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CPhA Pharmacare 2.0 Initiative
Presentation CCSN Roundtable on Pharmacare
June 1, 2016
Overview
 What is Pharmacare 2.0?
 What Canadians are Saying
 CPhA’s Principles & Priorities
 Pharmacare Models: Costs, Benefits & Drawbacks
 A Canadian Consensus
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
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
 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
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
What Canadians think about Pharmacare
What Canadians think about Pharmacare
CPhA Principles & Priorities
A pan-Canadian pharmacare framework must address
three key principles:
1. ACCESS & EQUITY
2. SAFETY & EFFECTIVENESS
3. INNOVATION & SUSTAINABILITY
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
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
Pharmacare Models: Costs
Coverage
Costs
POTENTIAL DRAWBACKSBENEFITS
Inappropriate Drug Therapy
Risk of Drug Shortages
Delayed Access
Value for Health Care Dollars
Pharmacare Models: Benefits & Drawbacks
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
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.
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

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Pharmacare 2.0 initiative

  • 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
  • 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