ontario) • Private payers: Do not have access to the same prices • Pharmacists: • No transparent pricing 9 pCPA overivew The IBM report Update Impacts on patient access
  10. 10. pCPA Stakeholders 10 • Provincial and Territorial drug program branches • Provincial cancer agencies (CAPCA) • Manufacturers (innovative) • Industry groups (Rx&D, BIOTECanada) • Regulatory bodies (pCODR, CADTH, PMPRB) • Patient groups • Cross Sector Alliance (CGPA, CACDS, CAPDM, CPhA) pCPA overivew The IBM report Update Impacts on patient access
  11. 11. 11 The IBM report
  12. 12. IBM Report - Mandate • Mandate. Recommend options for: • Innovative medicines: a permanent model • Generic medicines: achieving better value for money • Approach. IBM’s approach included: • An environmental scan of best practices • Strategic interviews with key senior stakeholders, and • Targeted survey with provincial drug programs on timelines for reimbursement of medicines negotiated through PCPA and future expected human resource needs • The focus was on innovative medicines, but governance and process recommendations could also apply to generic medicines. 12 pCPA overivew The IBM report Update Impacts on patient access
  13. 13. IBM Report – Findings Canada’s system is unique: no existing model to import Guiding Principles: • Holistic • Predictable • Consistent • Transparent • Timely • Efficient • Collaborative • Representative • Ethical 13  Somewhat aligned with pCODR principles  Provide accountability mechanism for stakeholders  Yet to be endorsed pCPA overivew The IBM report Update Impacts on patient access
  14. 14. IBM Report – Findings Common themes • pCPA goals (incl. non-price goals) are acceptable • Single negotiation better than multiple parallel processes in principle • pCPA seen as distinct from existing bodies in access continuum – e.g., CADTH • Subject matter expertise of provincial drug programs critical to success • Volume limited by resource constraints • pCPA young and evolving: needs more structure & more formal / consistent / transparent processes • Needs more collaborative, consistent, open and transparent communications • Metrics required to evaluate and benchmark pCPA performance 14 pCPA overivew The IBM report Update Impacts on patient access
  15. 15. IBM Report – General Recommendations • Name change from “pricing” to “pharmaceutical” • Improve communications: • Negotiation status • Benchmarks • Timelines • Annual reports on performance • Standardize LOIs & PLAs: flexible contracting process & ID complex issues early in process • Use tiered structure: different evidence needed for different products (Australia) • Possible pre-negotiation briefings: pCPA lead, manufacturer, HTA bodies & patient group representative • Develop metrics for different parts of the process – possibly include manufacturers 15 pCPA overivew The IBM report Update Impacts on patient access
  16. 16. IBM Report – Governance Recommendations • Governance model: Five potential options – secretariat recommended • Secretariat: central office providing support function (negotiating skills, templates, admin services, etc.) instead of reinventing the wheel each time • Process recommendations: • Increased standardization • Increased transparency • Clear timelines for exchanges between jurisdictions and manufacturers • Etc. 16 pCPA overivew The IBM report Update Impacts on patient access
  17. 17. 17 Update
  18. 18. Update • Decision to establish secretariat announced on September 30, 2014. • Secretariat will be physically located with the Ontario drug plan but administered separately. • The provinces launched a stakeholder consultation regarding the ongoing development of the new pCPA Office. • Consultations ended December 31, 2014. • The secretariat is expected to be operational by April 2015 18 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. pCPA overivew The IBM report Update Impacts on patient access
  19. 19. 19 Impacts on patient access
  20. 20. Impacts on patient access • Process longer BUT new medications that would not otherwise be listed are being reimbursed • More affordable / tailored through negotiation process • Increase in capacity and timeliness of decisions in smaller jurisdictions (Atlantic provinces and Manitoba) • Generally consistent with CDR / pCODR recommendations • Unclear how consistent they are with signed LOIs • In some cases, pCPA may represent the end of the road • Implications in other sectors: benefits don’t accrue to those not covered by public plan 20 pCPA overivew The IBM report Update Impacts on patient access
  21. 21. Thank you! Gerry Jeffcott gjeffcott@3sixtypublicaffairs.com 613.851.1602 (mobile) Rachael Manion rmanion@3sixtypublicaffairs.com 613.805.9552 (mobile)
  22. 22. Canadian Cancer Survivor Network Contact Info Canadian Cancer Survivor Network 1750 Courtwood Crescent, Suite 210 Ottawa, ON K2C 2B5 Telephone / Téléphone : 613-898-1871 E-mail jmanthorne@survivornet.ca or mforrest@survivornet.ca Web site www.survivornet.ca Blog: http://jackiemanthornescancerblog.blogspot.com/ Twitter: @survivornetca Facebook: www.facebook.com/CanadianSurvivorNet Pinterest: http://pinterest.com/survivornetwork/

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