A-29.01 - Act respecting prescription drug insurance

Section 60.0.4 Disposition versions

2016-12-07

60.0.4. The Minister may suspend the insurance coverage of a manufacturer’s medication or supply, end it or not re-enter a medication or a supply of that manufacturer on the list of medications when the list is updated in the following cases:

(1)  if the manufacturer fails to comply with a condition or commitment prescribed by ministerial regulation, a provision of a listing agreement or a provision of a contract entered into following a call for tenders;

(2)  if the selling price guaranteed by the manufacturer for a medication is higher than the maximum amount payable by the basic plan;

(3)  if a competing medication or supply is the subject of a listing agreement;

(4)  if the Institut national d’excellence en santé et en services sociaux recommends doing so; or

(5)  if the Minister considers that the public interest so requires.

The Minister suspends or ends the insurance coverage by publishing a notice on the Board’s website. The suspension or end of the insurance coverage applies on the date of publication of the notice or on any later date specified in the notice. Where applicable, a notice of the end date of the suspension is also published on the website. Publication imparts authentic value to such notices. The notices are not subject to the requirements concerning publication and date of coming into force set out in sections 8, 15 and 17 of the Regulations Act (chapter R-18.1).

However, the Minister may, in a suspension or end-of-coverage notice or on an updating of the list, maintain the insurance coverage of a medication or supply for persons undergoing pharmacological treatment.

A medication for which the Minister has issued a suspension or end-of-coverage notice or which has not been re-entered on the list of medications is excluded from the application of the sixth paragraph of section 60.

2016, c. 28, s. 44.