The pan-Canadian Pharmaceutical Alliance

Established in August 2010, the pan-Canadian Pharmaceutical Alliance (pCPA) conducts joint provincial/territorial/federal negotiations for brand name and generic drugs in Canada to achieve greater value for publicly funded drug programs and patients through the use of the combined negotiating power of participating jurisdictions.

The pCPA member jurisdictions include public drug plan and/or cancer agency participation from: British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Québec, New Brunswick, Nova Scotia, Prince Edward Island, Newfoundland & Labrador, Yukon, Northwest Territories, Nunavut, Non-Insured Health Benefits (NIHB), Correctional Services of Canada (CSC) and Veterans Affairs Canada (VAC).

The pCPA’s mandate is to enhance patient access to clinically relevant and cost-effective drug treatment options. It serves this mandate by conducting collective, expert-informed negotiations for drugs.

By capitalizing on the combined negotiating power of drug plans across multiple provinces and territories, the pCPA objectives are to:

  • increase access to clinically effective and cost-effective drug treatment options;
  • achieve consistent and  lower drug costs for participating jurisdictions;
  • reduce duplication of effort and improve use of resources; and
  • improve consistency of decisions among participating jurisdictions.

As of April 2018, these collaborative efforts between provinces and territories have resulted in over 200 completed joint negotiations on brand name drugs and price reductions on over 60 generic drugs.

For information on how the pCPA fits into the current process for drug approval in Canada, click here.

Brand Name drugs
All brand name drugs coming forward for funding through the national review processes Common Drug Review (CDR) or Pan-Canadian Oncology Drug Review (pCODR) and/or Institut national d’excellence en santé et en services sociaux (INESSS) are assessed by the pCPA before negotiations are considered.

Status of Negotiations on Brand Name Drugs

The following tables provide information on:

Click here for previous tables.

Biologics/Biosimilars

The emergence of Subsequent Entry Biologics (SEBs) in the Canadian market prompted pCPA to develop principles for these products and related reference biologics.

In April, 2016, pCPA issued the First Principles for Subsequent Entry Biologics (SEBs) to guide negotiations and inform expectations for biologics and biosimilars.

Generic drugs

On January 18, 2013, the pCPA announced the first step in achieving better value for generic drugs through the Value Price Initiative. This joint approach leverages combined purchasing power to obtain the lowest generic prices achieved to date in Canada, and to improve Canada’s status in the international market.

Between 2013 and 2017, various agreements were negotiated resulting in substantial savings. As of April 1, 2018, a new five-year agreement has been negotiated for 67 of the most commonly prescribed drugs in Canada to be priced at approximately 10 to 18 per cent of the equivalent brand name product (pan-Canadian molecules).

April 1, 2013:
The first phase of work established a price point for six of the most common drugs at 18 per cent of the equivalent brand name product:

  • Atorvastatin
  • Ramipril
  • Venlafaxine
  • Amlodipine
  • Omeprazole
  • Rabeprazole

April 1, 2014:
The following four products were priced at 18 per cent of the equivalent brand name product:

  • Rosuvastatin
  • Pantoprazole
  • Citalopram
  • Simvastatin

April 1, 2015:
Another four products were priced at 18 per cent of the equivalent brand name product:

  • Clopidogrel
  • Gabapentin
  • Metformin
  • Olanzapine

April 1, 2016:
An additional four products were priced at 18 per cent of the equivalent brand name product:

  • Donepezil HCl
  • Ezetimibe
  • Quetiapine
  • Zopiclone

April 1, 2017:
A one-year bridging period for the pCPA Generics Initiative was put in place. The bridging arrangement resulted in additional savings and allowed time for the evaluation of the current Generics Initiative, as well as to explore next steps. Under the bridging arrangement, the price of the following molecules was further reduced from 18 to 15 per cent of the brand reference price:

  • Atorvastatin
  • Amlodipine
  • Simvastatin
  • Pantoprazole
  • Ramipril
  • Clopidogrel

April 1, 2018:
Sixty-seven of the most commonly prescribed drugs in Canada were priced at approximately 10 to 18 per cent of the equivalent brand name product.

10 per cent Oral Solid

  • Amlodipine
  • Atorvastatin
  • Citalopram
  • Clopidogrel
  • Donepezil
  • Ezetimibe
  • Gabapentin
  • Metformin
  • Olanzapine
  • Olanzapine ODT
  • Omeprazole
  • Pantoprazole
  • Quetiapine
  • Rabeprazole EC
  • Ramipril
  • Ranitidine
  • Rosuvastatin
  • Simvastatin
  • Venlafaxine XR
  • Zopiclone

18 per cent Oral Solid

  • Alendronate
  • Almotriptan
  • Amiodarone
  • Anastrozole
  • Atenolol
  • Atomoxetine
  • Azithromycin
  • Bicalutamide
  • Bisoprolol
  • Candesartan
  • Candesartan HCTZ
  • Carvedilol
  • Celecoxib
  • Ciprofloxacin
  • Clonazepam
  • Cyclobenzaprine
  • Domperidone
  • Dutasteride
  • Eletriptan
  • Escitalopram
  • Famciclovir
  • Finasteride
  • Fluoxetine
  • Imatinib
  • Irbesartan
  • Irbesartan HCTZ
  • Lamotrigine
  • Levetiracetam
  • Memantine
  • Minocycline
  • Montelukast
  • Mycophenolate
  • Paroxetine
  • Pramipexole
  • Pravastatin
  • Pregabalin
  • Risedronate
  • Risperidone
  • Sertraline
  • Solifenacin
  • Sumatriptan DF
  • Telmisartan
  • Telmisartan HCTZ
  • Terbinafine
  • Topiramate
  • Valacyclovir
  • Valsartan
  • Valsartan HCTZ

For more detail on this initiative, please refer to the information on the Government of Saskatchewan’s website: http://formulary.drugplan.ehealthsask.ca/PanCanadian.aspx

pCPA Office

A pan-Canadian Pharmaceutical Alliance office (pCPAO) with dedicated staff to support the work of the pCPA is currently hosted by Ontario and located in Toronto. The office supports the work of the pCPA by providing administrative, analytical, negotiations, measurement, policy, and communications support.

Imran Ali (Senior Manager)
Shawna Robertson (Administrative Assistant)
Sang Mi Lee (Senior Pharmacist)
David Greiss (Senior Pharmacist)
Daniel Sperber (Senior Economist)
Nessa Jamal (Negotiations Consultant)
Anat Leibel (Negotiations Consultant)
Joanne Woodward Fraser (Communications Lead)
Khurram Bokhari (Senior Program Analyst)
Rohini Basur (Senior Negotiator)

Resources

For more information or queries please contact:
Email: pcpa@ontario.ca
Mailing address: 900 Bay St., M2-61 Macdonald Block, Toronto, ON, M7A 1L2
For any general inquiries: 416-326-6514

IBM Report Pan Canadian Drugs Negotiations Report