For the third time working, federal Well being Minister Patty Hajdu has delayed the introduction of latest guidelines to cut back the value of medicine.
The rationale for these guidelines, proposed by Ottawa’s Patented Medicines Costs Assessment Board, is to place an finish of the scandalously excessive costs Canada pays.
Amongst 32 developed nations, we pay extra for prescription medicines than all however three. Because of this, we now spend extra on medicine than we do on physicians.
When the brand new pricing regime was first proposed in July 2020, pharmaceutical corporations protested volubly, and gained a deferral. Then, when the deferral ran out and the brand new regime was poised to go, the business supplied Ottawa a $1-billion bribe to water down the foundations. Though the bribe was refused, there was one other deferral.
Now Hajdu has introduced a 3rd delay, until January 2022. The rationale she gave is that the business is simply too burdened with making COVID-19 vaccines to reply.
There’s a scene within the Brit comedy Sure, Minister the place a memo written by Sir Humphrey is returned to him with “spherical objects” scribbled within the margin. At his pedantic finest, Humphrey asks: “Who’s Spherical, and to what does he object?”
So, spherical objects. First off, there are greater than 100 main pharmaceutical corporations, worldwide, and solely a handful are making COVID-19 vaccines.
Second, nobody is asking them to tackle extra work. What we’re telling them is that we’re reducing the median costs that Canada pays.
Since they’ve recognized this for no less than two years (work behind the scenes has gone on that lengthy), they’ve had on a regular basis they should fireplace up their lobbying.
To sharpen the dialogue, I need to deal with a selected class of medicine, and present why we needs to be involved.
The medicines in query are costly medicine for uncommon ailments, or EDRDs. Costly means annual therapy prices per affected person of $100,000 or extra for non-cancer medicines (some can attain $2 million a 12 months), and $7,500 a month or extra for most cancers medicine.
Uncommon means a illness with an incidence of lower than one individual per 100,000 inhabitants. In B.C., that interprets to about 50 sufferers.
So if these instances are so uncommon, what’s the concern?
First, there was an enormous enlargement of EDRD medicine.
In Canada, just one such medicine was accepted to be used in 1997. By 2018, that quantity had climbed to 40 for non-cancer, and 39 for most cancers, and that pattern is continuous.
EDRDs are actually the fastest-growing phase within the pharmaceutical sector.
Partly, this explains why lower than one per cent of the Canadian inhabitants now accounts for 42 per cent of patented drug gross sales.
Pharmaceutical corporations argue, in fact, that since the marketplace for these medicines is small, they want excessive costs to recoup their R&D.
Extra spherical objects. A couple of excerpts from a report by the World Well being Group in 2018: “The value for lomustine — a therapy for mind tumours, lung most cancers and Hodgkin Lymphoma — elevated by 1,400 per cent between 2013 and 2017.”
Once more, “In whole, 99 most cancers medicines generated … a median return of $14.50 US in gross sales revenue for each greenback invested.”
The WHO’s conclusion: “In abstract most cancers medicines, by way of excessive costs, have generated revenues … in extra of R&D prices.” That’s one motive the pharmaceutical business is probably the most worthwhile sector of the U.S. economic system.
It was to rein on this overpricing that the Patented Medicines Costs Assessment Board proposed reforms.
It’s these reforms that Hajdu has now thrice kicked down the highway.
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