Reference Drug Program
For further information, consult the Low Cost Alternative/Reference Drug Program Booklet.
What is the Reference Drug program?
The Reference Drug program (RDP) is a PharmaCare policy to encourage cost-effective first-line prescribing for common medical conditions. Under the RDP, PharmaCare coverage is based on the cost of the reference drug or drugs in a therapeutic category. This is the drug(s) considered to be equally efficacious and the most cost effective in that category. Why was the Reference Drug Program (RDP) introduced?We recognize that cost-saving measures must be taken now to protect and preserve the benefits of PharmaCare, our provincial drug plan, for the long term. The RDP saves B.C. taxpayers millions of dollars each year. This is good management of tax dollars and a safe way to provide PharmaCare beneficiaries with the prescription drugs they need, while helping to keep PharmaCare affordable for the future. How does the Reference Drug program work?
For most common medical conditions, drug manufacturers market a wide variety of similar prescription drugs -- drugs that often vary greatly in price but achieve the same medical effect. Under this program, PharmaCare obtains independent, expert advice on which prescription drug products within a group of similar medications are equally safe and beneficial, and the most cost-effective. The cost of the preferred drug will then be the price of the "reference drug" for the level of coverage that PharmaCare will establish for any medication in that class used to treat that condition. Who benefits from the Reference Drug Program?
All British Columbians benefit from the Reference Drug Program. It saves tax dollars and enables PharmaCare to continue protecting British Columbians from high prescription drug costs. We also benefit as we discover that some of the more expensive prescription drug alternatives are not necessarily better. Through the Therapeutics Initiative we are learning more about the effectiveness of many prescription drugs competing in today's marketplace. Will I have to switch drugs under reference based pricing?
After consulting with your doctor, you may opt for an equally safe and effective drug that is less expensive than your current medication, or you may decide to take the higher-priced prescription drug and pay a portion of its cost. What if there are potential difficulties with switching medications?
If there is a demonstrated medical need for you to take an alternative prescription drug that is not covered by PharmaCare, your doctor can apply for Special Authorization for full PharmaCare coverage of that drug. PharmaCare will consider paying the full cost of that treatment if you are eligible for benefits. Are expensive drugs better than cheaper drugs?
Expensive drugs are usually new drugs that are either versions of existing drugs, or are still protected by patent laws. However, often there is limited or no evidence to support that they are more effective than existing drugs. By spending tax dollars wisely on safe and cost-effective medication, PharmaCare can provide more support for those new products that truly are better. Will I have to pay more for my prescription drugs?
PharmaCare wants to make sure you get the most effective prescription drug at a price fair to both consumers and the PharmaCare benefit plan we all support as taxpayers. For people who are eligible for benefits, PharmaCare will cover the cost of the Reference Drug or a less expensive medication, or pay a portion of the cost of a higher priced prescription drug. Is the Reference Drug program like the Low Cost Alternative Drug program?
It's similar but not exactly alike. The Low Cost Alternative Drug program bases PharmaCare coverage on the price of the lowest cost brand among those drugs that have identical active ingredients. The Reference Drug program applies to drugs that are not identical but are part of the same drug category and are used to treat the same conditions. |
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