For 2 I'm pretty familiar with the research process, testing requirements, and generics laws. Pharma companies still make huge amounts of money despite that (don't care if it's good or bad, just a fact).
Can't remember where I read it, but before they cut their generic prices, Ontario paid one of the highest prices for generics in the world. I suspect not higher than organizations/companies in the US, given the huge mail-order industry going on in Manitoba (with mainly US customers), but still quite high.
These things aren't decided by a national health service though, it's all done province-by-province (this may change in the near future to try and leverage more purchasing power, not necessarily legally, but defacto as all the provinces choose to follow the same formulary). Manitoba still pays the higher generic prices than Ontario and still allows pharmacies to get discounts/rebates from suppliers for loyalty. As far as I can tell this is because pharmacies have backed themselves into this corner: because of the great profits from generics, they've all offered things like bubble-packing, delivery, and patient counseling for free or very cheap, and have kept dispensing fees really low. If the generic profits erode, a lot of smaller pharmacies will have trouble making money, and most of the rural pharmacies are pretty small (say less than 100 scripts per day). Hiking all those ancillary fees would make patients pretty unhappy (being used to mostly-free medical care), so the solution is to limit those fees (as Ontario did) or make consumers pay for them which is politically problematic for the party that makes that change.
I'm working in Winnipeg. I'm actually still in school, have a couple of years left. I probably won't work in the US (family and all), but I'm considering doing my 4th-year internship somewhere that does advanced hospital practice, which is mostly in the US (and Australia).
Anyhow, my point about the supply is not far from yours... given the limited lifetime of brand names and the limits in prices in Canada (meaning prices don't vary with supply), you would expect suppliers to try and make hay while the sun shines. One or two drugs back-ordered from time to time wouldn't surprise me, but it seems like many are for long stretches. For the generics, if Apo (or whoever) could tells us "we'll always have something for you", I think they'd have a good shot of becoming our sole supplier for their catalog.
For 2 I'm pretty familiar with the research process, testing requirements, and generics laws. Pharma companies still make huge amounts of money despite that (don't care if it's good or bad, just a fact).
Can't remember where I read it, but before they cut their generic prices, Ontario paid one of the highest prices for generics in the world. I suspect not higher than organizations/companies in the US, given the huge mail-order industry going on in Manitoba (with mainly US customers), but still quite high.
These things aren't decided by a national health service though, it's all done province-by-province (this may change in the near future to try and leverage more purchasing power, not necessarily legally, but defacto as all the provinces choose to follow the same formulary). Manitoba still pays the higher generic prices than Ontario and still allows pharmacies to get discounts/rebates from suppliers for loyalty. As far as I can tell this is because pharmacies have backed themselves into this corner: because of the great profits from generics, they've all offered things like bubble-packing, delivery, and patient counseling for free or very cheap, and have kept dispensing fees really low. If the generic profits erode, a lot of smaller pharmacies will have trouble making money, and most of the rural pharmacies are pretty small (say less than 100 scripts per day). Hiking all those ancillary fees would make patients pretty unhappy (being used to mostly-free medical care), so the solution is to limit those fees (as Ontario did) or make consumers pay for them which is politically problematic for the party that makes that change.
I'm working in Winnipeg. I'm actually still in school, have a couple of years left. I probably won't work in the US (family and all), but I'm considering doing my 4th-year internship somewhere that does advanced hospital practice, which is mostly in the US (and Australia).
Anyhow, my point about the supply is not far from yours... given the limited lifetime of brand names and the limits in prices in Canada (meaning prices don't vary with supply), you would expect suppliers to try and make hay while the sun shines. One or two drugs back-ordered from time to time wouldn't surprise me, but it seems like many are for long stretches. For the generics, if Apo (or whoever) could tells us "we'll always have something for you", I think they'd have a good shot of becoming our sole supplier for their catalog.
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