2024-25 Gender-based analysis plus

General information: Institutional GBA Plus capacity

Governance

No changes in GBA Plus governance are planned for 2024-25.

Capacity

No major initiatives are planned to increase departmental GBA Plus capacity for 2024-25.  

Highlights of GBA Plus results reporting by program

Program name: Patented Medicine Price Regulation Program

The Patented Medicine Price Regulation Program does not collect sufficient data to enable it to monitor and/or report program impacts by gender and diversity.

This program aims to protect consumers by ensuring that the prices of patented medicines in Canada are not excessive. The PMPRB reviews the prices of the first sale of a patented medicine at arm’s length by the rights holder, directly to a class of customer, namely a wholesaler, hospital, pharmacy, or other. The PMPRB has no authority over prices charged by wholesalers or retailers or over pharmacists’ professional fees.

The information provided to the PMPRB by rights holders as set out in the Patent Act (the Act) and the Patented Medicines Regulations (Regulations) does not take explicit account of the diversity of user groups or their economic situation. By law, rights holders must file information about the sale of their patented medicines in Canada. The Act and the Regulations set out the following five factors to be used for determining whether a patented medicine is excessively priced, as outlined in section 85 of the Act:

• the prices at which the medicine has been sold in the relevant market;
• the prices at which other medicines in the same therapeutic class have been sold in the relevant market;
• the prices at which the medicine and other medicines in the same therapeutic class have been sold in countries other than Canada;
• changes in the Consumer Price Index; and,
• any other factors that may be set out in regulations.

The PMPRB reviews the average price of each strength of an individual dosage form of each patented medicine. In most cases, this unit is consistent with the Drug Identification Number (DIN) assigned by Health Canada at the time the drug is approved for sale in Canada.

Because of these limitations, the PMPRB’s price review process cannot take explicit account of the gender, age, of diversity of user groups or their economic situation. However, recent consultations undertaken to develop Guidelines for price reviews have intentionally sought out voices from underrepresented populations, such as Indigenous groups and senior patients, to ensure that these new policy tools are informed by the perspective of all affected groups. This approach may also allow us to identify areas of indirect program impact for future GBA Plus work.

The review of patented medicine prices has broad-reaching impacts across the segment of the population that uses pharmaceutical medicines, as lower medicine prices and associated savings for all payers translate to lower out-of-pocket costs and health system reinvestments. However, this program is likely to carry the most benefits for lower-income Canadians, particularly those who are not insured by a public or private drug plan, as well as those who are dependent on patented medicines to maintain their quality of life. This may include seniors, Canadians with disabilities and/or severe illnesses, and groups who are disproportionately affected by environmental health impacts.

Program name: Pharmaceutical Trends Program

The Pharmaceutical Trends Program does not collect sufficient data to enable it to monitor and/or report program impacts by gender and diversity.

Under this program, the PMPRB reports on trends in pharmaceutical sales and pricing for all medicines and on research and development spending by rights holders. Rights holders are required to submit detailed information on their sales of patented medicines, including quantities sold, gross and net prices, and net revenues, but not indirect discounts provided to third party payers, such as product listing agreements. Given that this information does not take explicit account of the diversity of user groups or their economic situation, relevant reporting cannot consider these factors.

However, the PMPRB also provides information on key pharmaceutical trends, including analyses of Canadian national, public, and private payer markets for all medicines as part of the reporting program under the National Prescription Drug Utilization Information System (NPDUIS) initiative. This reporting uses supplementary data suppliers including the Canadian Institutes for Health Information’s NDPUIS Database, IQVIA’s MIDAS and Private Payers databases, as well as GlobalData Health databases.

The PMPRB is exploring options for the application of GBA Plus on this side of its analytic reporting. Data used under the NPDUIS initiative includes age and sex but does not include other indicators such as race, ethnicity, or other socio-economic indicators. Analysis can also be limited by the absence of diagnostic information, which would provide more information on the health concern for which a drug is dispensed. In 2024-25, work will be underway to incorporate GBA Plus into reports on new medicines entering the market, demographic-driven cost analyses for public drug plan spending, and the market for medicines treating cardiovascular diseases. 

As PMPRB reporting is targeted to support decision-making at all levels of the healthcare system, including patients, prescribers, pharmacists, public and private drug plan administrators, federal/provincial/territorial policy-makers, and academics, among others, benefits are relatively widely distributed across demographic groups. Those who have greater need for pharmaceuticals or who are lower income may be more likely to benefit indirectly from the public availability of information on trends in pharmaceuticals sales and pricing, as well as research and development spending by rights holders. Conversely, those who do not see themselves adequately represented in the available data may experience a disproportionately lower indirect benefit from this reporting work, due to the lack of disaggregated demographic data in this field. This might include members of the 2SLGBTQI+ community, Black and Indigenous Canadians, and Canadians with disabilities.