The release of the Patented Medicine Prices Review Board (PMPRB) Annual Report is delayed once again this year – so much for transparency and the PMPRB’s mission statement to “provide stakeholders with price, cost, and utilization information to help them make timely and knowledgeable drug pricing, purchasing, and reimbursement decisions.”
The PMPRB reports to Parliament through the Minister of Health. The PMPRB’s Annual Report is the agency’s report – not the Minister’s – and under the Patent Act she must table it in Parliament within 30 “sitting days” of receiving it from the PMPRB.
Prior to 2014,the PMPRB would submit its Annual Report (for the previous year) to the Minister on or before May 31st.The Minister would then table the report before the House of Commons rose for the summer in June (unless Parliament had been dissolved for an election or prorogation). The 2016 Annual Report is now the third consecutive PMPRB Annual Report to be delayed until summer or fall the following year. Interestingly, the 2015 Annual Report was submitted to the Minister by the PMPRB Chair by letter dated July 29, 2016 despite her term as Chair having ended more than a month earlier on June 26.
It is not known if the 2016 Annual Report was submitted to the Minister by May 31, 2017, however when the House of Commons rose three weeks later, the report had not been tabled and still had not been tabled as of July 19, 2016, the first of two summer adjournment tabling dates. If the August tabling date is missed the report cannot be tabled until Parliament resumes in mid-September at the earliest.
So why does the PMPRB Annual Report matter? The PMPRB Annual Report is not the usual departmental public relations rag of self congratulatory spin obscuring evidence of overspending and under delivering. There is spin to be sure, but what distinguishes the PMPRB report from other government agencies and departments is that it is rich with figures and detailed analytics. Indeed, the Patent Act requires the PMPRB to report annually on its activities, pharmaceutical price trends, and industry R&D expenditures. The report contains analyses of drug pricing in Canada with international comparisons and whether price increases have stayed in line with the Consumer Price Index (CPI), key performance indicators for the PMPRB.
Furthermore, the report lists which medicines introduced in 2016 are within the PMPRB’s pricing guidelines and which are subject to investigation and potentially excessively priced. The PMPRB used to update new medicines status on its website as soon as it was available (and prior to release of the Annual Report) but now conceals current information until the Annual Report is released (contrary to their mission to be “timely”).
By not releasing the Annual Report, the PMPRB and the Minister have essentially locked this data in a vault. Although the Act does not explicitly prohibit the PMPRB from releasing the information prior to tabling in Parliament, as a practical matter, the bureaucracy believes that parliamentary protocol conveys such a prohibition and any departure from protocol could be career limiting.
So, what is to be done? If PMPRB is to be true to its mission of providing timely information to stakeholders, both the PMPRB and the Minister of Health must make timely release of the Annual Report information a priority and not succumb to the hackneyed excuse of parliamentary protocol. The Minister has made drug pricing a priority with consultations on potential new pricing Regulations in May and the PMPRB is in the midst of a major consultation to modernize its guidelines, and yet, these consultations are taking place devoid of timely information on pharmaceutical price trends because the PMPRB and the Minister can’t be bothered getting around to releasing the report, or worse, because they intend to delay releasing the information as long as possible. Both reasons are unacceptable.
Neil Palmer is the Founder and Principal Consultant at PDCI Market Access Inc. and a former staffer at PMPRB. The views expressed are his own.