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Executive Officer Communiqués
Notice to Pharmacies :
Regulation Changes made to the Ontario Drug Benefit Act (ODBA) and the Drug Interchangeability and Dispensing Fee Act (DIDFA)
Bill 102, Transparent Drug System for Patients Act
A number of amendments to regulations under the ODBA and DIDFA have been made to support the government's plan to reform the drug system as a result of the Transparent Drug System for Patients Act, 2006, which received Royal Assent on June 20, 2006.
Proposed draft regulations were posted on the ministry's website on July 24, 2006 for a 30 day comment period. The ministry received many submissions from stakeholders including individual pharmacies, the Ontario Pharmacists' Association (OPA), and other pharmacy associations about the draft regulations. Changes were made to the ODBA and DIDFA regulations based on this feedback. A copy of the amending regulations has been posted on the ministry's website.
Highlights of these changes
The change in mark-up on the drug benefit price from 10 per cent to 8 per cent has been deferred to April 1, 2007. In addition, the payment for pharmacy professional services has been deferred to no later than April 1, 2007.
An amendment clarifies that agreements can continue to be entered into with pharmacies regarding methadone capitation payments. This ensures there is no impact to the dispensing of methadone to eligible recipients.
Professional Allowances :
Professional allowances in the public sector are capped at 20% of the total generic drug costs reimbursed under the ODB program. A similar cap has not been established for the private sector. The amendments include a formula that will be used to determine if a professional allowance is considered a rebate if the 20% payment cap is exceeded.
Amendments include a requirement for the executive officer to review the Code and the definition of professional allowances by October 1, 2008.
Code of Conduct :
Drug Pricing :
Effective October 1, 2006, the drug benefit price of generic products listed in the ODB Formulary/Comparative Drug Index may be priced no more than 50% of the comparator (typically the brand) product. Prices will be adjusted to reflect this change to the regulations in the next update. This applies to all generic products currently listed on the Formulary as well as any new generic listings.
The executive officer has the ability to enter into agreements with manufacturers regarding the prices of products listed on the Formulary. Changes may be made to the existing drug benefit price of these products based on an agreement with the manufacturer.
Other Amendments :
Changes have been made to the drug submission requirements under the ODBA to support a rapid review process for certain drugs.
Authority has been provided to the executive officer to determine the drug benefit price for products reimbursed under the Exceptional Access program, in agreement with manufacturers.
For further information on Bill 102, the Transparent Drug System for Patients Act, including the legislation, can be found here.
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