Drug Price Lists and Pricing Policies

The New Brunswick Drug Plans set a maximum price that will be paid for all drugs listed on the NB Drug Plans Formulary. The New Brunswick Drug Plans include the New Brunswick Prescription Drug Program (NBPDP), New Brunswick Drug Plan (Plan D) and other government sponsored programs including the Extra-Mural Program (Plan W), and Public Health (Plan P).

This maximum price is applied during claims adjudication as outlined below:
 

The maximum amount that the New Brunswick Drug Plans will pay for one unit of a drug product on the MLP list is the Manufacturer List Price (MLP).

MLP List: PDF | XLS
 

The maximum amount that the New Brunswick Drug Plans will pay for one unit of a drug product in this category (e.g. pharmaceutical equivalent, pharmaceutical alternative, interchangeable) on the MAP list is the Maximum Allowable Price (MAP).

• Prices on the MAP list that are highlighted in grey have been increased due to shortages of products in the category.
• Product names that are highlighted in grey indicate that the manufacturer has not confirmed the MAP for all package sizes of the product.

MAP List: PDF | XLS

The maximum price for each drug category on the MAP list is determined by calculating a percentage of the price of the reference brand name drug in the drug category. The pan-Canadian Pharmaceutical Alliance (pCPA) reviews and sets the prices of most generic drugs.

pan-Canadian Tiered Pricing Framework (TPF)

The pan-Canadian Pharmaceutical Alliance (pCPA) and Canadian Generic Pharmaceutical Association (CGPA) have agreed on a Tiered Pricing Framework (TPF) for generic drugs. The NB Drug Plans implement the TPF in its generic drug pricing. Tiered pricing applies to certain MAP categories based on the number of competitors in the category. However, tiered pricing does not supersede existing NB Drug Plans regulations and policies.

If the price has not been assessed by the pCPA then the price is based on the provincial regulation as outlined below.

If there is no drug, other than the original product, with a Notice of Compliance on June 1, 2013:

Solid Oral Dosage Form: 25% of the MLP of the original product as of the date a Notice of Compliance is issued for the first product in a MAP category, other than the original product

Non-Solid Oral Dosage Form: 35% of the MLP of the original product as of the date a Notice of Compliance is issued for the first product in a MAP category, other than the original product

If there is another drug, other than the original product, with a Notice of Compliance on June 1, 2013:

Solid Oral Dosage Form: 25% of the original product price as of January 1, 2010

Non-Solid Oral Dosage Form: 35% of the original product price as of January 1, 2010

pan-Canadian Select Molecules

Prices for the pan-Canadian Select Molecules are set at fixed prices and are not part of the TPF process. Drugs not listed on the NB Drug Plans formulary are not subject to these fixed prices. The prices of certain generic drugs are set at 10, 15 or 18% of the brand name drug price

Exceptions

The MAP for a category may be varied if the proposed price is not higher than the price in another Canadian jurisdiction and one or more of the following conditions exists: 

• the manufacturer provides documentation indicating that a different unit price should be established;
• the manufacturer’s list price for the original product has changed;
• the original product is no longer marketed in Canada or another product with similar ingredients, strength and form has received a notice of compliance;
• it is justified having regard to market conditions; or
• it is justified in the public interest having regard to the safety of members of the Plan, access to the drug or costs to the Plan.
   

For extemporaneous preparations (compounds), the maximum amount that the New Brunswick Drug Plans will pay for one unit (e.g. tablet, capsule, milliliter, gram, etc.) is the actual acquisition cost.  Actual acquisition cost means the unit price of a drug to a participating provider, based on reasonable and customary purchasing practices, which is calculated by deducting from the total amount paid or payable to purchase the drug, (excluding franchise fees and shipping charges), the value of any price reduction.  

Payments made for actual acquisition costs that do not comply with this policy are subject to audit and recovery.