A statement from the Canadian Chamber of Commerce has welcomed Ontario premier Doug Ford’s decision to raise the matter of enhancing patient access to life-saving medicines at a recent meeting of the Council of the Federation.
“As we discuss important initiatives to improve our economic security and resilience, we must not lose sight of the critical role of the health sector,” said Liam MacDonald – the Canadian Chamber of Commerce’s director for policy and government relations – in the statement. “As we have learned, there can be no economic security without health security.”
MacDonald highlighted that Canadian patients with public drug coverage need to wait longer to access the most recent medical innovations, compared with those in peer countries.
In the statement, MacDonald stressed that this problem can worsen health outcomes, raise health care expenditures in the healthcare system’s other areas, and hamper investments in Canada’s life sciences industry.
According to MacDonald, cooperation among the federal, provincial, and territorial governments can hasten new drug approvals and help Canada lead the charge in terms of patient access.
MacDonald noted that the statement followed the joint letter of the presidents of the provincial and territorial chambers of commerce, addressed to Ford, regarding this issue.
Joint letter
In the letter, the Canadian Chamber of Commerce and the provincial and territorial chambers of commerce urged Ford, in his capacity as Ontario’s premier and chair of the Council of the Federation, to proceed with the work to hasten Canadians’ access to new medications on public drug plans.
The joint letter noted that the overly complicated approval and reimbursement process for new drugs led to delays.
“Following a drug’s first global launch, Canadians on public plans wait 52 months, on average, for access,” the letter stated. “Not only is this, by far, the worst in the G7, but it is also substantially above the OECD average of 45 months.”
The letter lamented the delays at every step of the process, particularly after successful health technology assessments by Canada’s Drug Agency (CDA) or Quebec’s Institut national d'excellence en santé et services sociaux (INESSS).
“At this stage, a drug has already been deemed to be safe, effective and socially beneficial, but before it is made available to patients on public plans, it must complete pan-Canadian Pharmaceutical Alliance (pCPA) pricing negotiations, which takes over one year on average,” the letter said.
“Governments must then actually include the drug on public formularies, which can take anywhere from an average of six weeks to almost two years, depending on the jurisdiction,” the letter added.
The joint letter called on Canada’s federal, provincial, and territorial governments to work together to:
- establish reimbursement models permitting the automatic listing of new drugs on public formularies after a positive CDA/INESSS recommendation, with the difference between the listed price and the pCPA-negotiated price retroactively reconciled after net pricing negotiations
- strengthen existing pathways for Health Canada and CDA/INESSS to review new drugs simultaneously and incentivize industry uptake
- equip Health Canada with the resources necessary to comply with timelines for reviewing new drugs, keep up with technological changes, and make regulatory processes more efficient
- look into other regulatory cooperation opportunities with peer jurisdictions and improve industry uptake of international regulatory work-sharing models like the Access Consortium and Project Orbis
- implement coordinated frameworks and transparent reporting mechanisms to oversee reimbursements for new medicines in Canada, including public reporting on timelines from Health Canada approval to health technology assessment (HTA) reviews, pCPA negotiations, and provincial formulary listings
The letter said these recommendations reflected consultations with life sciences companies and provincial chambers of commerce across Canada.
“When patients in other G7 countries wait as little as a few months to access new drugs, it is unacceptable that we continue to expect Canadians to wait years for the same level of access,” the letter said. “We also cannot continue to lose investment in our life sciences industry to other jurisdictions due to a lack of predictable and efficient regulatory pathways.”
The letter’s signatories were the following presidents and chief executive officers:
- Candace Laing of the Canadian Chamber of Commerce
- Daniel Tisch of the Ontario Chamber of Commerce
- Véronique Proulx of the Fédération des chambres de commerce du Québec, Chuck Davidson of the Manitoba Chambers of Commerce
- Newton Grey of the Northwest Territories Chamber of Commerce
- Prabha Ramaswamy of the Saskatchewan Chamber of Commerce
- Shauna Feth of the Alberta Chambers of Commerce
These signatories said they were eager to work alongside the federal, provincial, and territorial governments to help speed up access to life-saving treatments.