Global Trends for Pricing and Reimbursement and Implications for Canada

W. Neil Palmer
President & Principal Consultant, PDCI Market Access Inc.

• Implications to Canadian pricing (and PMPRB) as a result of EU price cuts, value based pricing (UK), end of free pricing in Germany
• Shifting roles, mandates of HTA agencies, collaboration between
• HTA agencies and impact on CADTH, INESSS
• Standards for assessing clinical and cost effectiveness – implications of “comparative effectiveness” and “evidence based medicine” initiatives
• Impact of increased transparency and participation by patients and industry in HTA decision making
• Implications of regionalization: national recommendations – local funding decisions and implementation
• Outlook for listing/risk sharing agreement and patient access schemes

Public Payers’ Perspective: Creating Innovative Approaches to Working with Formularies to Enhance and Expedite a Formulary Listing for Your Brand

Chad Mitchell, BSc. Pharm, MSc.
Partner, In Initiative Inc.
Consultant Lead, PLA Project for:
Pharmaceutical Funding and Guidance Branch
Health Policy and Service Standards Division
Alberta Health and Wellness
Get the latest update on what provincial formularies need for their
listings including:

• Eligibility criteria: how provincial formulary decisions are made and why some drugs are not covered
• Critical timelines
• Drug plan design and value-based reimbursement strategies
• Tendering, risk sharing, rebates, listing agreements and the evolving provincial reimbursement schemes
• Cost-containment strategies
• Strategies for designing, conducting, and reporting economic evaluations including outcomes-based solutions – right treatment for right patients at right time
• ‘Value for Money’ – designing, conducting, and reporting economic evaluations – what’s expected of pharma and what can they expect in return?

PMPRB 2011 Update Patented Medicine Prices Review Board (PMPRB)

Michelle Boudreau
Executive Director
Patented Medicine Prices Review Board (PMPRB)

Biologics and SEBs: Impact on Drug Pricing and Reimbursement Decisions

Adrienne Blanchard
Partner, Intellectual Property and Vice Chair
Life Sciences Industry Group
Gowling Lafleur Henderson LLP

Dr. Anthony Ridgway
Senior Regulatory Scientist, Office of the Director, Centre
for Evaluation for Radiopharmaceuticals and Biotherapeutics
Health Canada

• Regulatory, legislative and IP issues that are driving this developing and complex medical field
• Implications for patented medicines because of this regulatory initiative – how are payers going to handle them?
• Rules for manufacturers to demonstrate their relative (cost) effectiveness which informs pricing and reimbursement decisions
• International comparison

Generic Price Reforms: Private Payer, Generic, Pharmacist and Drug Chain Perspective

Barbara Martinez
Principal, Health & Benefits
Mercer Human Resource Consulting

Deb Saltmarche
Principal, Saltmarche Consulting

Sean P. Webster
Vice President – Pharmacy Professional Affairs
Shoppers Drug Mart

• Implications of new generics policies on brand pricing and reimbursement
• How plan designs are going to maximize value for members
• The impact of generic pricing in private plans and the impact of patients shifting to lower-cost generic alternatives
• Bill 179 regulations and Ontario’s expanded scope of practice

The Impact of Current Drug Policy Reforms on the Private Payer, the Employer and the Insurance Market

Arthur A. Fabbro, Jr., MA, SPHR
Director, Total Compensation Programs
Magna International, Inc.

Dave Jones
Vice President Market Development, Sun Life Financial

Barbara Martinez
Principal, Health & Benefits
Mercer Human Resource Consulting

• Market developments, including markups, dispensing fees and professional fee caps and the impact on the pharmaceutical industry and private plans in Canada
• Can private formulary managers look to government drug plan decisions to guide their formulary management?
• Are private drug plan policies converging with public drug plans?
• How new drug submissions by pharma can be more effectively tailored to private plans
• How industry and payers can work together to ensure that the best treatments make it to the right patient at the right time

Orphan Drugs and Rare Diseases: Overcoming Market Access Challenges

Durhane Wong-Rieger
President, Canadian Organization for Rare Disorders

• How is Ontario leading the charge for greater access to drugs
• Niche pricing challenges in initiating orphan drugs
• Working with payers, advocacy groups and regulators to guarantee patient access
• Reviewing Canadian payer pricing and reimbursement strategy to ensure market access
• Overcoming European market access challenges to ensure orphan drugs reach intended patient populations
• Exploring reimbursement challenges for manufacturers of orphan drugs
• Private payers interacting with public systems

Evolution and Status of the New Pan-Canadian Oncology Drug Review (p-CODR)

Gerry Jeffcott
Principal Consultant, Gerry Jeffcott Health
and Pharmaceutical Policy Consulting

• Review of the latest developments from pCODR
• Comparison of pCODR with CDR
• Overview of key policy issues related to pCODR’s implementation
• Future considerations

CADTH: New Directions and What this Means for You

Wayne Critchley
Senior Associate, Global Public Affairs Inc.

• What is the significance of the recent governance and organizational changes at CADTH?
• What are CADTH’s new strategic priorities?
• What should we expect to see in the years ahead?
• How does it impact your business?

Looking at the Evolution of Market Segmentation to Price Medication: Small, Medium and Large Clinician Practices

Michael Hurwich
President, Strategic Pricing Management Group

• Understanding how to evaluate existing clinical purchases
• Reviewing competitor dynamics in the market
• Building value and loyalty through bundling
• Tailoring programs that are win-win for Pharma & Physicians
• Identifying the relative importance of new medication attributes