The Quebec government recently announced, as part of its budget,
the intended abolishment of the rule known as "BAP-15."
Under the BAP-15 policy, which has been in place since 1994, the
Quebec government would pay the cost of the brand for 15 years for
publicly covered patients, even if a generic competitor entered
onto the formulary before that time. Although the 15-year rule was
put in place with the balancing "best available price
rule" (meaning that the manufacturer's selling price for a
covered product in the province of Quebec could be no more than the
selling price under other provincial plans), so far there has been
no formal announcement of any change to that aspect of the policy
in Quebec. In other words, the most favoured nation type of policy
for Quebec remains in place vis-à-vis pricing of products in
The RAMQ has now issued an Infolettre, dated December 14, 2012,
announcing that as of January 14, 2013, the 15-year rule in respect
of multi-source products will be abolished, and that the mechanism
of annual price increases has also been abolished. Accordingly to
the Infolettre, the prices of all products on the Liste des
medicaments will be maintained at their current level. It is,
however, possible for a manufacturer to submit a lower price.
The pricing and reimbursement landscape for pharmaceutical and
biologic products in Canada is ever-changing. We will be monitoring
developments in the Quebec market, with a view to reporting on
updates as they arise.
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When we previously reported on the limited effect of the decision in the case of Cuthbertson v. Rasouli, we noted that we were representing the health authority in a case was set to be heard by the British Columbia Supreme Court in December which would provide guidance on whether the offering of food by spoon to a patient with advanced dementia falls within the definition of "health care" in the BC legislation.