Sales of medications to treat cancer have nearly tripled in Canada over the past decade, reaching $3.9 billion last year, a report by a federal agency says.
The Patented Medicine Prices Review Board has released data showing cancer medications account for about 15 per cent of all spending on pharmaceuticals.
“In 2019, medicines with 28-day treatment costs exceeding $7,500 made up 43 per cent of private plan oncology drug costs, compared with 17 per cent in 2010,” says the report by the board, which aims to protect consumers by ensuring manufacturers aren’t charging excessive prices for patented medications.
It says growth in the Canadian oncology market last year exceeded that of other countries including the United States and Switzerland, with a 20 per cent increase over sales from 2018.
Sales of oral cancer medications account for half of all oncology sales in Canada, up from 37 per cent in 2010, the report says, adding that while intravenous chemotherapy is publicly funded in all provinces, reimbursement of oral drugs differs across the country.
Steve Morgan, a professor in the School of Population and Public Health at the University of British Columbia, said it doesn’t make sense to cover the cost of intravenous chemotherapy in hospitals and not medications prescribed to patients outside of those facilities, but that’s justified in a country without a national drug plan.
“This is one of the messy bits of the Canadian health care system,” he said, adding there’s a patchwork system of coverage across jurisdictions, with cancer agencies in some provinces providing limited payment for at-home oncology treatments.
Clouded pricing
A national pharmacare plan would allow Canada to negotiate better drug prices, Morgan said, noting it’s the only country in the world with a universal health care system without coverage for prescription drugs.
Much of the national-level negotiating countries do with manufacturers happens in secret, Morgan said. The negotiations start with a list or sticker price — much like buying a vehicle at a dealership — as part of a complicated regime involving rebates to bring down prices.
“It’s deliberately made to cloud the real transaction price, the real price to health the system, so that no country can look at it and say, ‘Hey, wait a second, I heard that the people in Australia got this amazing new price on this drug,'” Morgan said.
A pharmacist serves a customer from behind protective screens in Nice, France, in May. Canada’s list prices for prescription drugs are among the highest in the world. (Valery Hache/AFP via Getty Images)
“What we can’t know is exactly which countries are getting the most value for money because we don’t get to see their secret deals. We do know that Canada’s list prices are among the highest in the world, and even above the level that the (Patented Medicine Prices Review Board) would like to see in terms of just the beginning of negotiations.
Countries with universal single-payer systems for medications — including Norway, Sweden, the United Kingdom, Australia and New Zealand — are likely using their negotiating power to get better prices from manufacturers asking for unreasonable amounts of money, he said.
Canada is expected to have about 225,000 new cancer cases and 83,000 deaths from the disease this year alone, the report by the Patented Medicine Prices Review Board says.
Provinces negotiate with manufacturers individually and should not “cave” to requests for unreasonable prices, Morgan said.
“They cannot, in essence, have patients being used as hostages.”
Prescription drug affordability
Results of an online survey released Thursday by the Angus Reid Institute (ARI) say 26 per cent of Canadians had to pay for at least half their prescription drug costs over the past year. That figure rises to 37 per cent for households earning less than $50,000 annually.
“Regionally, the highest rates of self-payment for prescriptions are found in British Columbia, Saskatchewan, and Manitoba,” said the survey. “In all three of these provinces, one in three households reported paying half of their prescription drug costs or more. By contrast, Ontario and Alberta report the highest rates of insurance and government coverage.”
The survey was conducted in partnership with the University of B.C.’s School of Population and Public Health, St. Michael’s Hospital in Toronto, the University of Toronto, Carleton University’s Faculty of Public Affairs and School of Public Policy and Administration in Ottawa and Women’s College Hospital, Toronto.
It was done between Oct. 13 and 18 included a representative randomized sample of 1,936 Canadians who are members of the Angus Reid Forum. For comparison purposes only, a probability sample of this size would carry a margin of error of +/- 2.2 percentage points, 19 times out of 20.
The survey was self-commissioned and paid for by ARI.
VANCOUVER – Contract negotiations resume today in Vancouver in a labour dispute that has paralyzed container cargo shipping at British Columbia’s ports since Monday.
The BC Maritime Employers Association and International Longshore and Warehouse Union Local 514 are scheduled to meet for the next three days in mediated talks to try to break a deadlock in negotiations.
The union, which represents more than 700 longshore supervisors at ports, including Vancouver, Prince Rupert and Nanaimo, has been without a contract since March last year.
The latest talks come after employers locked out workers in response to what it said was “strike activity” by union members.
The start of the lockout was then followed by several days of no engagement between the two parties, prompting federal Labour Minister Steven MacKinnon to speak with leaders on both sides, asking them to restart talks.
MacKinnon had said that the talks were “progressing at an insufficient pace, indicating a concerning absence of urgency from the parties involved” — a sentiment echoed by several business groups across Canada.
In a joint letter, more than 100 organizations, including the Canadian Chamber of Commerce, Business Council of Canada and associations representing industries from automotive and fertilizer to retail and mining, urged the government to do whatever it takes to end the work stoppage.
“While we acknowledge efforts to continue with mediation, parties have not been able to come to a negotiated agreement,” the letter says. “So, the federal government must take decisive action, using every tool at its disposal to resolve this dispute and limit the damage caused by this disruption.
“We simply cannot afford to once again put Canadian businesses at risk, which in turn puts Canadian livelihoods at risk.”
In the meantime, the union says it has filed a complaint to the Canada Industrial Relations Board against the employers, alleging the association threatened to pull existing conditions out of the last contract in direct contact with its members.
“The BCMEA is trying to undermine the union by attempting to turn members against its democratically elected leadership and bargaining committee — despite the fact that the BCMEA knows full well we received a 96 per cent mandate to take job action if needed,” union president Frank Morena said in a statement.
The employers have responded by calling the complaint “another meritless claim,” adding the final offer to the union that includes a 19.2 per cent wage increase over a four-year term remains on the table.
“The final offer has been on the table for over a week and represents a fair and balanced proposal for employees, and if accepted would end this dispute,” the employers’ statement says. “The offer does not require any concessions from the union.”
The union says the offer does not address the key issue of staffing requirement at the terminals as the port introduces more automation to cargo loading and unloading, which could potentially require fewer workers to operate than older systems.
The Port of Vancouver is the largest in Canada and has seen a number of labour disruptions, including two instances involving the rail and grain storage sectors earlier this year.
A 13-day strike by another group of workers at the port last year resulted in the disruption of a significant amount of shipping and trade.
This report by The Canadian Press was first published Nov. 9, 2024.
The Royal Canadian Legion says a new partnership with e-commerce giant Amazon is helping boost its veterans’ fund, and will hopefully expand its donor base in the digital world.
Since the Oct. 25 launch of its Amazon.ca storefront, the legion says it has received nearly 10,000 orders for poppies.
Online shoppers can order lapel poppies on Amazon in exchange for donations or buy items such as “We Remember” lawn signs, Remembrance Day pins and other accessories, with all proceeds going to the legion’s Poppy Trust Fund for Canadian veterans and their families.
Nujma Bond, the legion’s national spokesperson, said the organization sees this move as keeping up with modern purchasing habits.
“As the world around us evolves we have been looking at different ways to distribute poppies and to make it easier for people to access them,” she said in an interview.
“This is definitely a way to reach a wider number of Canadians of all ages. And certainly younger Canadians are much more active on the web, on social media in general, so we’re also engaging in that way.”
Al Plume, a member of a legion branch in Trenton, Ont., said the online store can also help with outreach to veterans who are far from home.
“For veterans that are overseas and are away, (or) can’t get to a store they can order them online, it’s Amazon.” Plume said.
Plume spent 35 years in the military with the Royal Engineers, and retired eight years ago. He said making sure veterans are looked after is his passion.
“I’ve seen the struggles that our veterans have had with Veterans Affairs … and that’s why I got involved, with making sure that the people get to them and help the veterans with their paperwork.”
But the message about the Amazon storefront didn’t appear to reach all of the legion’s locations, with volunteers at Branch 179 on Vancouver’s Commercial Drive saying they hadn’t heard about the online push.
Holly Paddon, the branch’s poppy campaign co-ordinator and bartender, said the Amazon partnership never came up in meetings with other legion volunteers and officials.
“I work at the legion, I work with the Vancouver poppy office and I go to the meetings for the Vancouver poppy campaign — which includes all the legions in Vancouver — and not once has this been mentioned,” she said.
Paddon said the initiative is a great idea, but she would like to have known more about it.
The legion also sells a larger collection of items at poppystore.ca.
This report by The Canadian Press was first published Nov. 9, 2024.
