Legislation

Transparent Drug System for Patients Act, 2006

Overview

Why Ontario is introducing drug system legislation :

  • Ontario has one of the most generous drug coverage plans in Canada. Drug costs have been rising and are a threat to our entire public health care system. We need to ensure consumers continue to have access to the innovative drugs they need at reasonable prices.
  • Ontario's health care system provides a competitive advantage for Ontario's employers and a compelling reason to invest here. The rising cost of drugs affects employer drug plans and the ability to keep Ontario competitive with other provinces and countries.
  • This legislation will allow changes to bring provincial and employer drug plan costs under control, and ensure the sustainability of our drug coverage.

What this legislation will achieve :

  • If passed, this legislation will enhance Ontario's drug system to ensure :
    • that patients get better access to the innovative drugs they need,
    • that taxpayers get value for money spent,
    • that drug companies are fairly compensated for the money they spend on critical research and innovation.

What this plan would mean for Ontarians :

  • Patients will benefit from improved access to drug treatments at reasonable prices.
  • There will no changes to current benefits for Ontario Drug Program or Trillium Drug recipients.
  • Faster drug funding decisions mean patients will have access to innovative drugs faster.
  • Patients will be involved in priority-setting and in the drug funding decision-making.
  • Ontarians can expect clear communication about drug funding decisions.

What this plan would mean for employers :

  • Employer drug plans will have substantial savings through enhanced ability for generic drug substitution (interchangeability).

What this plan would mean for health care providers:

  • Clear roles, responsibilities, accountabilities, and reporting requirements for all providers throughout Ontario's drug system.
  • Pharmacists will be trained and compensated for providing patient counseling and medication management reviews, and will increasingly have opportunities to work in primary care models.
  • Pharmacy reimbursement structure will more accurately reflect actual costs of dispensing and distribution.
  • Independent best practice prescribing guidelines will help ensure the right drug for the right person at the right time.

The Government's Plan to Improve Ontario's Drug System

  • The passage of this legislation would allow the implementation of a plan that will improve Ontario's drug system. It will mean savings that can be reinvested in the drug system. It would :
    1. Ensure better value for money by :
      • Lowering the price paid for generic drugs
      • Negotiating more competitive prices for brand name drugs
      • Working to develop chronic disease partnerships with brand name drug companies
      • Increasing the fees paid to pharmacies to dispense drugs to better reflect the true costs of dispensing
      • Removing the hidden rebates paid to pharmacies
      • Enforcing drug pricing compliance from manufacturers which will protect pharmacists from unauthorized price increases
      • Allowing greater interchangeability of brand and generic drugs
    2. Improve patient access to drugs by :
      • Introducing a Conditional Listing category that allows patients to access new drugs on a conditional basis while they are being evaluated for a formal listing
      • Making rapid funding decisions on breakthrough drugs for life-threatening conditions
      • Eliminating restrictive listing categories like Limited Use and Inh4idual Clinical Review (Section 8) that burden patients and doctors with needless paperwork and impede access to needed drugs
      • Creating an Exceptional Access mechanism that will work as a safety valve for certain patients when they can't access a drug in any other way
      • Aligning all of Ontario's publicly-funded drug programs so that the same rules of access apply everywhere
    3. Promote the appropriate use of medications by :
      • Paying pharmacists for providing direct patient care services in the community, in recognition of their value as front-line health care providers
      • Developing web-based, independent, best practice guidelines to ensure the right drug for the right person at the right time. This "Shared Care Network" will help doctors make the best prescribing decisions and help patients adhere to their drug therapies
    4. Invest in innovative health system research by :
      • Establishing a $5 million Innovation Research Fund to support drug policy by investigating the value of medicines across the entire health care system
    5. Strengthen drug system transparency and accountability by :
      • Establishing formal governance principles to improve transparency and accountability
      • Appointing an Executive Officer, Drug Benefits to manage the publicly-funded drug system, including making listing decisions, publicly communicating listing decisions and working more closely with stakeholders
      • Giving patients an active role in drug listing decisions by appointing two patient representatives to the renamed Committee to Evaluate Drugs (formerly Drug Quality and Therapeutics Committee)
      • Creating a Citizens' Council to give the public an opportunity to guide public drug policy
      • Forming a Pharmacy Council to help develop policy and reimbursement models for pharmacists
      • Generating more transparency by publicly reporting on the status of drug reviews as well as the work of the Committee and Councils

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