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criteria/processes, be transparent, clearlycommunicated to all potentially interested partiesand fair. Task Force members further noted thatthe tendering process, a cost controllingprocurement methodology, should not be utilizedas an indirect method to effect clinical outcomes,(for example, tendering to indirectly implementtherapeutic substitution).Issue Three: Strengthening patient careand choice and building positive relationsbetween government decision makers andindustry to achieve those objectives.This aspect of the Task Force mandate hasbeen substantially addressed earlier in this report.Meaningful engagement, transparency inevidence-based decision-making processes and agenuine commitment to a much higher degree ofpartnership-based shared risk arrangements areviewed as the critical elements of a moreconstructive, cost-effective and higher qualitypharmaceutical management system.In many respects, the Task Force processitself has been a useful exercise in thedevelopment of improved relationships and itwould be in the public interest if the PSD andthe various stakeholders continued to buildupon that foundation after the work of the TaskForce is complete. The existing level ofengagement and cooperation between theparties is not sufficient and must be improved.At present stakeholder relations aremanaged almost exclusively by representativesof the PSD. While the Task Force sees this asuseful, and believes it will be important for aneven greater degree of engagement in thefuture, it would also be beneficial if patientgroups and the other key stakeholders had anannual opportunity for an accountability sessionwith the Deputy Minister of Health to discussprogress on improved patient outcomes and thelevel of constructive engagement between theparties.Recommendation Ten:The Deputy Minister of the Ministry of Healthshould commit to participate in an annualaccountability session to hear from patientgroups, from industry and from other keystakeholders regarding improved relationsand the strengthening of the commonobjectives of patient care and choice.Issue Four: The effectiveness of theCommon Drug Review and proposals forimprovement.The Task Force had the benefit of a veryuseful briefing and dialogue with Michael Teirneyof the Common Drug Review who wasforthright and helpful in addressing the status ofthe work conducted by the CDR.We were impressed by the responsivenessof the CDR to recently completed reviews ofthe agency that offered a number ofrecommendations regarding CDR practices andprocedures. It was evident, for example, thatthe CDR had taken steps to improve publicTHE REPORT OF PHARMACEUTICAL POLICY RECOMMENDATIONS FOR THE MINISTRY OF HEALTH 23 APRIL, 2008
participation in decision making, toincrease transparency, to facilitate“feedback loops” with industry and toaccelerate the pace of listingrecommendations. In many respects theCDR approach includes severalengagement attributes that could be usedto inform the positive evolution of therelationship between the PSD and keystakeholders.This does not mean that the TaskForce experienced universal support forthe CDR. Industry expressed concernsthat the CDR is disproportionatelyfocused on the cost of new therapies ratherthan on the potential for improved healthoutcomes and that this has resulted in a situationwhere approximately one-half (see Chart Two)of new therapies approved by Health Canadareceive a “recommendation to list” decisionfrom the CDR. According to industry, thisreflects a much lower level of marketengagement opportunity for new therapies inCanada when compared to approval and listingdecisions in other international jurisdictions.Similar concerns were expressed by theCanadian Diabetes Association who criticize theCDR's performance in making new drugtherapies available to Canadians.The Task Force notes that the CDR process,including recommendations to list, or not list,from the CDR's Canadian Expert DrugAdvisory Committee (CEDAC) takes 20-26weeks and that this includes a three weekperiod for manufacturers' comments on CDRreview reports. This commitment toopenness, transparency, engagement and tomuch more efficient decision-making shouldinform similar improvements to the <strong>BC</strong>32process.The Common Drug Review also could, andshould, play a significant role in developing andmaintaining a national data set on keyperformance indicators that would help tofacilitate cross-jurisdictional analysis on matterssuch as time-to-listing, (see: RecommendationTwo, p. 14).Chart TwoCDR Activity to December 31, 2008Number of submissions 115Number of final recommendationsissuedNumber of recommendations to“list”Number of recommendations to“not list”91454632See: <strong>Report</strong> of the Federal Standing Committee on Health, “Prescription Drugs Part 1 – The Common Drug Review:An F/P/T Process”, December 12, 2007.THE REPORT OF PHARMACEUTICAL POLICY RECOMMENDATIONS FOR THE MINISTRY OF HEALTH 24 APRIL, 2008
Page 1 and 2: REPORT OF THE PHARMACEUTICAL TASK F
Page 3 and 4: Table of ContentsTask Force Mandate
Page 5 and 6: In addition to the submissions from
Page 7 and 8: pharmaceutical coverage programs ha
Page 9 and 10: these factors may potentially resul
Page 11 and 12: 14formulary”; andBC should benchm
Page 13 and 14: meaningful engagement with stakehol
Page 15 and 16: contributions from Drs. Ken Bassett
Page 17 and 18: Recommendations for an Improved Lis
Page 19 and 20: Generic Drugs - Call for aFundament
Page 21 and 22: The Task Force also considered thea
Page 23 and 24: was understood that the cost of the
Page 25: The Task Force believes this is an
Page 29 and 30: Recommendation Twelve:Subject to Re
Page 31 and 32: Recommendation Eight: To increase t
Page 33 and 34: THE REPORT OF PHARMACEUTICAL POLICY

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