Inter-jurisdictional cooperation on pharmaceutical product listing agreements: views from Canadian provinces.
BACKGROUND
Confidential product listing agreements (PLAs) negotiated between pharmaceutical manufacturers and individual health care payers may contribute to unwanted price disparities, high administrative costs, and unequal bargaining power within and across jurisdictions. In the context of Canada's decentralized health system, we aimed to document provincial policy makers' perceptions about collaborative PLA negotiations.


METHODS
We conducted semi-structured telephone interviews with a senior policy maker from nine of the ten Canadian provinces. We conducted a thematic analysis of interview transcripts to identify benefits, drawbacks, and barriers to routine collaboration on PLA negotiations.


RESULTS
Canadian policy makers expressed support for joint negotiations of PLAs in principle, citing benefits of increased bargaining power and reduced inter-jurisdictional inequities in drug prices and formulary listings. However, established policy institutions and the politics of individual jurisdictional authority are formidable barriers to routine PLA collaboration. Achieving commitment to a joint process may be difficult to sustain among heterogeneous and autonomous partners.


CONCLUSIONS
Though collaboration on PLA negotiation is an extension of collaboration on health technology assessment, it is a very significant next step that requires harmonization of the outcomes of decision-making processes. Views of policy makers in Canada suggest that sustaining routine collaborations on PLA negotiations may be difficult unless participating jurisdictions have similar policy institutions, capacities to implement coverage decisions, and local political priorities.
Centre for Health Services and Policy Research, School of Population and Public Health, Faculty of Medicine, University of British Columbia, 201-2206 East Mall, Vancouver V6T 1Z3, Canada. morgan@chspr.ubc.ca
Steven G
SG
Morgan
Paige A
PA
Thomson
Jamie R
JR
Daw
Melissa K
MK
Friesen
D002170:Canada; D032982:Contracts; D003299:Cooperative Behavior; D004345:Drug Industry; D005569:Formularies as Topic; D009313:National Health Programs; D017008:Negotiating; D011050:Policy Making; D011057:Politics; D055553:Prescription Drugs / Q000191:economics*; D036301:Qualitative Research; D012051:Reimbursement Mechanisms
D055553:Prescription Drugs