June 20, 2006 and is now known as The Transparent Drug System for Patient's Act
The gov't plans to save up to $500 million per year with the reforms brought on from Bill 102, where does the gov't plan to reinvest this money?
support improved patient access to drugs
what are the key areas for patient access to drugs?
Conditional listings - new drugs will become available on a conditional basis while it is further evaluated
Elimination of LU mechanism - saves time filling out and tracking LU forms
Exceptional Access - funding decisions made faster for non-listed meds
Elimination of Section 8 coverage
Elimination of paperwork for physician, pharmacy, and DQTC (saves valuable time for patients with life-threatening conditions or illnesses)
faster review for breakthrough drugs by starting review process before drug is marketed
make more drugs interchangeable with brand name drugs
align hospital and ODB formularies for seamless patient care
TDSPA ensures better value for money by:
lowering prices for generic drugs
listing more drugs in ODB thereby decreasing the cost
enforcing pricing commitment by manufacturers
setting the reimbursement price for generic drugs at 25% of brand name
negotiating more competitive prices for brand name drugs
increasing dispensing fees to better reflect true cost of dispensing
removing hidden rebates paid to pharmacies
TDSPA promotes the appropriate use of drugs by
enhancing the pharmacist's role as part of the Primary Care Team
paying pharmacists for direct patient care
for services such as medication management, developing web-based best practice guidelines, assist doctors make the best prescribing choice
TDSPA will create an Innovative Research Fund that will:
investigate the value of drugs in our HCS and provide concrete evidence of better health outcomes
TDSPA will strenghten transparency and accountability by:
establishing governance of the public system
appointing an Executive Officer who will manage the system, make decisions faster, communicate to the public, and work closely with all the stakeholders
creating a Citizen's Council to give the public an opportunity to guide public drug policygive patients an active role in the drug listing decisions
appointing two patient representatives to the CED
what do the changes made by TDSPA mean to pharmacy?
a Pharmacy Council to be established that will help develop policy and reimbursement models
pharmacy will be protected from price increases
increase in fees will better reflect cost of dispensing
pharmacists will be paid for professional services
eliminate rabates from drug companies
some generic drugs will be exempt from the reduced prices What are two examples?
products older than 10 yrs
non-solid drug products
Phasing out of Professional Allowances for private sector:
currently at 35% of brand name price
25% by April 1, 2012
0% by April 2, 3013
On July 1, 2010 Professional Allowances completely phased out to 0% from 20% of ODB generic costs
How much has the dispensing fee increased for pharmacies? (for ODB only)
effective July 1, 2010 dispensing fee was increased by $1 for urban pharmacies (from $7 to $8), and increased up to $5 for rural pharmacies (totalling no more than $12) depending on location and distance between pharmacies.
What is the cap on markup for ODB/public plan?
no change to current markup of 8% on all drugs
no cap is applied; however, ODB will only pay the 8%
What extra funding for Professional Services are provided for pharmacies?
$50 million in place for MedsCheck progran
$100 million in additional funding to compensate pharmacies for professional services and to suppoer pharmacies in rural areas
What are professinal allowances?
money paid by drug companies to pharmacy owners
professional services were to be reported to ODB, but audits found that all PA were not reported and were being used towards overhead costs, bonuses, and other fringe benefits.
pharmacists claim that without professional allowances, professional services are jeoprodized.
have to cut pharmacy hours, staff, services.
many pharmacies have closed down
Who was involved in the re-selling scheme of generic drugs?
pharmacies and wholesalers
What were professional allowances used for?
used for patient focused activities such as clinic days, compliance packaging, educational activities for staff, counselling areas, continuing education for pharmacists, pharmacy staff
Transparent Drug System for Patient's Act defines:
clear roles, responsibilities, accountabillty, and reporting requirements for all providers