Pangaea Express Quebec - Bill 92 update

Following the special consultations on Bill 92 (An Act to extend the powers of the Régie de l’assurance maladie du Québec and to amend various legislative provisions) held last May, the Quebec Health Minister has introduced amendments to be discussed at the committee stage. These amendments are intended to address certain commercial practices around pharmaceutical business.

• No accredited manufacturer may enter into an exclusive procurement agreement for drugs listed on the drug list with accredited wholesalers or an intermediary
• No accredited manufacturer or wholesaler or intermediary may:
• Pay or reimburse, in whole or in part the price of a drug
• Limit supply of drugs to a few pharmacy owners
• Require that a pharmacy owner buy drugs directly from the manufacturer or the wholesaler
• Directly of indirectly encourage or force a pharmacy owner to sell a particular brand of listed drugs
• Directly or indirectly grant or receive from one to the other or a pharmacist any advantage with the sale of a listed drug

Operators of private senior’s residence are especially targeted with this amendment.

Pharmacists are also targeted. The followings are just a few of these amendments:

• Obligation for the pharmacy to provide to patients detailed description of the charges for drugs or supply that are covered by the drug list
• Compel pharmacies to negotiate honoraria and full transparency when billing
• Tighten commercial practice framework for all stakeholders that are part of the supply chain in order to reinforce pharmacist professional independence, patient freedom of choice and allow for a more competitive environment

Also noteworthy, one amendment would allow RAMQ to set conditions for the reimbursement of drugs for all listed products on the Quebec list. These conditions would be recommended by INESSS around the concept of optimal use of any given drug.

Also, Bill 92 would allow suspending or delisting of a drug if a manufacturer does not comply with RAMQ pricing requirements and for which there is a therapist substitute.

Bill 92 is in its final stage of review. We will monitor the development of these new amendments as they may impact all of the pharmaceutical stakeholders

For more information contact Ghislain Gauthier, Director, The Pangaea Group