This document discusses CPhA's Pharmacare 2.0 initiative to build consensus around improving Canada's pharmacare system. It provides an overview of Canadians' views and experiences with medication access and affordability. CPhA's principles for pharmacare emphasize access, safety, and sustainability. The document reviews potential pharmacare models and considers their costs, benefits, and drawbacks. It argues for an incremental, patient-focused approach to pharmacare that addresses coverage gaps while supporting optimal drug therapy.

1. CPhA Pharmacare 2.0 Initiative
Presentation CCSN Roundtable on Pharmacare
June 1, 2016

2. Overview
 What is Pharmacare 2.0?
 What Canadians are Saying
 CPhA’s Principles & Priorities
 Pharmacare Models: Costs, Benefits & Drawbacks
 A Canadian Consensus

3. Pharmacare 2.0
CPhA’s Pharmacare 2.0 initiative is designed to build a
Canadian Consensus:
 Status Quo is Not Acceptable
 PharmaCARE vs. PharmaCOSTS
 Pharmacy Service & Optimal Drug Use
 Incremental & Longer Term Solutions

4. Pharmacare 2.0
 CPhA’s Pharmacare Principles & Priorities
 Defining the Issues: Member & Public Opinion
 Research on the Costs/Benefits/Drawbacks of
Pharmacare Models
 Developing Broader Consensus on Pan-Canadian
Pharmacare Plan/Strategy

5.  Have you ever been prescribed a medication for a medical condition or illness
that you have either not filled, not taken as you were directed, or stopped
taking?
30%
26%
26%
70%
74%
74%
0% 20% 40% 60% 80% 100%
Stopped taking the medication before you were advised to
Not filled a prescription you were given
Took less medication than you were instructed to take
Yes No
What Canadians are Saying:
Why Did Not Fill

6. What Canadians are Saying:
Why Did Not Take as Prescribed
 Thinking of the medication(s) that you have been prescribed but did not take as directed,
which of the following best describes the reason for not taking the amount of medication
as prescribed or for stopping the use of it?
8%
1%
18%
18%
8%3%
45%
I couldn’t afford to keep taking the drug
It was removed from my drug plan
I didn’t think it was working well
It made me sick
There was an interaction with the other
medications I was taking
I felt embarrassed to tell people I was taking
it
I felt that that I no longer needed to take it

7. What Canadians think about Pharmacare

8. What Canadians think about Pharmacare

9. CPhA Principles & Priorities
A pan-Canadian pharmacare framework must address
three key principles:
1. ACCESS & EQUITY
2. SAFETY & EFFECTIVENESS
3. INNOVATION & SUSTAINABILITY

10. CPhA Principles & Priorities
 PRIORITY 1: No Canadian left out
 PRIORITY 2: More than just drugs
 PRIORITY 3: Coverage when and where it’s needed
 PRIORITY 4: Evidence-based coverage
 PRIORITY 5: E-prescribing
 PRIORITY 6: Drug supply and quality
 PRIORITY 7: Evolution not Revolution
 PRIORITY 8: Cost-Sharing
 PRIORITY 9: Investment in Innovation

11. Models of Pharmacare
 National Pharmacare Model
 Pan-Canadian Approaches:
1. Modified Quebec Model
2. PEI Generic Model
3. Private Payer Variation
 Pan-Canadian Catastrophic Program

12. Pharmacare Models: Costs

13. Coverage
Costs
POTENTIAL DRAWBACKSBENEFITS
Inappropriate Drug Therapy
Risk of Drug Shortages
Delayed Access
Value for Health Care Dollars
Pharmacare Models: Benefits & Drawbacks

14. Access to Cancer Drugs: NZ
 New Zealand ranks last out of 20 comparable OECD
countries for access to innovative medicines.
 Out of 13 countries, New Zealand has the lowest ranking for
access to cancer medicines.
 “There is little doubt among medical oncologists and
cancer scientists that New Zealanders cannot access
many state-of-the-art cancer medicines through our
public healthcare system.” -- Dr. Francis Hunter is the
John Gavin Postdoctoral Fellow at the Auckland Cancer
Society Research Centre at the University of Auckland

15. Access to Cancer Drugs: UK
 The UK has one of the lowest rankings for access to cancer
medicines in Europe.
 UK cancer survival rates lag more than 2 decades behind
many European countries with similar health systems, while
the use of recently launched cancer drugs is half the
international average.
 In 2015, 25 cancer treatments were delisted, affecting nearly
8000 patients – including those with breast, prostate and
bowel disease.

16. A Canadian Consensus
 Evolution vs. Revolution: Incremental change to address
gaps & catastrophic costs
 Patient Focused Approach: Government focus on reducing
drug prices to improve affordability and access to drugs must
not come at the expense of improving care and health
outcomes or value for health dollars
 PharmaCARE: An effective pharmacare system must not
only address gaps in patient coverage, it must address gaps
in access to services that support safe and effective drug
therapy for patients