[Viva] FW: CTAC Daily Info - April 23

Mon Apr 26 13:57:51 PDT 2010

Subject: CTAC Daily Info - April 23

In this e-mail:

1.    Drug spending in Canada hits $30B

2.    Shoppers picks a fight that it will not win 

3.    Funding Opportunity Announcement:  Non-Reserve First Nations, Inuit
and Métis Communities HIV/AIDS Project Fund

4.    AIDS Organization Welcomes Crown Decision To Stay Criminal Charges In
Hamilton HIV Case

1.

Drug spending in Canada hits $30B

Last Updated: Thursday, April 22, 2010 | 7:03 PM ET 
http://www.cbc.ca/health/story/2010/04/22/pharmaceutical-drug-spending-canad
a.html 

CBC News <http://www.cbc.ca/news/credit.html>  

Some blockbuster drugs like Lipitor are set to come off patent in the next
few years, which could further slow the rate of spending on
pharmaceuticals.Some blockbuster drugs like Lipitor are set to come off
patent in the next few years, which could further slow the rate of spending
on pharmaceuticals. (Mel Evans/Associated Press)

Spending on prescription and non-prescription drugs in Canada reached an
estimated $30 billion, or $836 per person, last year, but the rate of
increase is slowing significantly, according to a report.

The Canadian Institute for Health Information said total spending in 2009
rose by about $1.5 billion over the previous year, but that 5.1 per cent
increase was "the lowest annual growth rate observed in more than a decade."

The institute's annual report on drug expenditure lists spending trends for
prescribed and non-prescribed drugs by province and territory and whether
the spending was by government-paid drug plans or private sources. It also
includes international comparisons.

In 2009, drugs accounted for the second-largest share of total health care
after hospitals — 16.4 per cent of the country's total $183-billion
health-care bill, or about $30 billion. Hospitals consumed about $50
billion.

"We spend a lot of money on drugs; $30 billion is a lot of money," said
Michael Hunt, director of pharmaceuticals and health workforce at CIHI.
"Even when we see increases slowing, we're still increasing by more than a
billion a year."

Of total drug spending, 85 per cent country-wide was on prescriptions. The
reminder was non-prescribed, discretionary drug purchases such as Aspirin
and Gravol.

$4.5-billion difference

The most up-to-date international comparisons with OECD countries were for
2007. Canada was second behind the U.S., which spends $1,062 per capita.

"The U.S. and Canada are conspicuous outliers in that they spend the most on
medicines of all these countries," said Steve Morgan. an associate professor
at the Centre for Health Services and Policy Research at the University of
British Columbia, commenting on the report.

"Because they express these things in per capita terms, you think, 'Oh well,
what's the difference between say $711 spent in France versus the $836 spent
in Canada?' That may not seem like a particularly big difference until you
realize that translated to the Canadian population, that's a $4.5-billion
difference. It's real money."

The highest per capita spending on prescribed drugs was in Newfoundland and
Labrador at an estimated $908, followed by Nova Scotia at $903 and Quebec at
$879. The national average was $756. The lowest per capita spending was in
British Columbia at $596.

Ways to save

In Atlantic Canada, public plans have opened up, Hunt noted, while Ontario
has been reigning in costs on public spending for several years.

Last year in Ontario, public spending on prescribed drugs actually decreased
by 0.8 per cent, according to the report.

Few new blockbuster pharmaceutical drugs have come on the market in the past
few years, which could be in part why growth in spending has fallen for the
third straight year, Hunt said.

Another reason spending growth is slowing is that existing blockbuster
selling drugs are also set to come off patent in the next year or two, and
some have already, Hunt and Morgan noted. 

To achieve more savings without a national pharmacare program, another
approach would be common price negotiation, Morgan suggested.

"Can we find mechanisms to actually combine the purchasing power of all of
the payers in this country — the private sector, the public sector and the
different provinces — through some mechanism that actually negotiated on the
collective behalf?" he said.

Such an approach could apply savings not just to the public plan but to
everyone, Morgan said, adding it would not be easy.

//

To see table of public vs private drug expenditure per province, go to:
http://www.cbc.ca/health/story/2010/04/22/pharmaceutical-drug-spending-canad
a.html 

Related:
Growth in drug spending is slowing, CIHI reports

http://www.theglobeandmail.com/life/health/growth-in-drug-spending-is-slowin
g-cihi-reports/article1543669/  

2.

Shoppers picks a fight that it will not win 

http://www.theglobeandmail.com/globe-investor/investment-ideas/features/vox/
shoppers-picks-a-fight-that-it-will-not-win/article1535129/ 

Shoppers Drug Mart

Shoppers Drug Mart 

The generic drugs kickbacks were nice while they lasted, but that's over
now. Move on

Fabrice Taylor
<http://www.theglobeandmail.com/news/opinions/columnists/fabrice-taylor>  

Published on Thursday, Apr. 15, 2010 7:26AM EDT Last updated on Sunday, Apr.
18, 2010 9:48AM EDT 

You can't blame Jurgen Schreiber for being upset with the Ontario
government. But as a shareholder, you should be horrified about the way he's
handling it. 

Smart people never pick a fight with powerful politicians, and in provincial
politics they don't come much more powerful than the minister of health. You
can't win that scrap at the best of times and this is far from the best of
times. 

Mr. Schreiber, chief executive officer of Shoppers Drug Mart, (SC-T
<http://www.theglobeandmail.com/globe-investor/investment-ideas/features/vox
/shoppers-picks-a-fight-that-it-will-not-win/article1535129/>
37.67-0.03-0.08%) doesn't get it. His stock has been bludgeoned since
Ontario said it would radically alter the pharmacy business. 

Some say the retailer's shares are cheap. Since other provinces will likely
follow suit I'm not so sure, but at any rate I'd think twice about investing
in a company whose CEO instigates a public relations battle against a
government – especially a government trying to cut costs because it's nearly
broke and everyone knows it. 

There's no question that the changes Ontario Health Minister Deb Matthews
introduced are going to batter Shoppers' bottom line. The government is
effectively cutting the price of generics in half and banning professional
allowances. That's a big drop in revenue and it flows straight to the bottom
line (before taxes are factored in). Shoppers will suffer more than anyone
else because of its big share of the market. 

http://beta.images.theglobeandmail.com/archive/00136/Shoppers_Drug_ma_136441
artw.jpg

Jurgen Schreiber, chief executive officer of Shoppers

Mr. Schreiber, as well as investors and analysts, sounded shocked by Ms.
Matthews' move, which in and of itself is surprising. Shoppers' own
financial reports says that the primary risks to the company are “adverse
changes to 
 pharmacy reimbursement programs and the availability of
manufacturer allowances.” 

Shoppers was as right about that danger as it's wrong about the way it's
dealing with this blow. Ms. Matthews implies that these “allowances” are
kickbacks. Shoppers' senior vice-president John Caplice takes umbrage,
saying that “Minister Matthews' wholesale accusation of impropriety is
nothing more than a smear campaign to which we, and others, take great
offence.” 

Give me a break. The Competition Bureau took a hard look at the generic drug
industry and found that while there is competition, consumers aren't
benefiting. One reason? Those allowances come from generic drug
manufacturers to “entice” drugstores to stock their pills. 

But these are generic drugs, indistinguishable from one manufacturer to the
next. In a commodity business, you can only compete on price and service.
But the generic drug makers are not. And those kickbacks aren't free. The
generic makers just add them to the price of the drugs, which consumers pay
for either directly or with tax dollars. The pharmacy industry says the
allowances are spent on customer services. That's clearly not true: Analysts
all say that the loss of allowances will sharply cut profits. 

These legal kickbacks put a lot of money in the jeans of Shoppers
shareholders – $150-million annually, according to one analyst. But even Mr.
Schreiber knew that revenue was at risk. It was nice while it lasted, but
it's over now. Move on. 

“ Mr. Schreiber could have taken the high road and stressed the potential
positives. He could have made a case for hard work and a nimble response to
all this adversity. Instead he petulantly stuck a pole in a beehive. ”

As for cutting generic prices, governments are not stupid, and when it comes
to their own finances, they're amazingly clever. Ontario is facing enormous
and lasting deficits. Health spending is out of control, so cutting there
makes obvious sense. 

Here's an easy way to do that: With a lot of blockbuster drugs coming off
patent soon, generic demand for those molecules is going to surge. So cut
the cost of generics. 

That doesn't just help the government. It makes it cheaper for everyone,
including, crucially, auto makers, who are shedding jobs. The industry says
health insurance has been one of the fastest rising costs of doing business.
So the province is helping the auto makers too, and they're way more
important politically than drugstore chain shareholders. 

Mr. Schreiber doesn't get it though. He thinks he can intimidate Ms.
Matthews by reducing service in her riding and threatening not to open new
stores in the province. 

Says an angry Ms. Matthews in response: 

“I remain absolutely committed, in fact more committed than ever, to move
forward with the reforms that will clean up a system that has been open to
abuse, that will bring down the cost of generic drugs.” 

Those are fighting words and she carries a big stick. 

Mr. Schreiber could have taken the high road and stressed the potential
positives, as some analysts have. He could have made a case for hard work
and a nimble response to all this adversity. 

Instead he petulantly stuck a pole in a beehive. Shoppers shareholders
should hope he wakes up or the next thing you know the government might
threaten to get into the business of dispensing drugs itself. 

3.

Funding Opportunity Announcement:  Non-Reserve First Nations, Inuit and
Métis Communities HIV/AIDS Project Fund

Deadline for Submissions:  May 28, 2010

The main goal of the Non-Reserve First Nations, Inuit and Métis Communities
HIV/AIDS Project Fund is to reduce HIV incidence and to facilitate access to
testing, counselling, diagnosis, care, treatment and social support for all
Aboriginal People Living with HIV/AIDS (APHAs) and those at risk.

The Invitation to Submit Applications (ISA) provides an overview of the
fund, eligibility requirements and detailed instructions.  The ISA, the
Guide for Applicants, the Non-Reserve First Nations, Inuit and Métis
Communities HIV/AIDS Project Fund Application Form, and the PHAC Application
for Funding Form are posted on the website at the following

address:  http://www.phac-aspc.gc.ca/aids-sida/funding/isa/isamin-eng.php

Please note that a list of Questions, Answers and Corrections will be
available on the web site at a later time.

****************************************************************************
*************************************************************************

ANNONCE DE POSSIBILITÉ DE FINANCEMENT

Le Fonds pour les projets sur le VIH/sida des communautés hors réserve des

                Premières nations, des Inuits et des Métis

         Date limite de présentation des demandes : le 28 mai 2010

Le Fonds pour les projets sur le VIH/sida des communautés hors réserve des
Premières nations, des Inuits et des Métis vise principalement à réduire
l'incidence du VIH et améliorer l'accès aux tests de dépistage, counseling,
soins, traitement et services de soutien social chez tous les Autochtones
vivant avec le VIH/sida et les personnes à risque.

L’invitation à soumettre une demande de financement (ISD) offre un aperçu du
Fonds, des critères d'admissibilité et des instructions détaillées.

L’invitation à soumettre une demande, le Guide des requérants, le formulaire
de demande pour le Fonds pour les projets sur le VIH/sida des communautés
hors réserve des Premières nations, des Inuits et des Métis ainsi que le
formulaire de demande de financement de l'ASPC sont affichés sur le site
internet à l'adresse suivante:

 <http://www.phac-aspc.gc.ca/aids-sida/funding/isa/isamin-fra.php>
http://www.phac-aspc.gc.ca/aids-sida/funding/isa/isamin-fra.php

Veuillez prendre note qu'une liste de questions, réponses et corrections
sera disponible sur le site internet à une date utlérieure.

Thanks / Merci

Sonia Hamel

Senior Program Consultant / Consultante en programme principale HIV/AIDS
Policy, Coordination and Programs Division / Division des politiques, de la
coordination et des programmes sur le VIH/sida Public Health Agency of
Canada / Agence de la santé publique du Canada Tel. / Tél. : (613) 946-3569
Fax. / Télec.: (613) 941-2399  <mailto:sonia_hamel at phac-aspc.gc.ca>
sonia_hamel at phac-aspc.gc.ca

4. 

AIDS Organization Welcomes Crown Decision To Stay Criminal Charges In
Hamilton HIV Case

RJ_vihSida_couleur1    

News Release

Communiqué

For immediate release

Également disponible en français

  AIDS ORGANIZATION WELCOMES CROWN DECISION TO STAY CRIMINAL CHARGES IN
HAMILTON HIV CASE

But guidelines needed to avoid unsound, unjust prosecutions

TORONTO, April 22, 2010 — The Canadian HIV/AIDS Legal Network welcomed the
announcement at Hamilton’s courthouse this morning that the prosecution is
staying the criminal charge of aggravated sexual assault against Justus
Zela.  He was charged in February 2009 after an ex-partner alleged they had
oral sex without Zela disclosing that he had HIV.  The ex-partner has not
tested HIV-positive.

“We’re pleased with the Crown’s announcement this morning, but it must go
further.  This case should never have proceeded in the first place, and the
charges should be withdrawn entirely,” said Richard Elliott, Executive
Director of the Canadian HIV/AIDS Legal Network.  “There was never any solid
basis for significant risk of transmission.  It’s a misguided overreaction
to lay and pursue some of the most serious charges in the Criminal Code when
no harm has occurred and the risk of HIV transmission was miniscule at
most.”

According to information available to the Legal Network, the charges were
based solely on the claim that oral sex had taken place on a few occasions —
and mostly with Mr. Zela performing oral sex, rather than receiving it.

“This case is yet another example of why the Attorney General of the
province should work with community groups to develop some clear guidelines
for prosecutors and police about when criminal charges are, and are not,
warranted,” said Elliott.  “Guidelines should be informed by the evidence
about actual risks of transmission.  They should also consider the damage
that misusing the criminal law does to individual lives, and how it
undermines public health, including HIV prevention efforts, through
contributing to misinformation, fear and stigma.” 

In 1998, the Supreme Court of Canada ruled that a person living with HIV has
a duty to disclose his or her status to a sexual partner only if there is a
“significant risk” of transmission, but much uncertainty remains about what
this means.  

Over the past decade, there has been an alarming increase in both the
frequency and severity of charges against individuals with HIV for not
disclosing their status to a sexual partner.  Prosecutors have pursued
serious assault charges even in circumstances where the risk of HIV
transmission, already statistically small in any single sexual encounter,
has been lowered further by the responsible practise of safer sex.  In light
of this “criminalization creep,” it is all the more urgent to address
legitimate questions about where, as a matter of public policy, we should
draw the lines.

Leading organizations and members of the HIV community — including health
care providers, service providers, people living with HIV, academics and
lawyers — have questioned the expansive use of the criminal law with respect
to HIV non-disclosure in Canada.  While recognizing that there is a limited
role for criminal law on this issue, many legitimate concerns exist as to
the impacts of this trend.  Not only is studying, evaluating and critiquing
the application of the criminal law appropriate, it is absolutely necessary
to ensure it is used sensibly and fairly.

About the Canadian HIV/AIDS Legal Network

The Canadian HIV/AIDS Legal Network (www.aidslaw.ca <http://www.aidslaw.ca/>
) promotes the human rights of people living with and vulnerable to
HIV/AIDS, in Canada and internationally, through research, legal and policy
analysis, education, and community mobilization. The Legal Network is
Canada’s leading advocacy organization working on the legal and human rights
issues raised by HIV/AIDS.

Contact:

For more information:

Gilles Marchildon

Director of Communications

Canadian HIV/AIDS Legal Network

Telephone: +1 416 595-1666 ext. 228

Cell: +1 416 278-3750

E-mail: gmarchildon at aidslaw.ca

“Criminal Law and HIV”

A series of 5 info sheets on-line at: www.aidslaw.ca/criminallaw

Béatrice Cardin

Communications Manager

Canadian Treatment Action Council (CTAC)

Phone/Fax:  (416) 410-6538 

 <mailto:ctac at bellnet.ca> ctac at ctac.ca 

w <http://www.ctac.ca/> ww.ctac.ca

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