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Lawrie McFarlane: We've lost a great chance to reform drug prices

In case anyone took seriously Prime ­ Minister Justin Trudeau’s promise to introduce a national pharmacare plan, this just out of Ottawa: The ­government will not proceed with drug pricing reforms promised two years ago.
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Long-awaited changes to Canada’s drug-pricing regime by another six months are no longer proceeding. GRAEME ROY, THE CANADIAN PRESS

In case anyone took seriously Prime ­Minister Justin Trudeau’s promise to introduce a national pharmacare plan, this just out of Ottawa: The ­government will not proceed with drug pricing reforms promised two years ago, and deferred since then three times.

Here’s what happened. A quasi-judicial agency known as the Patented Medicine Prices Review Board oversees the ­maximum price of new drugs in Canada.

Back in 2020, the PMPRB noted that there is no process in place to link price to value. We were simply taking the industry at its word.

Likewise we had no way of knowing the actual cost of the drugs we bought. The industry refused to disclose this.

What we did know, from experience, was that some medications were being offered at prices many times what it could possibly have cost to develop and manufacture them.

In 2018, the World Health ­Organization reported that a treatment for brain tumours, lung cancer and Hodgkin Lymphoma increased by 1,400 per cent between 2013 and 2017.

Again, the WHO found that 99 leading cancer medicines generated an average of $14.50 in sales income for every dollar invested.

Clearly consumers were being taken for a ride.

That led the PMPRB to recommend that a review process be set up to ­determine how much benefit a new drug actually conferred.

Had they proceeded, these reforms would have been the first substantive update to drug pricing policy in more than 30 years.

This recommendation, which landed on then health minister Patty Hajdu’s desk, was put aside for six months, then deferred a second time, then a third. Hajdu pleaded COVID exigencies as the reason for the repeat delays.

That excuse, already threadbare, has now expired. Last month, the new minister of health, Jean-Yves Duclos, announced that his government had rejected the PMPRB’s advice. No further steps will be taken in this direction.

We’ll come to the sordid reason in moment, but first a thought about where this leaves us.

We are to set about erecting a national pharmacare plan, at a time when drug costs are steeply rising, with no ­mechanism in place to link price to ­effectiveness.

This is the very height of madness, or it would be if the prime minister means to keep his promise. There are several good reasons for believing he doesn’t, not least among them that Ottawa has no constitutional authority to deliver a drug program, a responsibility that resides exclusively with the provinces.

Nevertheless, since this promise was central to his deal with the NDP to keep his minority government in office, he has at least to look like he’s trying.

So why did Duclos fold his cards? Two weeks after his climb down, the prime minister proudly announced the ­construction of a new $180-million ­vaccine production facility. The Moderna plant will be located, you guessed it, in Quebec.

Why should you have guessed it? Trudeau’s riding is there, and more ­pointedly, so is Duclos’. A coincidence perhaps?

Recall that earlier in the game, while Hajdu was supposedly considering her options, big pharma allegedly offered the federal government $1 billion to gut the PMPRB reforms.

So we got taken twice. We settled for $180 million, instead of the $1 billion bribe it’s said we were offered.

And a chance in a generation of reforming drug pricing rules has fallen by the wayside.

A more troubling example of putting politics above the public interest you will not find.

jalmcfarlane@shaw.ca