since 1987, the pmprb has evaluated what is known as the “list price” that a manufacturer proposes to charge for its drug in canada against the asking price in seven countries — france, germany, italy, sweden, switzerland, the united kingdom and the u.s. under the new regulations, the u.s. and switzerland — countries with relatively high drug prices — will be replaced by lower price countries australia, belgium, japan, the netherlands, norway and spain, leading to a lower price ceiling.
in certain circumstances, the pmprb would use a new factor — hta recommendations, even though htas are intended for price negotiation, not regulation — to make an additional assessment of whether the price is excessive, which could lead to a further substantial price reduction. other factors like the medicine’s potential market size and its price in relation to canada’s gross domestic product (gdp) may also be considered and could lead to an even lower regulated price.
so we’re lowering drug prices. isn’t that a good thing?
changing the international comparison to include lower price countries may initially seem reasonable. however, canada is not alone in comparing prices. many countries — except the u.s. — do it. when the pmprb first performs its assessment, prices might only be known for some countries, for example france, germany, sweden, the netherlands and the united kingdom, because the drug hasn’t been launched in the others. the canadian ceiling price based on prices in these european countries will be less than with the current assessment because the u.s., where drugs are most often launched first, is excluded.