Bill 28 – An Act mainly to implement certain provisions of the Budget Speech of 4 June 2014 and return to a balanced budget in 2015-2016was tabled by Carlos Leitão, Quebec’s Minister of Finance, on November 26, 2014. This Bill, which would amend various laws, intends to give effect to certain measures proposed in the 2014 budget.

Listing agreements with drug manufacturers

Bill 28 would allow the Minister of Health and Social Services to enter into “drug listing agreements” directly with manufacturers.

Under such listing agreements manufacturers would pay rebates or discounts to the government, which could vary according to the sales volumes of the drugs listed.

The agreements could be entered into before the drugs are listed on the “List of medications covered by the basic drug insurance plan”. They could also be entered into before drugs are listed on the “List of medications provided in institutions”, provided the contracts for the supply of such drugs are not subject to a public call for tenders.1

Bill 28 also provides that the listing agreements would remain confidential notwithstanding the right of access to documents held by public bodies contemplated by s 9 of the Act respecting access to documents held by public bodies and the protection of personal information.2 However, some of the information in these agreements, for example, the manufacturer’s name, the drug name and the total annual amount received by the government under the listing agreement would have to be published in the Department of Health and Social Services’ annual financial report and would thus become public knowledge. The total annual amount received under these agreements would not be disclosed unless three or more listing agreements are entered into with different drug manufacturers in a given fiscal year.

The Pan-Canadian Pharmaceutical Alliance

A legislative amendment would allow Quebec to participate in the collective negotiations of the pan Canadian Pharmaceutical Alliance (pCPA), whose goal is to conduct common negotiations between the provinces and territories and the manufacturers of brand-name drugs.

By joining the pCPA’s common negotiation platform, Quebec may eventually, like the other provinces and territories,3 be able to increase its purchasing power, reduce drug costs, ensure uniform pricing and coverage criteria and increase access to pharmacological treatment options.

The Premier of Quebec said that the aim of this new measure is to ensure the economic viability of the public drug insurance plan and to increase the public’s access to drugs, as well as producing savings of about $25 million for Quebec.

Next steps

Special consultations on Bill 28 will be held in early 2015. Individuals or associations that are affected by Bill 28 will be invited to submit briefs and to testify before the Public Finance Committee. Dates of committee sessions have not been announced yet.

Pharmaceutical companies will definitely want to track Bill 28’s progress closely, as it will certainly affect their approach to negotiations with the Government of Quebec.