Canada’s Drug Agency/L’Agence des médicaments du Canada (CDA-AMC) has launched a consultation on advice for a national bulk purchasing strategy for prescription drugs and related products. Notably, the advice proposes making the pan-Canadian Pharmaceutical Alliance (pCPA) the negotiation body for national pharmacare and generally expanding the pCPA’s role in procurement for public drug plans. The consultation is open until August 1, 2025. CDA-AMC now has two consultations ongoing, having asked earlier this summer for feedback on a proposed list of essential prescription drugs and related products (our report here).

Background

On October 10, 2024, An Act respecting pharmacare (the Pharmacare Act) came into force (our report here). The Pharmacare Act sets out foundational principles for the first phase of a national, universal, single-payer, first-dollar drug coverage plan. In the first phase, the federal government is to make bilateral agreements with provincial and territorial governments to fund prescription drugs and related products for contraception and diabetes. So far, 4 bilateral agreements have been announced (our report here).

The Pharmacare Act requires the development of a national bulk purchasing strategy by October 10, 2025. On December 4, 2024, the Minister of Health asked the CDA-AMC to advise on such a strategy, with the expectation that the strategy would “strengthen the collective purchasing power of Canada’s pharmaceutical management system” and “work in conjunction with two existing system features”: the pCPA and the Patented Medicine Prices Review Board (PMPRB) (our report here). The CDA-AMC convened a time-limited 9-member advisory panel to develop this advice.

Proposed advice on a national bulk purchasing strategy

On July 10, 2025, the CDA-AMC published the advisory panel’s draft advice. The 29-page report is intended to present “opportunities” for the federal government “to consider in the near future (i.e., 1 to 2 years) when developing a robust bulk purchasing strategy for pharmacare in Canada.” The panel concluded that “wholesale changes to the current approach to how drug plans, manufacturers, and retailers negotiate drug access… would not be practicable at this time”. The panel instead focused on “enhancements that could be made by leveraging existing structures”. The panel’s advice is also meant to be “scalable beyond the 2 drug classes initially announced for national pharmacare” (i.e., contraception, diabetes).

The panel’s advice consists of 5 key observations, listed in bold below, and related “high-level” recommendations, some of which are noted below:

  1. Establishing a collaborative environment. Create a forum for stakeholders to continuously improve the system, identify value, and enhance access.  The report lists a number of topics that such a forum could explore (e.g., supporting industry in Canada in advocating for earlier launch dates, increasing the transparency of negotiated prices).   
  2. Encouraging health system efficiencies to promote predictability and accelerate access. Include more publicly-funded drug plans in pCPA negotiations with drug manufacturers. In addition, these public plans should use a single standard product listing agreement template, commit to accepting the outcome of pCPA negotiations, and explore centralized contract management (e.g., by the pCPA).
  3. Examining hospital or group purchasing organization procurement and expertise. Consider if these organizations’ procurement practices can be leveraged. There may be opportunities for collaboration between hospitals and the broader public system.
  4. Enhancing existing pooled public procurement mechanisms. Make the pCPA the negotiating/procurement body for national pharmacare. The report provides a range of recommendations for pCPA, were it to assume this role, that may be of interest to innovator and generic drug manufacturers. 
  5. Exploring harmonization of public and private payer systems. There may be opportunities to align public and private drug plans, however, further research is required given the complexities and dynamics between the two sectors.

The consultation will run until August 1, 2025 at 5 pm ET.

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