Physician's role in drug selection continues to decline

    /Not for distribution to U.S. news wire services or dissemination in the
    United States./

    Ongoing shift in influence towards drug plan managers, new prescribers
    and consumers

    MONTREAL, June 17 /CNW Telbec/ - IMS Health Canada recently released its
annual PharmaFocus report, a comprehensive independent review of the Canadian
pharmaceutical marketplace that covers a broad range of topics, from politics
and health care, to government reform initiatives to regulatory, business and
pharmaceutical marketing issues.
    According to its "Stakeholder Influence on Pharmaceutical Product
Selection 10-Point Scale", IMS foresees that by the end of the forecast period
(2012) physicians will see their influence on pharmaceutical product selection
increasingly diminished as compared to today. This shift is shaped by the
increasing collective influence from a number of healthcare stakeholders (see
table 1 for trends in stakeholder influence).

    Payers/Managers Growing in Influence

    A large part of this shift is cast by the provincial drug plans and
related federal bodies and initiatives like the Common Drug Review (CDR). Drug
approval and advisory groups are collectively becoming more prominent due to
expanded mandates and heightened scrutiny on cost expenditures. It is expected
that provincial drug plan initiatives will spawn a new era of deal-making
between provincial plans and manufacturers. "The new agreement-making powers
embodied in Ontario's Executive Officer (EO) could lead to many diverse and
innovative arrangements being struck between pharmaceutical companies and
provincial drug plans," said Ian Therriault, Vice President Thought
Leadership, IMS Health Canada.
    In addition, drug plan management by the provinces will have more
consumption data - thanks to initiatives like the National Pharmaceutical Drug
Utilization Information System (NPDUIS) - along with more comprehensive drug
information systems. These new tools are expected to spawn more sophisticated
techniques for plan management, resulting in greater and more specific control
over beneficiary coverage and benefit conditions tied to the individual's
condition and broad clinical practice guidelines - as opposed to today's
simple listed or not listed formulary-driven approach.
    While the private payer segment will continue to be a significant portion
of the market by 2012, IMS predicts that its overall influence will only
marginally change over the next five years. The expectation for this market
sector is that there will be more off-loading of costs from the public sector
to employees as employers will continue their move to cap financial exposure.

    New practitioners on the horizon

    The new prescribing powers that have been bestowed on pharmacists in
Alberta (expected in other provinces in the foreseeable future) and more
licensed nurse practitioners will have their collective influence increase
from today's current levels. This shift represents just one aspect of the
broader healthcare reform agenda to establish more integrated health care
teams, which in turn will likely trigger more support activities to the these
teams from pharmaceutical manufacturers.

    Accelerating patient influence

    While on a relative basis, the consumer is still viewed as a relatively
minor influence, IMS sees their influence increasing as they become better
informed and get more involved financially in the prescription transaction.
This extends from asking the right questions of their physicians and
caregivers right through to greater adherence of treatment protocols. As a
result of this rise in influence, the patient or consumer of health care is
expected to become a more important part of go-to-market activities from drug

    Implications for Pharmaceutical, Biotech and Generics Manufacturers

    "These indicators show a marketplace in a slow but significant
transition," said Therriault. "Canadian pharmaceutical companies need to
respond in a timely and adequate way to these fundamental shifts in influence
and determine the optimal deployment of their commercial activities. Today,
commercial strategies and tactics are being re-assessed to better align with
future opportunities. In this market environment, building relationships
directly with patients as they become better educated and take a more active
role in their own healthcare also is essential. And, the industry must
continue to engage this broader array of stakeholders in the health care
community to ensure that the value and innovation from their drugs does lead
to improved patient care outcomes and an improved health care system."

    About IMS Health

    Operating in more than 100 countries, IMS Health is the world's leading
provider of market intelligence to pharmaceutical and healthcare industries.
With US$2.2 billion in revenue in 2007 and more than 50 years of industry
experience, IMS offers leading-edge business intelligence products and
services that are integral to clients' day-to-day operations. IMS information
is also used by researchers, academics, government and other stakeholders to
advance health through informed decision-making. Additional information is
available at

                                   Table 1
          Stakeholder Influence on Pharmaceutical Product Selection
                              10-Point Scale(*)
    Stakeholder                 Description              2004  2008  2012
    - Physicians              - FPs/GPs, specialists,     5.0   3.0   2.5

    - Pharmacists             - Hospital/community        0.5   0.5   0.5(xx)

    - Nurses and              - RNs, nurse                0.0   0.0   0.0(xx)
      other prescribers         practitioners

    - Government Drug         - Provinces/territories,    3.0   3.0   3.5
      Plans                     catastrophic drug
                                program and NIHB

    - Drug approval/          - Common Drug Review        0.5   1.5   1.5(xx)
      advisory groups           and other drug
                                expert groups
    - Regional Health         - Provincial equivalents    0.0   0.0   0.0
      Authorities               (e.g., Ontario's

    - Private Drug Plans      - Insurers, employers       1.0   1.0   1.0(xx)
                                and other

    - Consumers/              - Consumers at large,       0.0   1.0   1.0(xx)
      Disease Groups            and organizations
                                (seniors/ women's
                                groups, disease
                                consumer groups)
    Total                                                10.0  10.0  10.0

    (1)  Family Physicians/General Practitioners and others who prescribe
         drugs in different settings including the hospital environment

    (2)  Local Health Integration Networks

    (3)  Includes organizations set up to advise insurers/employers such as
         benefit managers, preferred- provider organizations

    (*)  The awarding of influence points takes into consideration the breath
         of environment and marketplace changes that are monitored by
         PharmaFocus and that are expected to occur over this forecast
         period. For PharmaFocus 2012 we have rebalanced our weighting
         criteria to provide a revised portrait of the shift of each group's
         influence on pharmaceutical product selection moving through the
         three time periods: 2004, 2008 and 2012. One of the characteristics
         of the forecast period is the ascendancy in the influence of a
         number of groups. This is the product of a pharmaceutical
         environment where costs are coming under increasing scrutiny and
         there are more sectors sharing the cost burden - or at least some
         level of responsibility for it.

    (xx) Increasing influence

For further information:

For further information: Madeline Gareau Lagden, IMS Health Canada,
(514) 428-6018; Lynn Bessoudo, NATIONAL Public Relations, (514) 843-2365

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