Generic and Biosimilar Pricing Policies for Canadian Public Drug Plans

British Columbia

October 15:
50% existing generics

42% new generics

July 4:
40% all generics

April 2:
35% all generics

April 1:
25% most generics

April 1:
25%* for oral solids

35% for other forms

Alberta

April 1:
56% existing generics

45% new generics

April 1:
45% new generics

July 1:
35% new generics

May 1:
18% all generics

April 1:
Lowest available price for existing generics; tiered pricing for new generics:

70% one generic

50% two generics

25% three generics

18% four or more generics

April 1:
Adopts Tiered Pricing Framework

Saskatchewan

April 1:
40% new generics

May 1 and June 1:
45% existing generics

April 1 and October 1:
35% generics in former Standing Offer Contract categories

April 1: 35%

April 1:
25% for oral solids

35% for other forms

Manitoba

Generic drug pricing is subject to utilization management agreements with the manufacturers, which declare that the price of a generic is equal to that of other select provinces.

Ontario

July 1:
25%^†public

50% private & out-of-pocket

April 1:
25%^†public

35% private & out-of-pocket

April 1:
25%^† public, private & out-of-pocket

May 20:
Tiered pricing for generics ^‡

Quebec

Quebec requires that generic manufacturers provide the province with the lowest price available in other provinces

New Brunswick

June 1: 40%

December 1: 35%

June 1:
25% for solid oral forms

 
35% for non-solid oral forms

Nova Scotia

July 1: 45%

January 1: 40%

July 1: 35%

November 12:
25% solid oral form

35% for non-solid oral form

Prince Edward Island

July 1: 35%

December 1: 25%

Newfoundland & Labrador

April 16: 45%

October 1: 40%

April 1: 35%

July 1: 25%

Yukon

There is no generic pricing policy in place; pharmacies order from Alberta or British Columbia wholesalers and therefore receive the prices listed in those provinces

NIHB

The NIHB Program reimburses the lowest-cost alternative product in a group of interchangeable drug products and therefore adopts the pan-Canadian Tiered Pricing Framework where applicable

Generic price reductions compared to brand reference price*

April 1:
6 of the most common generics are reduced to 18% of the brand reference price

April 1:
4 additional common generics are reduced to 18% of the brand reference price for a total of 10

April 1:
4 additional common generics are reduced to 18% of the brand reference price for a total of 14

April 1:
4 additional common generics are reduced to 18% of the brand reference price for a total of 18

April 1:
One-year bridging period during which the prices of 6 existing generics are further reduced to 15% of the brand reference price

April 1:
Prices of 67 of the most commonly prescribed generics are reduced by 25% to 40%, resulting in up to 90% off the price of their brand reference

Tiered Pricing Framework

• Tier 1 (single source) – one generic: 85% of brand reference price if a Product Listing Agreement (PLA) does not exist for the brand product; 75% if there is a PLA
• Tier 2 (dual source) – two generics: 50% of brand reference price
• Tier 3 (multi source) – three or more generics: 25% of brand reference price for oral solids; 35% for non-oral solids

Biosimilars

April 1:
Issued the First Principles for Subsequent Entry Biologics to guide negotiations

September 2018:
The pCPA’s Biologics Policy Directions document was created to guide and define the process that will govern how biologic and biosimilar products will be negotiated and considered for reimbursement by Canada’s public drug plans

March 2019: Pan-Canadian Oncology Biosimilars Initiative Action Plan was generated by the pan-Canadian Oncology Biosimilars Initiative (partnered by the pCPA and CCO) to provide a map for implementing oncology biosimilars across Canada

February 2020: pCPA engaged with the Canadian Agency for Drugs and Technologies in Health (CADTH) and released the final report National Consultation on the Use and Implementation of Biosimilars