Bill 148, An Act to regulate generic medication procurement by owner pharmacists and to amend various legislative provisions, was tabled in the National Assembly on October 5. It will amend An Act respecting Prescription Drug Insurance, introducing the Regulation to govern generic medication procurement by owner pharmacists. The new Regulation will provide, subject to certain exceptions, that an owner pharmacist may not, in a given calendar year, procure generic medications from the same manufacturer for an amount in excess of 50% of the monetary value of all the generic medications purchased by that pharmacist during that year.

Pharmacists will have to report annually on their purchases of each brand of generic medication. The Bill also will provide for fines of up to $100,000 for owner pharmacists who fail to comply with the new Regulation.

The Bill has been referred to the Committee on Health and Social Services for special consultations, with public hearings scheduled for November 7 and 8. Comments on the Bill can be made online, but only until November 8 (see here).

Since 2015, Bills 28, 81 and, most recently, 92 have made significant changes to the way the prescription drug insurance regime is governed in Quebec. The province has given itself the right to enter listing agreements with drug manufacturers, has allowed private insurers to reimburse drug purchases on the basis of the lowest cost alternative on the market, thereby favouring generic over innovative drugs, has given itself the power to issue calls for tenders for listing of drugs, and has introduced new “prohibited commercial practices” transforming the relationships between all the actors in the chain of distribution.  Most of these new measures aimed to reduce the cost of providing public drug insurance. A number were intended to enhance competition in the hope of reducing drug prices and, hence, insurance costs.  Bill 148 appears intended to fit within the latter policy, designed to encourage a multiplicity of suppliers, presumably with a view to increasing competition and, therefore, reducing prices.  Whether this will have the desire effect remains to be seen.  It is also plausible that it might have the opposite effect, forcing pharmacists to diversify their sources of supply even if doing so increases costs.