In an ideal Pharmacare world…• All Canadians would have prescription drug coverage• All Health Canada approved drugs would be reimbursed by drug plans• There would be no copays / deductibles• Manufacturers would charge cost-effective prices• All new drugs would have sufficient evidence to demonstrate clinical

effectiveness• No diseases would have special preference• Drug plans would have adequate budgets to reimburse costs of all drugs• All drugs would be reimbursed immediately once approved by Health

Canada• The HTA process reviewing the clinical and cost effectiveness would be

fully transparent• Patients would have a clear voice in decision making

Pharmacare and Access to Cancer Drugs

• Timely access: No proposal to ensure that drugs are funded immediately upon Health Canada approval– HTA process takes up to 18 months

• Evidence based: pCODR is designed for specifically for cancer drugs – uncertainty tbhat cancer specific plan would continue under 20/20

• National formulary: 20/20 model wants to integrate single national formulary into 13+ health plans – fails to account for provincial health care priorities– How do we define “national formulary”– Note that there is already federal / provincial coordination through pCODR/

pCPA– National formulary will evolve over time

Pharmacare and Access to Cancer Drugs

• All drugs equal: 20/20 model specifies “medically necessary” – no priority for disease severity, burden of illness, life expectancy– Practical reality – there are insufficient public dollars to fund all medically necessary

prescription drugs – Lessons learned: Patient advocacy is necessary to ensure priority for cancer drugs

(e.g., cancer agencies, pCODR)

• Source of Funding:– 20/20 suggests public only pharmacare will result in significant savings – but at what

cost?• Lessons learned: limited public only budgets will result in in fewer drugs being available

– Multiple sources of funding are necessary– Mechanisms are required to remove / prevent financial barriers to patients