Through the centralized price change process, requests are made directly to the pCPA instead of individual drug plans, removing the need to navigate separate submission processes for each plan.
When a request is received, the pCPA evaluates the price change to ensure eligibility for respective public drug plan price change mechanisms. Final decisions remain at the discretion of participating drug plans, subject to jurisdictional policy, and regulatory and legislative requirements.
Submitting a price change request
Price change requests can be made by completing the pCPA price change request form and submitting it by email.
Price change requests can only be made for drugs that are currently listed on a drug plan's formulary. Manufacturers may be requested to provide additional information to support price change requests. Incomplete submissions won’t be considered.
- For drug plans with established submission and response timelines, manufacturers can submit price increase requests once a year. Price increase requests won’t be considered outside of the submission deadline, except submissions for Ontario, which are accepted on a rolling basis.
- Price decrease requests are considered at any time.
- Approval of a price change request is at the sole discretion of the respective drug plans.
- Manufacturers will be informed of the decision outcome of their price change requests, or requests for additional information, by the respective drug plans.
By submitting a price change request, the manufacturer is consenting to the pCPA distributing submitted information to drug plans, and the pCPA and drug plans exchanging information about the request.
Generic drugs submitted through the market entry and exit assessment process that have been granted a tier change due to 1 or more competitors entering or leaving the market aren’t eligible to apply for further price increases. Individual drug plans may consider price increase requests for generic products not affected by the tiered pricing framework (TPF), according to their respective policies and requirements.