Canada ranks 23 out of 32 developed-nation members of the Organisation for Economic Cooperation and Development (OECD) in terms of access to new medicines, according to a new study.

Public drug plans in Canada fall below the international survey average in every disease area with the exception of arthritis and urology, according to the 2011-12 International Report on Access to Medicines (IRAM), which is published each year by industry group Canada's Research-Based Pharmaceutical Companies (Rx&D).

IRAM does find that Canada provides comparable access to medicines for HIV/AIDS and addiction to other OECD member-states, but also that it falls far below in many other categories, most notably pain management, mental health, blood disorders and neurological conditions.

The report compares how drug plans in 32 OECD nations are publicly reimbursed. It reviews a total of 204 drugs representing 257 indications, placing them into a number of specific categories, including those based on the review agencies in Canada, and finds that:

- for all eligible drugs and indications - 204 drugs representing 257 indications - Canada ranks 26th out of the 32 in terms of access:

- for all drugs and indications reviewed under Canada's Common Drug Review (CDR) - 153 drugs representing 175 indications - Canada is 27th out of the 32 OECD nations;

- for non-CDR-reviewed drugs and indications - 51 drugs and 82 indications - Canada is 21st;

- for Canada's interim Joint Oncology Drug Review (iJODR) - 35 drugs representing 51 indications - Canada is in 21st position; and

- for first-in-class reviewed drugs and indications - 53 drugs representing 78 indications -  Canada's international rating is 26th.

The nation ranks in the fourth quartile in terms of access for most of the medicines included in the review, except for cancer where it is in the third quartile, IRAM notes. 

It also points out that listing rates of public drug plans in Canada continue to hover around 50%, meaning that only half of the new medicines approved by Health Canada are made available to the population through public drug plans. "As a result, Canadians do not benefit from the full range of new pharmaceutical innovations," says Rx&D.

In addition, more and more, public drug plans in Canada are making new medicines available only on a condition, case-by-case basis, it says. This results in more administration, wait times for patients before beginning treatment, increased paperwork for physicians and no guarantee that patients will receive coverage, it adds.

According to a 2012 study by the Canadian Health Policy Institute (CHPI), patented prescription medicines (excluding drugs used in hospitals) were estimated to account for only 4.7% of provincial/territorial government health spending for 2011-12, continuing a trend that began in 2004, says Rx&D.

"Access to new medicines and vaccines is important to Canadians, and a key component of a sustainable healthcare system," commented the industry group's president, Russell Williams. "Our hope is that this report will spark dialogue with all stakeholders about how to better identify and leverage value in the healthcare system. It's good for patients, good for the healthcare system, good for employers and good for Canada's economy overall," he added.