Gender-based analysis plus 2023-24

Introduction

In 2018, Parliament passed the Canadian Gender Budgeting Act. The departmental plans and departmental results reports are being used to fulfill the President of the Treasury Board’s obligations to make public, every year, analysis on the impacts of expenditure programs on gender and diversity.

Each organization is responsible for conducting their own Gender-based Analysis Plus (GBA Plus).

The Policy on Results indicates that Program officials, as designated by Deputy Heads, are responsible for ensuring data collection for meeting policy requirements.

Applicability

All organizations must complete GBA Plus supplementary information tables in departmental plans and departmental results reports on an annual basis.

Section 1: institutional GBA Plus governance and capacity

Governance

The PMPRB’s mandate and small size means that work on the GBA Plus initiative is undertaken as an integrated lens within our operations. At the end of 2023-24, a Chief of Inclusion, Diversion, Equity, and Accessibility (IDEA) was named to advance work in this area within the PMPRB. This work will include and support the tracking, awareness, and implementation of GBA Plus action items and will be addressed in the 2024-25 reporting cycle.

Capacity

No major initiatives were undertaken to expand GBA Plus capacity in 2023-24.

Human resources (full-time equivalents) dedicated to GBA Plus

No full-time-equivalents were dedicated to working on GBA Plus during the 2023-24 fiscal year.

Section 2: gender and diversity impacts, by program

Core responsibility: Regulate Patented Medicine Prices

Program name: Patented Medicine Price Regulation Program

Program goals: Given data collection restrictions, the PMPRB’s price review process does not take explicit account of the diversity of payers or their economic situation. However, lower medicine prices and associated savings benefit all populations directly through lower out-of-pocket costs and indirectly through health system reinvestments and improved access to better care.

Target population: All Canadians

Distribution of benefits

Distribution	Group
By gender	Third group
By income level	Second group
By age group	Second group

Specific demographic group outcomes

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 or severe illnesses, and groups who are disproportionately affected by environmental health impacts.

Key program impacts on gender and diversity

Not available.

GBA Plus data collection plan

The Patented Medicine Price Regulation Program does not collect sufficient data to enable it to monitor 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 (the 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.

Program name: Pharmaceutical Trends Program

Program goals: The PMPRB reports on trends in pharmaceutical sales and pricing for all medicines and research and development spending by rights holders through its Annual Report and at the request of the Minister of Health. As available databases have little demographic information, analysis from an explicitly GBA Plus lens is limited.

Target population: All Canadians and public and private drug plan administrators

Distribution of benefits

Distribution	Group
By gender	Third group
By income level	Third group
By age group	Second group

Specific demographic group outcomes

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 policymakers, 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.

Key program impacts on gender and diversity

Not available.

GBA Plus data collection plan

The Pharmaceutical Trends Program does not collect sufficient data to enable it to monitor 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.

The PMPRB also provides information on key pharmaceutical trends, including analyses of Canadian national, public, and private payer markets for all medicines, to the Minister of Health as part of the reporting program. This reporting uses supplementary data suppliers including the Canadian Institutes for Health Information’s NPDUIS Database, IQVIA’s MIDAS and Private Payers databases, as well as GlobalData Health databases.

Data used for this reporting 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.

Definitions

Scales

Gender scale

• First group: predominantly men (80% or more men)
• Second group: 60% to 79% men
• Third group: broadly gender-balanced
• Fourth group: 60% to 79% women
• Fifth group: predominantly women (80% or more women)

Income‑level scale

• First group: strongly benefits low-income individuals (strongly progressive)
• Second group: somewhat benefits low-income individuals (somewhat progressive)
• Third group: no significant distributional impacts
• Fourth group: somewhat benefits high-income individuals (somewhat regressive)
• Fifth group: strongly benefits high-income individuals (strongly regressive)

Age ‑group scale

• First group: primarily benefits youth, children or future generations
• Second group: no significant intergenerational impacts or impacts on generations between youths and seniors
• Third group: primarily benefits seniors or the baby boom generation