Good afternoon.

I’m delighted to be here, and I certainly appreciate your kind invitation.

Events such as this allow for a full and vigorous dialogue on substantial issues, and I welcome the opportunity to address such an impressive gathering at such an important time.

I’d like to speak about our government’s efforts to reform Ontario’s drug system.

As most here will know, these long-awaited reforms are proceeding through the legislative process. The Transparent Drug System for Patients Act serves as the cornerstone of our comprehensive strategy – a strategy designed to provide the right drug to the right patient and the right price.

Appropriately, there has been spirited discussion about what these changes mean – what they mean for doctors, for pharmacists, for retailers, for name-brand manufacturers and for generic manufacturers.

And most importantly, what our package means for Ontario’s patients.

Our objective is very clear: we want good value for taxpayer dollars. And we intend to use all gains to enhance their access to drugs and the help they get to use them, to the greatest possible impact.

The way we get better value is multi-faceted. We need to make our drug system more efficient. We need to make it more accountable and transparent. We need to get better pricing – pricing that reflects the volumes of drugs we purchase.

We believe Ontarians deserve a drug system in which patients get better access to the drugs they need, and taxpayers get better value for the money we spend. A system that is fair to retailers, pharmacists, doctors, and manufacturers.

With these goals and values guiding us, we developed a comprehensive set of reforms, based on recommendations from the Drug System Secretariat we appointed in 2005 to review the system.

The Secretariat held more than 100 meetings with more than 350 stakeholders.

What the Drug System Secretariat found was that there were huge opportunities to improve patient access to drugs, and for Ontario to receive better value for the money we spend on the provision of prescription drugs.

And while I’m speaking of the Drug System Secretariat, let me take a moment to acknowledge the remarkable job done by Helen Stevenson, the Executive Lead. She has carried out her role with remarkable energy and determination.

But before I say more about our changes, let me back up for a moment. Let me tell you what kind of system we’ve been working with in recent years.

I won’t sugar-coat my words here. Our drug system has been failing us. It hasn’t served patients as well as it should. It hasn’t been serving taxpayers. It hasn’t been serving professionals who work within the system day after day – including many of you in this room.

In fact, if you can actually pretend to understand it… you need to get out more!

Let me share some stark numbers with you. Drug costs have risen more than 140% since 1997.

This makes drug costs the single fastest-growing area of health care in Canada.

Drug costs now account for more than 10% of provincial spending on health care – ten years ago it was only 8%.

And it’s not just governments feeling the heat from these price increases.

Employers, who use the government’s drug formulary as a guide to what drugs they will pay for, are suffering dramatic increases. They spend $2.6 billion a year.

And the private sector needs government support to help manage drug costs, the most significant factor in company drug plans and a matter important to Ontario’s economic competitiveness.

As I mentioned, Ontario has one of the most generous plans going – or at least one of the most costly. Our formulary lists more than 3,400 drug products reviewed and approved for recipients of the Ontario Drug Benefit Program.

Those recipients number almost 2.2 million Ontarians who are on social assistance, or receiving provincial disability coverage, or who are seniors 65 and over.

Think of the irony of a program which is the second most generous in the land – and that costs $3.5 billion! – but is seen by the people who depend on it as cumbersome, inefficient, and badly-managed!

So… the case for change was strong. And the need for reforms was urgent.

Our government was elected on a platform of change. Our goals were not just to muddle through, avoid tough decisions, and dodge difficult issues for four years.

The commitment we made was to bring in the changes needed for a stronger, more competitive Ontario. And with respect to health care, our objective has been very clear : to ensure that our public medicare system remains sustainable, and to ensure that all Ontarians receive the quality health care they deserve.

Changes to our drug system are one more step – a big step – toward these goals.

Better access to drugs translates as better value for taxpayers’ money…which amounts to $3.5 billion spent annually on the Ontario Drug Benefit Program through 2 government ministries, Health and Community and Social Services.

Standard business practice dictates that volumes are rewarded, giving the consumer the best-possible price. This hasn’t been the case in Ontario. We’re doing something about it.

We’re going to leverage our $3 billion in purchasing power to ensure we get the best-possible value for what we spend.

And we’re going to recoup approximately $222 million of that.

We’re determined to improve patient access by getting better drugs to Ontarians faster and more efficiently.

And if a drug is not approved, we’ll tell patients – and manufacturers why—quickly and honestly.

Our package of reforms also contains the following changes :

• better value for money through changes to drug pricing and reimbursement.
• competitive pricing and partnership agreements allowing us to take advantage of the offers from pharmaceutical companies.
• conditional listings to get drugs to people who need them more quickly.
• we’ll restrict unapproved price increases – taken by generics and brand names alike -- that have been squeezing the markup provided to our pharmacists.
• We’re creating a joint Pharmacy Council to help develop new pharmacy policy. The OPA will play a key role in composition of this Pharmacy Council and its operations.
• we’re increasing the dispensing fee by 7%, from $6.54 per prescription to $7; a change worth $52 million.
• And our plan introduces off-formulary interchangeability, also known as OFI or, to some, as “generics first.”

The Big 3 automakers have already embraced a “generics first” policy, with a bit of leadership from the Buzz Hargrove and the CAW. It’s also been embraced by OPSEU and the OHA.

There’s been a fair bit of discussion about off-formulary interchangeability lately, including some remarkably uninformed comments by the leader of the opposition, who seems to reject the use of generics.

Let me tell you exactly what OFI means. It means that less expensive, but equally effective, generic drugs can be used in place of brand names.

Health Canada reviews these generic products to ensure they are safe. And Ontario does a second review, either internally or through our expert advisory committee, to ensure that they are equally effective.

Interchangeability has been in place for some time now. Our changes will allow more of these generic products to be used.

This is good news for patients. It’s also good news for people who pay for drugs. Out-of-pocket purchasers and employers will save an estimated $30 million on their drug plans as a result of OFI.

Our legislation also promotes the appropriate use of medications by paying pharmacists for some of the services they are providing as direct patient care.

$50 million for cognitive services addresses an age-old opportunity to better use all of the brainpower of our pharmacists.

Our package of reforms also contains a commitment to establish a Fund for research projects to help us make the case that certain drugs help to save on overall health costs.

This research will also provide us with the evidence we need to make the right investment decisions for the benefit of patients.

I know from personal experience that innovations in pharmaceutical products can mean renewed life for Ontarians. I’ve seen innovative drugs extend and enhance the lives of loved ones challenged by HIV.

And I often think that drugs available to us today might have prevented my father’s untimely death from a stroke 14 years ago.

Innovation must be fostered, must be nurtured, must continue.

It’s essential for our province and for our people.

The money spent by pharmaceutical companies on research and development is money well-spent. Companies must be fairly compensated for the innovative drugs they bring to market.

As I mentioned earlier, our province’s drug system lacks transparency and accountability. Reforms are needed here as well.

We’re going to introduce some badly needed democracy into our drug system by, for the first time, giving patients a significant role in drug-listing decisions. We’ll build a more accountable system through the creation of a Citizens’ Council.

This will make Ontario the first province in Canada to permit direct patient involvement in both decision-making and policy direction.

To make the system even more efficient, we will create a new position of Executive Officer of Ontario public drug programs to manage the publicly funded drug system and make listing decisions. This will make the entire system leaner, more responsive to our patients.

I’ve said before this is a balanced package, and I mean it. Doctors will also benefit. We’re freeing them from the crushing burden of paperwork associated with Section 8.

It’s our belief that doctors and pharmacists should be spending their time on patient care, not filling out forms.

In turn, Section 8 will be replaced by a much more effective conditional listing system, supported by a new access mechanism for exceptional cases.

These mechanisms will fall under the Executive Officer.

We appreciate that there are many players in today’s drug marketplace—doctors, drug manufacturers, pharmacists, retailers, and patients. We intend to be sensitive to the needs of everyone. And I firmly believe that in our reform package we have struck a fair and equitable balance.

Our reforms must succeed. The cost escalations I noted earlier illustrate how urgently we need better drug pricing. We cannot compromise patient access to drugs because of an uncontrollable cost spiral.

The balanced, comprehensive package of changes anchored in the Transparent Drug System for Patients Act will enable us to reach these goals.

I’m personally proud of this bill and everything in it. Ontarians deserve it. This bill takes us a long way in the right direction.

It’s part of a larger determination to make our health system meet the changing needs of our population on every level.

These are commitments I take very seriously.

And I’m very proud of the progress we’re making – on behalf of the people and families of Ontario – toward meeting these goals.