Impact of Patented Medicine Prices Review Board New Reference Countries on Drug Prices in Canada: A Comparison of Current and Anticipated List Prices for Top Drugs in the Country

Poster (PDF)

Presenter: Chloé Langevin, Université de Montréal
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Objective: To assess the impact on list prices in Canada of modifying the basket of reference countries used by the Patented Medicine Prices Review Board (PMPRB). Methods: Fifteen therapeutic classes were selected from the 2019 Canadian Institute for Health Information report on prescribed drug spending in Canada in the category “Top drug classes by total program spending (TPS).” Ontario list prices were used as Canadian prices for the analysis, and international prices were retrieved from each country’s drug price platform. The estimated impact on list prices was calculated as the difference between current list prices and projected median international prices under the new regime. Results: Forty-one brand name drugs (100 Drug Identification Numbers) still under the PMPRB’s jurisdiction were analyzed. Modifying the reference countries is expected to be associated with an overall weighted average list price reduction of 28.4%. The greatest anticipated list price reduction is for selective serotonin Reuptake inhibitors, with an average of 68.4%. In comparison, the smallest anticipated reduction is an average 0.7% for direct factor Xa inhibitors. Conclusions: List prices in Canada will significantly decrease as a result of the change in reference countries used by PMPRB. The weighted average price reduction required for the 41 brand name drugs included in the analysis is estimated at 28%. Variability was observed across classes, but expected reductions are as high as 68%. The analysis does not consider other measures included in the new regulations and, as such, likely underestimates the total anticipated impact of the reform on list prices in Canada.