Generic and Biosimilar Pricing Policies for Canadian Public Drug Plans

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This reference document summarizes (a) provincial generic pricing policies implemented between 2010 and 2015 and (b) the pan-Canadian Pharmaceutical Alliance policies on generics and biosimilars initiated beginning in 2013.

Table 1. Provincial generic pricing policies, generic prices as a percentage of the brand-name price, 2010 to 2015
  2010 2011 2012 2013 2014 2015
British Columbia October 15:
50% existing generics
42% new generics		 July 4:
40% all generics		 April 2:
35% all generics		 April 1:
25% most generics

April 1:
25%* for oral solids

35% for other forms

 
Alberta April 1:
56% existing generics
45% new generics		 April 1:
45% new generics 		July 1:
35% new generics		 May 1:
18% all generics		 April 1:
Lowest available price for existing generics; tiered pricing for new generics: 
70% one generic
50% two generics
25% three generics
18% four or more generics		 April 1: Adopts Tiered Pricing Framework
Saskatchewan   April 1:
40% new generics

May 1 and June 1: 
45% existing generics

April 1 and October 1:
35% generics in former Standing Offer Contract categories		 April 1: 
35%		     April 1:
25% for oral solids 35% for other forms
Manitoba Generic drug pricing is subject to utilization management agreements with the manufacturers, which declare that the price of a generic is equal to that of other select provinces.
Ontario July 1:
25%† public
50% private & out-of-pocket		 April 1:
25%† public
35% private and out-of-pocket		 April 1:
25%† public, private and out-of-pocket		     May 20:
Tiered pricing for generics‡
Quebec Quebec requires that generic manufacturers provide the province with the lowest price available in other provinces.
New Brunswick     June 1: 40%
December 1: 35%		 June 1: 25% for solid oral forms 35% for non-solid oral forms    
Nova Scotia   July 1: 45% January 1: 40%
July 1: 35%		   November 12: 
25% solid oral form
35% for non-solid oral form		  
Prince Edward Island     July 1: 35% December 1: 25%    
Newfoundland and Labrador     April 16: 45%
October 1: 40%		 April 1: 35%
July 1: 25%		    
Yukon There is no generic pricing policy in place; pharmacies order from Alberta or British Columbia wholesalers and therefore receive the prices listed in those provinces.
NIHB The NIHB Program reimburses the lowest-cost alternative product in a group of interchangeable drug products and therefore adopts the pan-Canadian Tiered Pricing Framework where applicable.

* Effective April 1, 2019, changed from 20% to 25%.
† Generic pricing policies apply to oral solid forms; all others are 35%.
‡ Changes to regulations applicable to generics listed on the Ontario Drug Benefit (ODB) Formulary on or after April 1, 2013.

Table 2. pan-Canadian Pharmaceutical Alliance initiatives
  2013 2014 2015 2016 2017 2018 2019 2020
Generic price reductions compared to brand reference price* April 1: 6 of the most common generics are reduced to 18% of the brand reference price April 1: 4 additional common generics are reduced to 18% of the brand reference price for a total of 10 April 1: 4 additional common generics are reduced to 18% of the brand reference price for a total of 14 April 1: 4 additional common generics are reduced to 18% of the brand reference price for a total of 18 April 1: One‐year bridging period during which the price of 6 existing generics are further reduced to 15% of the brand reference price April 1: Prices of 67 of the most commonly prescribed generics are reduced by 25% to 40%, resulting in up to 90% off the price of their brand reference - -
Tiered Pricing Framework  
  • Tier 1 (single source) – one generic: 85% of brand reference price if a Product Listing Agreement (PLA) does not exist for the brand product; 75% if there is a PLA
  • Tier 2 (dual source) – two generics: 50% of brand reference price
  • Tier 3 (multi source) – three or more generics: 25% of brand reference price for oral solids; 35% for non-oral solids
Biosimilars       April 1: Issued the First Principles for Subsequent Entry Biologics to guide negotiations   September 2018: The pCPA’s Biologics Policy Directions document was created to guide and define the process that will govern how biologic and biosimilar products will be negotiated and considered for reimbursement by Canada’s public drug plans March 2019: Pan-Canadian Oncology
Biosimilars Initiative Action Plan was generated by the pan-Canadian Oncology Biosimilars Initiative (partnered by the pCPA and CCO) to provide a map for implementing oncology biosimilars across Canada

February 2020: pCPA engaged with the Canadian Agency for Drugs and Technologies in Health (CADTH) and released the final report National Consultation on the Use and Implementation of Biosimilars

Note: After April 1, 2013, the general provincial generic pricing policies no longer apply to drugs that are subject to the 18%, 15%, or 10% pricing policies set by the pan-Canadian Pharmaceutical Alliance.

* Generics under the 18% rule by date of implementation:

  • April 1, 2013: atorvastatin, ramipril, venlafaxine, amlodipine, omeprazole and rabeprazole.
  • April 1, 2014: rosuvastatin, pantoprazole, citalopram, and simvastatin.
  • April 1, 2015: clopidogrel, gabapentin, metformin, and olanzapine.
  • April 1, 2016: donepezil HCl, ezetimibe, quetiapine, and zopiclone.

Generics further reduced to 15%:

  • April 1, 2017: atorvastatin, amlodipine, simvastatin, pantoprazole, ramipril, clopidogrel.

Generics further reduced to 10% and additional generics reduced to 18%:

  • April 1, 2018: 67 of the most commonly prescribed generics in Canada were priced at approximately 10% to 18% of the brand reference. For a full list of affected drugs, see the pCPA website.
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