Pangaea Express: Bill 92 - Updated Regulations

July 11, 2018

Quebec’s Bill 92 Update: Regulation regarding the exceptions to patient support programs covered by the basic prescription drug insurance plan.

More than 18 months after Bill 92 has been enacted, the Health Ministry has released the long-awaited exceptions for patient support programs that will ensure the continuation and implementation of the financial part of patient support programs.

The regulation is detailed in three short provisions:

  1. The first regulation provides the criteria for which patient reimbursement is acceptable.

An accredited manufacturer, wholesaler or an intermediary may pay or reimburse to a person covered by the basic prescription drug insurance plan all or part of the price of the listed medications when:

(1) lowest price method does not apply; (2) those for which there is no generic or biosimilar version available

(Note: there is some confusion with the language in the proposed draft as they may need to clarify the ‘do not substitute’ rules when a generic exists.)

  1. The second regulation describes the grandfather clause that would allow patients who received financial support before the implementation of Bill 92, to continue receiving their financial assistance.

An accredited manufacturer, wholesaler or an intermediary may pay or reimburse a person on the basic prescription drug insurance plan all or part of the price of a medication if that person has already received such a payment or reimbursement for that medication (before the regulation comes into force - paragraph 1 of section 80.2 of the Act). Funding providers should identify who received payments before the prohibition comes into effect as enrollment of new patients to existing programs would not be permitted.

  1. The regulations will come into force on the 15th day following the date of publication in the Gazette officielle du Quebec.

Manufacturers, wholesalers or intermediaries are encouraged to participate in the consultation process. Comments may be provided in writing within 45 days following the publication of the Draft Regulations.

For more information, please contact Ghislain Gauthier, Director, The Pangaea Group or by telephone at (514) 867-8362.