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Archive for the ‘Advocacy’ Category

In the wake of pharmacy reform and massive rebates still flowing to retail chains and independent pharmacy buying groups, the one time darling of the pharmacy world SDM’s future as a investor bet is being openly challenged.

The one time SDM “cheerleader”, analyst Perry Caico of CIBC World Markets, who had been referred to by politicians as THE unbridled stock promoter for SDM, has said he is “concerned” for the once great stock investment.

He claims pharmacy reform and government strong-arming has and will compromise the viability of SDM as the perfect investment.

As the former CEO of the largest professional association of pharmacists in Canada and, immodestly, as a go-to resource for government and private sector organizations on drug plan reform and augmentation, I submit that the issue is not government – it’s a flawed business model in pharmacy.

There is a disconnect between what the public wants and what traditional retail pharmacy in Canada is begging to keep.

In fact, the pall on traditional pharmacy in Canada is not the fault of government. Governments across the country have been and remain concerned that rebates to pharmacy from generic manufacturers artificially keep prices for generic medicines the highest in the world. Pharmacy has been slow to react to government reform from the outset, catering to the notion of staying “whole” rather than adjusting their business models.

I make speeches across North America on drug reform. Audiences tell me they become enraged at what they hear about the massive profits being made by pharmacy when costs continue to rise year over year on private sector plans. It doesn’t make sense in my opinion. With demographic increases in numbers of prescriptions being dispensed, the patent cliff making generic drugs more prolific, one would assume prices and costs would decrease. So how does it work that costs are increasing?

In the work we do, we can confirm that the public and government are ahead of the curve on pharmacy reform and will talk and walk with their feet when confronted with high prices for drugs, variable fee structures from one pharmacy organization to the other and an increasing understanding of how this drug system has set pharmacy up as the biggest beneficiary.

The US, UK, Italy, Spain, Australia, New Zealand and even Ireland have undergone real drug reform. One that doesn’t hide the fact that designing a system means realizing lower costs and prices.

With governments leading the charge on making real change in prescription drug plan reviews and retail pharmacy still playing the game of introducing schemes and ‘blueprints’ to maintain their position – little wonder analysts are turning on the once and mighty chains!!

The beneficiaries are undoubtedly the public and plan members who may see new models considered and introduced.

M. Kealey - Economic Club of Canada

Economic Club of Canada

- Marc Kealey
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Is Canada on sleeping medication?

Sunday, December 11, 2011 @ 05:12 PM

I’m here in Hanoi, Vietnam – again.  This is my second trip in the last two months.  It’s interesting, the last time I was here at the beginning of September; the former Ambassador to Canada and now a noted advisor to the Central Government scolded us by saying “Canada is asleep on Asia Pacific”.   I think he’s right!

Our trip this month was to sign a cooperation agreement between the Vietnamese Chamber of Commerce and Investment, which, as many who do international business know, is the government’s external link to other countries seeking business opportunity.

Our signing ceremony was historic, it is the first such agreement between private sector enterprise in Canada and the government of Vietnam.  There were noted dignitaries from Vietnam at the event, including the current Vietnamese Ambassador to Canada, who spoke glowingly about Canada and the opportunity that exists between the two countries.  There was decent media coverage too, but the meeting was cut short. Why? Because the US government, with a large business contingent, was in the same building as we were to celebrate the 10th anniversary of the trade cooperation agreement between the two countries.

As I reflected on that, I wondered why our Canadian Embassy wasn’t at our event.  Why no one from the Canadian government showed up.  It’s not as if either wasn’t given ample notice.  In fact, on our last visit, we specifically met Embassy commercial counsel to brief up on the event to happen in the ensuing months.

This leads me to my point – Is Canada asleep when it comes to Asia Pacific?

I’d say it has one eye closed. The sum total of Canada’s interest in Asia Pacific lays, in my opinion, with China.  Why?  Because I believe we think we have a better opportunity there because of the strained relations China shares with the USA.

If the former Ambassador is right about Canada being asleep, and I believe he is, then the opportunity for Canada is the fact that Vietnam is the gateway to ASEAN (Association of South East Asian Nations) – some 680 million people strong.  Countries like Cambodia, Laos, Thailand, Indonesia, etc. all of whom need healthcare innovation, quality education, high technology industry and good manufacturing processes and natural resources like oil, gas and minerals.

Canada has traditional north-south dialogue (witness recent free trade agreements with Chile and Colombia).

But what about a dialogue with ASEAN countries?

The Keystone XL fiasco from Obama’s chicken-hearted approach to dealing with environmental lobby groups in Washington is a case in point.  Let’s take advantage of his misstep by helping develop ASEAN by putting an elbow bend in the Oil Sands pipeline and having a terminal on the west coast of Canada to deliver our oil to energy developing ASEAN countries.

With this beach-head, we can lay to waste the notion that Canada is asleep and we can use large-scale exports as a means to deliver on other expertise in healthcare, education, hi-tech and other natural resources.

And maybe, just maybe, the Canadian embassies and their commercial counsels in ASEAN countries might wake up and help Canadian business flourish there.

Canada Vietnam Business Council signing ceremony

- Marc Kealey
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I will be speaking with Dr. Gordon Atherley from Family Caregivers Unite! for a podcast on how to help with diabetes for diabetics and their families.

You can get the latest information on the podcast by visiting VoiceAmerica.com.

Marc Kealey is a lead voice in North America on health reform, integrated health and drug benefit plan enhancement, and healthcare policy. John Wunderlich is an independent information and privacy consultant in Toronto who describes himself as a middle-aged guy with Type II diabetes who’s active in a political party. They discuss diabetes-related challenges. They say how well these challenges are being met by the healthcare system, healthcare professionals and persons with diabetes and their families. For improving the way the challenges are being met, they explore the responsibilities they see for the healthcare system, for healthcare professionals and for persons with diabetes and for their families. Then they say what they would see done to improve responses to the challenges of diabetes, and what would change if their prescriptions for change were implemented.

Tune in on July 26th at 1PM EST.

- Marc Kealey
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What healthcare reform should mean for family caregivers.

May 3, 2011 – Hosted by Dr. Gordon Atherley

Marc Kealey, Chief Advocate, Kealey & Associates, is a lead voice in North America on health reform, enhancement of health and drug plans, and healthcare policy. He describes his own experience with family caregiving, and way this has influenced his views on healthcare reform. He explains the three toughest challenges for healthcare reform in North America. He talks about the challenges for family caregiving, the ways family caregivers help the healthcare system, and the help family caregivers get, and don’t get, from the healthcare system. He identifies the health conditions for which family caregivers particularly need more help, and about the help they need. He explores the help for family caregivers that healthcare reform currently visions, and tells us what he would like to see done through healthcare reform to get more help for family caregivers, and from where and how the help should be provided. He suggests ways in which family caregivers can influence healthcare reformers.

Listen Online – http://www.voiceamerica.com/voiceamerica/vshow.aspx?sid=1669

- Marc Kealey
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Ontario Alone Acts On Drug Costs.

Friday, April 8, 2011 @ 05:04 PM

Interesting article in Benefits and Pensions Monitor:

Ontario is the only Canadian province trying to protect the public from drug prices, says Marc Kealey, an expert on healthcare reform and governance. Speaking at the International Society of Certified Employee Benefits Specialists Toronto Chapter’s ‘Leveraging the Benefits of Rx Drug Reform,’ he said since Bill 102 in 2006, it has taken measures to ensure the drug costs are transparent and fair for public and private payers. In fact, he said the province plans to appeal a recent court decision by an “uninformed” judge which would allow one retail chain to sell private label prescriptions from a generic drug manufacturer it owns. Part of the problem is that most plan members really don’t understand or care about their drug benefit plan. As long as they can go to the drug store and get a prescription filled, they are content. However, they fail to understand that escalating drug costs are a demotivator for businesses which can lead to layoffs and even businesses closures. “We have to educate the public because this is going to really hurt and if it doesn’t stop, government will step in and try to control it through legislation.” And that, he said, is the last thing that major pharmacy chains want.

You can read it here: http://www.selectpath.ca/EARC/articles.php?action=display_article&article_id=150

 

- Marc Kealey
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Voters need to be engaged.

Saturday, April 2, 2011 @ 10:04 AM

How do we get people engaged in this election?  Many I talk with are feeling so disenfranchised or completely UN-interested!  Nice job political parties and main-stream media!

- Marc Kealey
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Interesting article in the Toronto Star:

http://www.thestar.com/Business/article/410418

Federally owned Atomic Energy of Canada Ltd. is no longer pursuing the sale of its next-generation nuclear reactor in the United Kingdom, announcing yesterday it will focus its energy on capturing business at home.

Some industry critics said AECL, which says it has spent “less than $10 million” trying to snag a purchase from the U.K., is trying to soften the blow of a certain loss and how it might be perceived as it bids for contracts in Canada.

“Why let it blow up later when you can back out now and save some face?” said Shawn-Patrick Stensil, who closely follows the nuclear power sector for Greenpeace Canada.

Less than two weeks ago, Mississauga-based AECL announced that its Advanced Candu Reactor made it onto a short list of four reactor designs approved by the U.K. nuclear regulator, which said it found no safety or security shortfalls serious enough to rule out the Canadian design. The short list also included Areva NP, Westinghouse Electric Co. and GE Nuclear – the same companies currently being considered for a new reactor in Ontario.

At the time, the U.K. government said it would whittle the list to three designs sometime in May. Sources say the regulator sent letters to all the U.K. utilities asking them to rank the designs they preferred. Their responses still left AECL on the bottom of the list.

Hugh MacDiarmid, AECL’s president and chief executive officer, told the Toronto Star that a business decision had to be made.

“We’ve been very carefully evaluating our realistic prospects over there. How much money is it going to cost us to go through step three, how much time, and without any commitment at the end of that?” he said. “Our sense was that we were unlikely to get the blue ribbon this time around, because we didn’t have the demonstration project under way here in our home country.”

MacDiarmid said the U.K. plans to build several new reactors and that AECL intends to participate in subsequent rounds, once it has proven itself in Canada.

With three opportunities to sell in Canada – in Ontario, New Brunswick and Alberta – the Crown corporation didn’t want to spread itself too thin, he added.

“I’m a real believer in having a core mission in life, and I believe AECL’s core mission is to be the supplier of choice to the Canadian electrical utility market. Everything else has to be secondary to that.”

Marc Kealey, an international energy consultant and former general manager at AECL, said the company made the right decision. The Canadian government, ultimately responsible as AECL’s owner, is better off backstopping a new nuclear project on its home turf than taking on huge financial risk in a foreign market, he said.

Even with a contract in Canada, Kealey added that AECL and its Candu technology face an uphill battle in overseas markets, dominated by the pressurized-water reactor technology used by Areva and Westinghouse.

Much of AECL’s efforts are focused on Ontario. The province expects to make a decision on reactor technology, and where the new plant will be built, by year end.

- Marc Kealey
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AECL abandons effort to sell U.K. reactor

Monday, March 28, 2011 @ 08:03 AM

From the Toronto Star:

Federally owned Atomic Energy of Canada Ltd. is no longer pursuing the sale of its next-generation nuclear reactor in the United Kingdom, announcing yesterday it will focus its energy on capturing business at home.

Some industry critics said AECL, which says it has spent “less than $10 million” trying to snag a purchase from the U.K., is trying to soften the blow of a certain loss and how it might be perceived as it bids for contracts in Canada.

“Why let it blow up later when you can back out now and save some face?” said Shawn-Patrick Stensil, who closely follows the nuclear power sector for Greenpeace Canada.

Less than two weeks ago, Mississauga-based AECL announced that its Advanced Candu Reactor made it onto a short list of four reactor designs approved by the U.K. nuclear regulator, which said it found no safety or security shortfalls serious enough to rule out the Canadian design. The short list also included Areva NP, Westinghouse Electric Co. and GE Nuclear – the same companies currently being considered for a new reactor in Ontario.

At the time, the U.K. government said it would whittle the list to three designs sometime in May. Sources say the regulator sent letters to all the U.K. utilities asking them to rank the designs they preferred. Their responses still left AECL on the bottom of the list.

Hugh MacDiarmid, AECL’s president and chief executive officer, told the Toronto Star that a business decision had to be made.

“We’ve been very carefully evaluating our realistic prospects over there. How much money is it going to cost us to go through step three, how much time, and without any commitment at the end of that?” he said. “Our sense was that we were unlikely to get the blue ribbon this time around, because we didn’t have the demonstration project under way here in our home country.”

MacDiarmid said the U.K. plans to build several new reactors and that AECL intends to participate in subsequent rounds, once it has proven itself in Canada.

With three opportunities to sell in Canada – in Ontario, New Brunswick and Alberta – the Crown corporation didn’t want to spread itself too thin, he added.

“I’m a real believer in having a core mission in life, and I believe AECL’s core mission is to be the supplier of choice to the Canadian electrical utility market. Everything else has to be secondary to that.”

Marc Kealey, an international energy consultant and former general manager at AECL, said the company made the right decision. The Canadian government, ultimately responsible as AECL’s owner, is better off backstopping a new nuclear project on its home turf than taking on huge financial risk in a foreign market, he said.

Even with a contract in Canada, Kealey added that AECL and its Candu technology face an uphill battle in overseas markets, dominated by the pressurized-water reactor technology used by Areva and Westinghouse.

Much of AECL’s efforts are focused on Ontario. The province expects to make a decision on reactor technology, and where the new plant will be built, by year end.

http://www.thestar.com/Business/article/410418

 

- Marc Kealey
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The Aftermath of Reform

Sunday, November 21, 2010 @ 05:11 PM

Recently articles have been written about the aftermath of the drug reform legislation in Ontario and on the eve of the Canadian Foundation for Pharmacy’s Annual Meeting, I wonder if  pharmacy officials attending  will address the issue of their behaviour during the legislation period.

In mid 2009, the government of Ontario made public overtures that it intended to review the Transparent Drug System for Patients Act ( legislation that was originally passed in 2006 to save costs to the public drug program in Ontario). Written in the Act in 2006 was a provision that government will review the Act every two years.  In the intervening years since the original Act was passed, Pharmacy was noticeably absent from any positive discussions with government on how it (pharmacy) could impact positively on patient care and save dollars to an ever-increasing cost for drug plans in both the public and the private sectors.

The review of 2009 was meant to assist private sector drug plans to manage cost increases on their formularies and match the savings realized in the public sector.  It should be noted that when the Transparent Drug System for Patients Act was originally passed in 2006, its jurisdiction extended to both the public and the private sectors.  However, the enforcement of the Act, at that time, never extended to the private sector.  This issue, in and of itself, created a two-tiered drug plan system where drug plan and actual drug costs in private sector plans were double digit higher than in the public system.  It was an untenable proposition from 2006 to 2009 and plan designers (among others) in the private sector appealed to government to right the legislation.

Pharmacy’s reaction to the proposed legislation in the months after 2009 was not only surprising, it was shockingly out of touch with the current economic thinking of Ontarians.  There were mass protests by pharmacy and intellectually dishonest comments made by pharmacy  officials(some suggested that stores would close, others suggested that service would be impacted and some even called the government reckless).  Pharmacists did not stand up for their profession during this time.  In fact, many protested in the face of government suggesting that the end was near.

I was a delegate at a public policy conference in the summer of 2010 in Collingwood where two bus loads of pharmacy students protested against those in attendance.  When pressed as to why they were protesting, there was a flurry of dramatic and factually incorrect comments from them. It was a shameful exercise – largely because none present had an open mind to the reasons why government needed to enact these changes –  it was, in the minds of these students apparently, only about them and their economic futures.

Pharmacy is a lucrative business.  In Canada it amounts to over $25 billion in annual sales.  Fees for pharmacy service in the public sector amount to about $700 million annually (it’s similar for private sector plans).  So what’s  the beef?

It has everything to do with how professions manage when public policy changes occur.  When I was CEO of the Ontario Pharmacists’ Association, I told pharmacists time and time again that the ONLY way to manage through the changes of the Transparent Drug System for Patients Act was to be actively and positively involved with government.  Pharmacy rebuked that exhortation and designed what they called “an opposition strategy”  (in short to use the opposition MPPs to attack the government).   Those who remember the election of 2007 know that pharmacy failed miserably in that fight.

Again, three years later, the sector is stymied as to why government distrusts pharmacy and why several stakeholder organizations, including CARP and CLIHA, have lined up against them.  And what is pharmacy’s response?  They punish their professional association (the Ontario Pharmacists’ Association- OPA).

It’s astonishing that Shopper’s Drug Mart, the apparent leader for the profession in Canada, would make public statements suggesting that it would no longer support its pharmacists who wish to belong to the OPA.  This kind of short sighted thinking fans the flames of mistrust between public policy framers and the professions with whom they aspire to collaborate on the future of the profession.

The outcomes of the drug reform measures introduced by Ontario have taken hold across Canada and helped this country come of age in world where drug costs are spiralling out of control and this has been a boon for patients.

Pharmacists need to embrace the notion that public policy is the purview of government and that people govern people!  When an entity pushes, the pushed either ignore the pusher or push back themselves.  Pharmacists as a profession need a lesson in how to manage through public policy debates in a positive manner.  Without the support of their member organizations –  like Shoppers –  they are destined for a rebuke from government!

- Marc Kealey
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