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Editorial: Federal drug price board has been emasculated

There is a wealth of evidence showing that pharmaceutical companies charge excessive prices.
Canada has the third-highest drug prices of 31 OECD countries. ROB STRUTHERS, TIMES COLONIST

The federal NDP has called for an inquiry into the actions of Health Minister Jean-Yves ­Duclos.

Duclos is accused of trying to undermine the national body that sets the maximum price that can be charged for new drugs, the Patented Medicine Prices Review Board (PMPRB).

This is not the first time the federal Liberals have shown hostility to the board and its mandate.

Three times running, ­Duclos’ predecessor Patty Hajdu delayed a new pricing regime recommended by the board. That regime would have seen the price charged for a new drug linked in part to its proven ­effectiveness.

Had this reform been adopted, provincial pharmacare programs across the country would have saved an estimated $13 billion over 10 years.

Nevertheless, in the face of intense industry pressure, Hajdu retreated and called for a six-month delay.

When that first deferral ran out, she imposed a further six-month delay, then a third.

Still this did not go far enough, and in Hajdu’s place the prime minister appointed ­Duclos, altogether a more formidable handler.

Last November, Duclos pounced. He demanded that the PMPRB suspend indefinitely consultations aimed at reining in excessive prices.

In response, two board members resigned, and the acting chair, Melanie Bourassa Forcier, also stepped down, saying she required legal advice before giving her reasons.

One of the board members who quit, Matthew Herder, a professor of health law at Dalhousie University, wrote that the minister had “fundamentally undermined the board’s independence and credibility” by consistently sidetracking its efforts.

Duclos then took a further step toward reining in the board by appointing a new chair, pharmaceutical patent lawyer Thomas J. Digby, who for 10 years worked closely with Novartis, one of the top five pharmaceutical companies in the world.

For the past 30 years every chairperson of the PMPRB had been a physician or pharmacist. The optics of appointing someone with such close ties to the industry and no medical background were, to say the least, not encouraging.

Does it matter if the government is moving PMPRB toward a more industry-friendly position? Yes, it does.

Canada has the third-highest drug prices of 31 OECD countries. And there is a wealth of evidence showing that pharmaceutical companies charge excessive prices.

By way of example, in the U.S., leading manufacturers have increased the cost of insulin by 600 per cent over the past two decades.

They were able to do so, not because of cost pressures, but because among the companies that produce insulin, just three have cornered 90 per cent of the world market. They have in effect a monopoly.

There is an additional concern. The arrival of enormously expensive new medications places huge pressure on provincial drug plans.

B.C. Pharmacare covers 26 drugs that have annual list prices ranging from $350,000 to more than $1 million per patient per year. And many more are in the pipeline.

The PMPRB, with its quasi-judicial status, was the one Canadian institution that had the ability to link value-for-money to price and bring some needed transparency to drug pricing. The steps taken by Duclos have greatly weakened this institution.

A cynic might say this is hardly surprising since the federal government doesn’t pay for prescription drugs and Duclos is from Quebec, which has a ­significant pharmaceutical ­sector.

Nevertheless, when the Liberals were elected in 2015, one of their promises was to reduce the cost of prescription drugs. There was also talk of a national pharmacare plan.

No progress has been made on either of these commitments.

The only action we have seen to date is the emasculation of the national body with the strongest mandate to control prices. Shame.

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