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Trump proposes rule for importing prescription drugs from Canada – CBC.ca

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The Trump administration proposed a rule Wednesday to allow states to import prescription drugs from Canada, moving forward a plan announced this summer that the president has said will bring cheaper prescription drugs to Americans.

Importation of drugs from Canada as a way to lower costs for U.S. consumers has been considered for years. Alex Azar, secretary of the Department of Health and Human Services (HHS), called the move “a historic step forward in efforts to bring down drug prices and out-of-pocket costs.”

Industry trade groups in both countries opposed the plan, saying it will not lower costs and could hurt Canadian drug supplies.

Azar said HHS would also offer guidance to drugmakers that wish to voluntarily bring drugs they sell more cheaply in other countries into the United States for sale here.

The pathways for importation were announced in July, when Azar unveiled a “Safe Import Action Plan.”

Many prescription medicines would be excluded from importation from Canada. (Chris Wattie/Reuters)

Azar could not provide an estimate of how soon Americans could start seeing cheaper drugs from Canada. The proposed rule would need to pass through a 75-day comment period before being finalized, he said.

“We’re moving as quickly as we possibly can,” he added.

Governors of states including Florida, Maine, Colorado, Vermont and New Hampshire have already expressed an interest in importing drugs from Canada once the pathway to do so is fully in place, Azar said. States would be required to explain how any proposed drug imports would reduce drug prices for consumers.

The proposal faces opposition from large U.S. pharmaceutical and biotech companies.

Jim Greenwood, current head of biotech industry group BIO and a former Republican congressman, said that importation would not result in lower prices for consumers, citing nonpartisan budget experts and past U.S. Food and Drug Administration commissioners.

“Today’s announcement is the latest empty gesture from our elected lawmakers who want us to believe they’re serious about lowering patients’ prescription drug costs,” Greenwood said.

Ottawa also has criticized the plan. Canada’s ambassador to the U.S. said last month that importing medicines from north of the border would not significantly lower U.S. prices. Reuters previously reported that Canada had warned U.S. officials it would oppose any import plan that might threaten the Canadian drug supply or raise costs for Canadians.

The federal government has suggested it could step in and block exports in the event that any such plans threaten Canada’s drug supply. In fact a previous government already introduced a bill in the House of Commons that would have allowed a block on exports.

The Paul Martin government introduced Bill C-83 in 2005 when American politics was previously awash in talk of importing from Canada. But it never became law, as the Martin government was defeated soon thereafter and the issue died down in the U.S.

Canada drug supply ‘insufficient’

“The drug supply is insufficient for the Canadian market, let alone trying to divert it to a much larger market like the U.S.,” said Daniel Chiasson, president of the Canadian Association for Pharmacy Distribution Management, a trade group that represents drug distributors.

“We’re not supportive of any policy initiative or policy proposal that has the capacity to threaten the stability of medications available to Canadians.”

The Canadian Pharmacists Association (CPHA) was still analyzing the announcement Wednesday afternoon to assess whether it might have a practical impact.

“With an average of five new drug shortages reported each day in Canada, we are not in a position to supply a country 10 times our size. These proposals could significantly restrict the availability of medications for our patients,” CPHA chair Christine Hrudka said in a statement to CBC News. 

Speaking to reporters in Florida on Wednesday, Azar said Canadians’ cheaper drug prices were the result of a free ride off of American investment and innovation.

“Obviously the Canadians are going to be looking out for Canadians,” he said. “We’re here to put American patients first.”

Many prescription medicines would be excluded from importation from Canada, such as biologic drugs, including insulin, controlled substances and intravenous drugs.

Tip-toeing around big pharma

U.S. President Donald Trump, a Republican, has struggled to deliver on a pledge to lower drug prices before the November 2020 election. Health-care costs are expected to be a major focus of the campaign by Trump and Democratic rivals vying to run against him.

The Trump administration in July scrapped an ambitious policy that would have required health insurers to pass billions of dollars in rebates they receive from drugmakers to Medicare patients.

Also in July, a federal judge struck down a Trump administration rule that would have forced pharmaceutical companies to include the wholesale prices of their drugs in television advertising.

Both the House of Representatives and the Senate are proposing drug pricing bills that contain some of the proposals Trump has advocated, such as indexing public drug reimbursements to foreign drug costs.

But Trump has said he will veto the Democrat-led House bill if it comes to his desk on the grounds that it would slow down innovation.

“Once again, the Trump White House is tiptoeing around big pharma with a spectacularly pinched and convoluted proposal that excludes insulin and has no actual implementation date,” said Henry Connelly, a spokesman for U.S. Speaker of the House Nancy Pelosi, a Democrat.

“If President Trump actually wants to lower drug prices, he should pick up the phone and tell Senator McConnell to send him the House-passed Lower Drug Costs Now Act.” 

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We looked at every confirmed COVID-19 case in Canada. Here's what we found – CBC.ca

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Canada’s first known case of COVID-19 was detected eight months ago this week. As of Sept. 22, the coronavirus has been confirmed in 146,663 people across the country.

CBC News has dug deep into the data collected by the Public Health Agency of Canada (PHAC) to examine how COVID-19, the illness caused by the virus, affects the young, the elderly, men and women in order to better understand what’s most likely to land you in hospital — or worse.

The data contains details on 121,795 cases up to the first week of September. See the methodology at the bottom to learn more.

Here are our findings.

Who is getting the virus?

In the early days, people over 80 years old made up the largest group getting sick as long-term care homes were hit hard, resulting in more older people getting tested.

But CBC’s analysis reveals that since mid-August, infections among young people (under 30) have surged and now, after a summer of provincial reopenings and expanded testing, cumulatively outnumber the elderly.

COVID-19 infections are also on the rise among the very youngest (under 20) as schools, colleges and universities reopen.

How is the virus affecting us?

Symptoms can vary by age group from youngest to oldest. Chills, sore throat and runny nose were reported more frequently among those under 50.

PHAC only has symptom data on seven per cent of cases in the detailed data as not every province records this. The way symptoms are defined and recorded may also vary across jurisdictions. But the 9,000 cases that do list those details suggest that people with COVID-19 suffer differently depending on age and symptoms.

*Other symptoms can include loss of taste and smell.

Who’s being hospitalized?

Close to 10 per cent of people who tested positive for coronavirus wound up in hospital, according to the cases tracked by PHAC.

Two per cent of cases landed in intensive care units (ICU) across all ages but mostly among people over 50.


In people admitted to hospital, shortness of breath and fever were more common symptoms while headaches, sore throat and runny nose were seen more often in less severe cases.

In fatal cases, shortness of breath and fever were also more common. 

“Keep in mind that mortality is often through respiratory distress,” said University of Ottawa epidemiologist Raywat Deonandan.

“It’s not surprising that those showing an early symptom of that distress [shortness of breath] would be on a shorter path to death.”

Deaths and serious illness

More than 9,200 people have died in Canada because of COVID-19.

Of all confirmed infections in Canada, six per cent, or 9,274 cases, have been fatal, with the elderly hit the hardest. Only two people under 20 are known to have died from the disease so far.

The age gap in deaths is so wide that the chart below had to be stretched for the younger victims to be visible:

More women in Canada have died from COVID-19, especially in the 80+ age group where they outnumber men. Outside that age group, more men are dying from the virus.

Deonandan says differences between men and women’s health might be affecting COVID-19 outcomes.

“Older men are more likely than women to have serious heart disease. COVID-19 might be expressing mortality through these disproportionate vulnerabilities that already exist,” he said.

But more men have been hospitalized or wound up in an ICU with COVID-19.

Recovery

By Sept. 22, of the 146,663 confirmed and presumptive cases in Canada, 126,905 had recovered.

Canada’s public health data only shows recovery times for about 10 per cent of cases.

Older people tend to suffer longer (based on this small sample), not surprising given the greater presence of other medical conditions among the elderly.

Some COVID-19 cases took as many as 11 weeks to resolve, though the average recovery time is two to three weeks.


“Older people are more likely to be hospitalized and need more intensive interventions, which in turn are associated with longer recovery periods,” said Deonandan.

Similarly, more severe cases that required hospitalization had longer recovery times.

The future

The fall return to school has health officials bracing for a rise in exposures and new infections, particularly among young people.

The data shows that the youngest cohort, age 19 or younger, is making up an increasingly larger share of Canada’s overall cases and by early September had overtaken people in their 70s.

METHODOLOGY

The main data source for this article is the detailed preliminary information on confirmed cases of COVID-19 compiled by the Public Health Agency of Canada and published by Statistics Canada.

The data is based on a case report form that provincial authorities send to PHAC for each confirmed case.

Provinces might define a confirmed case, symptoms and recovery time differently, so that must be taken into account when interpreting the data.

Not every province reports symptoms and recoveries, and those that do don’t report them for every case. Only about 9,000 cases out of 121,795 in the data contain symptom information, and only about 12,500 cases contain the recovery date.

Symptom onset and recovery dates are noted only with the week of the year. Recovery times were calculated by subtracting the recovery week from the diagnosis week and do not account for possible variations in days.

In some cases, details are excluded or modified by Statistics Canada if there is a risk of identifying a patient in the data. For example, the data does not show any fatal cases under 50 years of age, even though there were nearly 80 such cases in the daily epidemiological report from PHAC, which contains the most recent confirmed numbers. CBC used the daily epidemiological data for the chart on deaths by age and gender.

The data analysis was done in Python. Questions about how it was done? Contact data journalist Roberto Rocha at roberto.rocha@cbc.ca.

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Things To Consider When Getting Motor Vehicle Insurance

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Owning and driving a vehicle is an exciting milestone. It brings about a level of independence that you might not have enjoyed before when you had to rely on others or public transport to get around. With car ownership comes the complex process of getting the right motor vehicle insurance. Several factors have to be taken into consideration when deciding which one works best for you.

 

Here’s a list of things to consider when getting motor vehicle insurance:

  1. Paperwork

 

Before you look into the kind of insurance to get, make sure that you have the correct paperwork required for the process. This usually includes a valid license and registration. Remember, the one who is registered is the one who has to apply for the insurance and drive the car majority of the time. You can’t have another party apply for insurance for you .

 

  1. Research

Once you have your documentation in order, dedicate some time researching different insurance providers. Familiarize with  Nova Scotia insurance laws and the standard insurance policy form. Knowing your local laws and how insurance works allow you to understand what you’re signing up for and what you’re entitled to in case an accident occurs.

The insurance dynamics you need to look into include the type of insurance and what exactly it covers. For instance, during your research, you’ll encounter a third party, third party fire and theft, and fully comprehensive car insurance options.

Third-party insurance is the minimum insurance required by the law, covering damages in an accident caused by another person. Third-party fire and theft insurance packages cover the basic legal requirements of insurance as well as damages caused by fire or theft. The fully comprehensive policy covers different types of damages, events, and scenarios. Different insurance companies cover different scenarios and factors for their fully comprehensive policies. You can get more information by requesting for a quote from the insurance company.

Once you research the various insurance dynamics that are provided by various providers, you’ll be able to figure out which one offers a policy that best suits your needs.

 

  1. Calculate Mileage

Every insurance policy application includes information about your mileage. This information is required because the further or more frequently you drive, the higher the risks of you getting involved in an accident, making your premiums more expensive. Make sure to be accurate about the information you provide about your mileage. In case you’re involved in an accident and the mileage recorded doesn’t match with the mileage assessed at the time of the accident, you might not get paid out.

Mileage costs are factored in differently depending on the insurance provider you choose. This can be calculated through quotes and consultations.

 

  1. Online Reviews

Independent online reviews about specific insurance motor vehicle providers can indicate whether they’re reliable or not. You must however use your discretion when analyzing online reviews as not all are authentic. The more positive the reviews, the more likely you’ll have a positive experience when you choose that specific provider.

 

  1. Consultation

Now that you’ve already come up with a list of your top options, it’s highly recommended to have a consultation session with these potential insurance providers. You can discuss and ask about certain details during this time, such as what the insurance company doesn’t cover. You can also get information about what they explicitly cover to avoid any assumptions or confusion. Give them a call, visit their office, or use the various contact channels provided by the insurance providers on their websites.

 

  1. Financial Means

When getting insurance, you must factor in your personal finances for monthly payments. Choosing an insurance provider and policy that can fit into your budget is advisable. It’ll be tough to commit to a policy only to find later on that you’ll be struggling to pay it off. Compare the different insurance policy costs and choose one that you can reasonably handle along with your other expenses.

 

Conclusion

Finding the right motor vehicle insurance requires effort on your side. You want to make sure that you’re securing the insurance policy and insurance provider that is right for you. Before you start the process, make sure that you have the correct documentation in order. Take the time to calculate your mileage as this is information that will be required from you. Research about the local motor vehicle insurance standards and regulations to know exactly what you’re signing up for. Once you’re familiar with the legal dynamics, don’t forget to factor in your finances and make sure you’re choosing one that budget.

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Mapping out Canada's COVID-19 hotspots: new modelling shows where cases are rising – CTV News

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TORONTO —
A map released by the federal government Tuesday as part of new COVID-19 modelling data shows that over the last 14 days, the rise in cases has been far from even across the country, with several hotspots bumping up numbers nationwide.

Canada has been experiencing a worrying uptick in new cases recently, leading federal health officials to recommend that we re-adopt earlier, more strict levels of health precautions.

Dr. Theresa Tam stopped short of calling it a second wave on Tuesday, noting that it’s too early to tell whether cases will continue trending upwards or go back down, but cautioned that a new jump in cases could “overwhelm our health system capacity and significantly impact social and economic systems as well.”

According to the latest modelling data, the hotspots across Canada are largely centred around metropolitan areas, but also, in some instances, include regions that saw far lower case levels in the first wave of the pandemic.

WHERE ARE THE NEW CASES?

The map of recent case data shows that the three territories in Canada’s north have had zero new cases over the past two weeks, along with Labrador, northern Manitoba, and some regions of northern Quebec.

The Atlantic provinces have also fared well, with regions ranging from zero cases to four for every 100,000 people.

The darkest regions of the map, which represented areas with 50 to 99 new cases per 100,000 people, were northern Alberta, the Edmonton region, several regions around Quebec City and up the St. Lawrence River, the Gatineau region directly across the river from Ottawa, and in B.C. the region around Vancouver.

One difference from the first wave is that across the country, more cases are thought to be due to community spread, as opposed to outbreaks in long-term care facilities, which pushed numbers up earlier in the pandemic. This likely reflects the fact that Canadians have been returning to workplaces, retail spaces and larger gatherings as provinces have loosened restrictions over the last few weeks.

The map was put together with data from the COVID-19 Canada Open Data Working Group.

QUEBEC

In Quebec, 489 new cases were confirmed on Tuesday.

The province’s health minister, Christian Dube, announced on Tuesday that two more regions in Quebec were moving from yellow (denoting regions in Level 2 – Early Warning) to orange (Level 3 – Alert). Laval and Outaouais joined Montreal, the Quebec City region and Chaudiere-Appalaches to make five regions of Quebec in Level 3.

Regions in Level 3 have extra measures to “target specific sectors of activity and settings where the risk of transmission is deemed higher,” according to the province.

Outaouais, which has had 1,157 cases of COVID-19 since the start of the pandemic, is one of the regions with the highest levels of new cases in the province (50 to 99 per 100,000), according to the map released Thursday, along with the Quebec City area, Chaudiere-Appalaches, and Bas-Saint-Laurent.

Bas-Saint-Laurent has had 274 total confirmed cases since the start of the pandemic. Capitale-Nationale has had 3,153.

Dube pointed out that the new cases are not necessarily following the same path as the first wave.

“We see that regions that have been spared such as Capitale-Nationale, Chaudiere-Appalaches during the first wave are now very affected by the virus,” he said.

Quebec’s public health director Dr. Horacio Arruda said on Monday that the province had officially hit a second wave after they reported 586 new cases.

ONTARIO

Although vast swaths of Ontario are seeing barely any new cases, in the most populated regions of the province it’s a different story. The province recorded 478 new cases of COVID-19 on Tuesday, which is the highest number for a single day since May 2, when 511 cases were reported.

Most of these new cases are in Ottawa, Peel region and Toronto, with 90, 95, and 153 new cases respectively.

ALBERTA

In the province’s capital, the COVID-19 case count reached the highest it has ever been since the start of the pandemic last week. Including the region around the city as well, the Edmonton area had 751 active cases of COVID-19 last Thursday, which was more than half of Alberta’s active cases at the time.

Within the city, the neighbourhoods with the highest active case count were Northgate with 109 cases, Northeast with 104 and Eastwood with 74.

The province as a whole reported 150 new cases of COVID-19 on Tuesday, bringing them to more than 1,500 active cases. 

BRITISH COLUMBIA

On the map showing hotspots, it appears as though two separate regions on British Columbia’s coast are experiencing a surge, but they actually are counted together — both fall under the Vancouver Coastal Health region, and are assessed as one area.

There have been nearly 3,000 cases recorded in the Vancouver Coastal Health region, with more than 4,200 recorded in the neighbouring Fraser Health region. The new modelling showed that the Fraser Health region has had 20 to 49 new cases for every 100,000 people over the last two weeks, putting them in the second highest category on the map.

A new outbreak at Vancouver’s St. Paul’s Hospital was discovered Tuesday, according to provincial health officer Dr. Bonnie Henry.

Over the weekend, 366 cases of COVID-19 within the province were recorded, and 96 new cases were identified on Tuesday.  

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