December 1, 2014

Pangaea Express: Quebec Bill 28

by Ghislain Gauthier, Director; Marc M. Lafoley,

On November 26th, 2014, the Quebec Minister of Finance, Carlos Leitao, introduced Bill 28. This omnibus Bill is focused on the implementation of certain provisions of the June 4th, 2014 Budget Speech with the goal of achieving a balanced budget in 2015-2016.

There are two main provisions that will impact the delivery of healthcare in the province; the first is about providing the right for a limited time and under certain circumstances the power to foresee or modify pharmacy services fees and secondly to allow to the Health Minister to conclude private listing agreements for drugs that are part of the insured benefit of the public plan. This Pangaea Express will focus on the provisions that will affect the public drug plan.

The proposed legislation will permit the Minister of Health to enter into a listing agreement with the manufacturer of a drug before it becomes an insured benefit of the public plan. The agreement will be in the form of a rebate or discount which will vary according to the drug sales of the product.

Key points of the proposed legislation surrounding listing agreements are:

  • The price that will be included in the RAMQ drug benefit list will not take into account the rebates/discounts that are part of a listing agreement
  • To ensure confidentiality of the agreements, the legislation clearly stipulates that NO person may have access to a listing agreement
  • To ensure confidentiality of the agreements, reporting of the rebates/discounts received will only be on a consolidated basis with the provision that there must be at least three listing agreements in place with drug manufacturers to allow reporting.   Look for future Pangaea Express that will review the potential impact of the proposed legislation on the retail pharmacy and long-term care channels.