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Proposed new drug regulations will hurt all Canadians — and Ottawa has been warned

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In December 2017, the federal government proposed amendments to the regulations governing the Patented Medicine Prices Review Board (PMPRB), the federal organization that has set ceiling prices for new medicines for the past 30 years. The revisions are intended to make prescription medicines more affordable. The final regulations, shared last week in the dead of summer, are virtually the same as those originally proposed, despite strong concerns about their negative effects having been expressed by patients, the pharmaceutical industry and others.

The amendments, due to come into effect in July 2020, include three significant changes. The first is on the roster of countries whose drug prices are compared with the proposed Canadian price in the PMPRB’s international comparison. Six lower-price countries are replacing two with higher prices. The effect of the switch will be to reduce the maximum prices for new medicines in Canada to around the median of prices charged in over 30 OECD countries.

Ottawa is either burying its collective head in the sand or deliberately misleading Canadians

The second change is that the PMPRB will be required to assess the “value” of each new drug using cost-effectiveness analyses already reviewed by the Canadian Agency for Drugs and Technologies in Health (CADTH) when it makes its reimbursement recommendations to Canada’s public drug insurance plans (except those in Quebec). CADTH doesn’t set prices but frequently recommends big reductions — 50 to 80 per cent, sometimes over 95 per cent — to achieve cost-effectiveness.

The third major change is a requirement for pharmaceutical manufacturers to divulge information to the PMPRB on confidential rebates and other commercial terms negotiated with Canadian insurance plans.

The federal government says its amendments will not impact the way pharmaceutical companies view Canada as a place to do business. It is either burying its collective head in the sand or deliberately misleading Canadians.

A well-defined relationship exists between the market prices of medicines and manufacturers’ investments in a country. Pharmaceutical R&D investment in Canada is about $30 per capita. In the U.S., where drug prices are considerably higher, it is more than C$360 per capita. In New Zealand, where prices are tightly controlled, pharmaceutical investment was under C$10 per capita in 2011 and may be less today after several leading pharmaceutical companies ceased or severely restricted R&D in response to new, more rigid price controls.

The governments of Ontario and Quebec, where 84 per cent of the pharmaceutical investment is spent in Canada and 87 per cent of the industry’s employees are based, understand the risks to investment and jobs posed by the regulation amendments and have warned Ottawa.

Market price restrictions also negatively impact new drug launches. An analysis of the relationship between the number of new drug launches in each of 31 OECD countries and the associated price level for patented drugs, per capita gross domestic product and total population in each country demonstrated that price was the only variable that was a statistically significant predictor of the number of new drug launches.

Greater access to newer medicines has been shown in numerous studies to improve patient health by preventing premature death and/or significantly improving patients’ quality of life. But patients cannot benefit if pharmaceutical companies do not seek regulatory approval for their medicines because they view Canada’s market conditions unfavourably. This already occurs in Canada — about 20 per cent of new therapeutic drugs approved in the U.S. do not come here — and it undoubtedly impacts New Zealand: only 54 per cent of new drugs approved in the U.S. receive regulatory approval there.

Pharmaceutical companies might be able to adjust to a change in the PMPRB’s international price comparison leading to around a 20 per cent reduction in new drug prices, but any requirement for much greater reductions, say 40 to 80 per cent, would render most business models unsustainable. And if business-sensitive information regarding confidential rebates and other commercial terms negotiated with payers does not remain confidential, companies’ prices and sales in other countries will be jeopardized, thus further reducing Canada’s market appeal.

A company’s sustainability depends on its ability to keep its profitability attractive to investors, who want long-term predictability in the company’s capacity to generate and commercialize its innovative products. The federal government’s amendments to the PMPRB may make medicines more affordable for some patients, but they will certainly reduce Canada’s attractiveness as a jurisdiction in which manufacturers seek regulatory and reimbursement approval for new beneficial drugs, and that will hurt all Canadians.

Nigel Rawson is president of Eastlake Research Group, based in Oakville, Ont, and an affiliate scholar at Toronto’s Canadian Health Policy Institute.

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Biometric Vaccines Are Here Preceding Forced Digital ID

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The future of vaccines is here, just in time for the coming forced digital ID. This isn’t some sci-fi movie based on some conspiracy theorists’ idea of Revelation where every living being is required to be tagged. Biometric vaccines are real, are in use and have been deployed in the United States.

Biometric vaccines are immunizations laced with digital biometrics, created from merging the tech industry with big pharma. This new form of vaccine injects microchips into the body creating a global ID matrix to track and control every person. Not only has this satanic system already been rolled out, billions may already have been injected unaware.

ID2020 Alliance, a program aimed at chipping every person on earth, has collaborated with GAVI (Global Alliance for Vaccines and Immunizations) to inject these microchips into the body through immunization. 

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How to get more of everything you love about Ottawa

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We love Ottawa, and we want to help you make the most of living in the capital.

Ottawa Magazine is launching a new membership program, with front-of-the-line access to events, special offers at cultural institutions, and exclusive access to one-of-a-kind food and drink experiences at the city’s best restaurants. And of course, a subscription to our award-winning magazine.

Basically, everything you love about the city… just more of it.

Sign up for more information now and you’ll be one of the first to hear when memberships go on sale!

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Where to Live Now: A data-driven look at Ottawa neighbourhoods

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What does community have to do with buying a house? Do people really want friendly neighbours, or do they just want the most square footage for their buck?

In The Village Effect: How Face-to-Face Contact Can Make Us Healthier, Happier and Smarter, Montreal psychologist Susan Pinker cited a 2010 study conducted at Brigham Young University in Idaho that analyzed relationship data for more than 300,000 people over nearly eight years. She discovered that people who were integrated into their communities had half the risk of dying during that time as those who led more solitary lives. In Pinker’s analysis, integration meant simple interactions such as exchanging baked goods, babysitting, borrowing tools, and spur-of-the-moment visits — exactly the kinds of exchanges we saw grow when COVID-19 forced us all to stay home.

For this year’s real estate feature in the Spring/Summer 2020 print edition, we crunched the numbers to find the neighbourhoods where we think you’re most likely to find such opportunities for engagement. Using data available through the Ottawa Neighbourhood Study (ONS), we chose six indicators that we believed would attract those looking to connect with the people around them. Omitting rural areas, we awarded points to each neighbourhood according to where it landed in the ranking. (In the event of a tie, we used a secondary indicator of the same theme to refine the ranking.) You’ll find the ten neighbourhoods that performed the best according to those six indicators listed below, along with resident profiles and notable destinations in each ’hood — though many have been forced to adapt to COVID-19, most are offering delivery and/or take-out, and we are hopeful they will resume normal operations once it is safe to do so.

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