Date: 20110712
Docket: T-83-10
Citation: 2011 FC 859
Ottawa, Ontario, July 12, 2011
PRESENT: The Honourable Justice Johanne Gauthier
BETWEEN:
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SANOFI PASTEUR LIMITED
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Applicant
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and
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ATTORNEY GENERAL OF CANADA
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Respondent
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AMENDED CONFIDENTIAL
REASONS FOR JUDGMENT AND JUDGMENT
[1]
The
applicant, Sanofi Pasteur Limited [Sanofi] seeks judicial review of part of the
decision of the Patented Medicines Prices Review Board [the Board] dealing
with the remedy granted with respect to the excessive prices it charged between
2002 and 2006 that is a payment in the amount of $2,512,878.74 to Her Majesty
the Queen pursuant to subsection 83(2) of the Patent Act, RSC 1985, c
P-4 [the Act].
[2]
The
applicant raised several issues which, for reasons described below, are not
founded, such as:
a. That the
Board erred by imposing a penalty pursuant to subsection 83(2) of the Act,
b. That it fettered
its discretion by relying blindly upon the Compendium of Guidelines, Policies
and Procedures [the Guidelines] and past Board decisions with respect to the offsetting
of excess revenues in the context of subsection 83(2) of the Act.
[3]
It
also argued that the Board had abused its power under subsection 83(2) of the Act
by ignoring the evidence and the particular circumstances of its case and
making findings that are based on pure speculation. It was agreed that these
issues are to be reviewed on the reasonableness standard. After really struggling
to understand the reasoning of the decision-maker, the Court concludes that the
decision did not meet the transparency, intelligibility and justification
criteria included in the reasonableness standard.
Background
[4]
Even
though most of what follows is not in dispute, I feel that it is important to
put the issues raised in their proper context, including what was argued before
the Board, for this is helpful and necessary to assess the intelligibility and
transparency of the decision.
[5]
In
Teva Neuroscience G.P.-S.E.N.C. v Canada (Attorney
General),
2009 FC 1155 at para 2, my colleague Justice Roger Hughes briefly described the
Board and its duties as follows:
The Patented Medicines Prices Review
Board (the Board) was established in 1987 and continued in 1993 under the
provisions of the Patent Act, R.S.C. 1985, c. P-4 as amended in 1993 and
1996 and in particular sections 79 to 103 of that Act. It has many duties
including the monitoring of prices of what are described as
"medicines" if such medicines are the subject of a "patent",
the reporting of such prices to Parliament and, importantly in the context of
these applications, the determination as to whether such prices are
"excessive" and, if so, the imposition of a variety of remedies.
[6]
It
is clear that Parliament’s intention in creating the Board was for it to
control the market power of the monopoly created by the exclusivity of a
patent. The Board is given wide discretion as indicated in sections 83 and 85 of
the Act which will be discussed later on. It publishes bulletins setting
out policies, procedures and guidelines which are now consolidated in the Guidelines.
The version of the Guidelines at issue in this particular judicial review is
the version in effect in 2009 which is reproduced in Volume 1, Tab 10 of the
Applicant’s Record.
It has been in force since 1994 and amended several times. The Guidelines have
since been amended again and a new version, including certain relevant
passages, has been applied since January 1, 2010. This version was produced by
consent of the parties at the hearing before me. The sections referred to by
the parties are set out in Appendix “A” together with the various relevant provisions
of the Act. It is not disputed that the Guidelines are not binding and
they clearly say so.
[7]
As
both parties did, it is worth saying a few words about how the Board collects
information and fulfills its mandate. Within 30 days of the date on which a
medicine is first sold in Canada, the patentee is required to file a “Form
2” document which identifies the medicine and provides average pricing
information. The Board’s staff [Board Staff] uses this information and conducts
price tests (considering prices for that medicine or comparable medicines in
other countries as well as in Canada) to establish a price ceiling referred to
as the “maximum non-excessive price” [MNE] for the particular medicine.
[8]
The
Board has set out two six-month reporting periods per year and within 30 days
of the end of each period, the patentee is required to fill out a “Form 2”
setting out average price data for the period. The average transaction price
[ATP] is the total net revenue for all package sizes sold during the pricing
period divided by the number of units sold. During the benchmark period, the
period from the date of the first sale to the end of the six-month period, the
ATP is presumed not to be excessive if it does not exceed the MNE for the
medicine.
[9]
According
to the Guidelines, a patentee is allowed to increase the price of the medicine
(the MNE will increase year-to-year) in line with increases in the consumer
price index [CPI] and the Guidelines prescribe a methodology known as the CPI-Adjustment
Methodology for implementing these increases.
[10]
Following
the benchmark period, prices are averaged on an annual basis to determine the
ATP for the year. In each year following the benchmark period, the MNE for a
given year is based on the previous year’s ATP with allowances for a price
increase in accordance with the CPI-Adjustment Methodology. Provided
the ATP remains at or below the MNE, the patentee will be presumed to be
compliant with the Act.
[11]
According
to the Guidelines, if the ATP exceeds the MNE by an amount that is too small to
trigger an investigation (de minimus level), the ATP
is considered to be within the Guidelines. Schedule 5 of the Guidelines, which
sets out the investigation criteria, also stipulates that “[i]n most instances
where a price exceeds the maximum allowable price by an amount too small to
trigger an investigation in one year, it is offset by a price below that which
is permitted by the Guidelines the following year” [emphasis added]. The
respondent stated that this flexibility was allowed after extensive
consultation as it was felt to be an acceptable balance considering the Board’s
mandate to protect the public against excessive pricing versus the practical
realities of overseeing about 1,200 patented medicines in Canada with limited
resources. The criteria for commencing an investigation are intended to ensure
that all significant cases of pricing outside the Guidelines will be subject to
an investigation and “to balance the need for pricing flexibility on the part
of the patentee with the [Board’s] mandate of protecting consumers […].” (Guidelines
(2009), Schedule 5, Annex A).
[12]
Board
Staff sends patentees a “review and onside letter” advising them of the
compliance status of their medicines. Such form letters include statements
which will be referred to in dealing with Sanofi’s argument with respect to
reasonable expectations (see footnote in para 33 below).
[13]
Where
the price appears to be outside the Guidelines, Board Staff may conduct an
investigation pursuant to the Guidelines. If the investigation confirms the
price exceeded the Guidelines, the matter will be referred to the chairperson
of the Board who may commence a formal proceeding by issuing a Notice of
Hearing.
[14]
It
appears that a patentee under investigation may sign a voluntary compliance
undertaking [VCU] to reduce its price(s) such that it will not exceed the MNE;
such VCUs may include remedial actions (paragraph 7.1 of the Guidelines). When
the matter is under investigation, the VCU must be approved by the Chairperson
of the Board and if a Notice of Hearing has been issued, it must be approved by
the Board itself.
[15]
Paragraph
7.6 of the Guidelines provides that, in most cases, the VCUs should specify a
payment to Her Majesty the Queen as the means to offset the excess revenues.
However, it appears that in two instances referred to during this hearing, a
VCU that included the lowering of the price of a medicine for a period of time
to offset the excessive revenues from previous years was approved (Applicant’s Record, Vol
2, Tab 13C, 13D). This even though the price reduction had been put in
place before the VCU was approved.
[16]
When
a hearing proceeds, Board Staff fill a prosecutorial role.
[17]
As
noted by Justice Anne MacTavish in Pfizer Canada v Canada (Attorney
General), 2009 FC 719, it is worth mentioning again that the Board’s mandate
is not to set prices for patented medicines in Canada, rather, its duty is to ensure
that a patentee is not selling at a price which, in the opinion of the Board,
is excessive. The Board is a “watchdog”, to use the expression of then Minister
of Consumer and Corporate Affairs Harvie Andre (see paragraph 60 in Pfizer)
when he introduced the Bill which established the Board in 1987.
[18]
Subsection
85(1) of the Act sets out some factors that must be considered by the
Board in determining if a price is excessive. When the Board finds that, in its
opinion, a price is excessive; subsection 83(1) of the Act empowers it
to order the patentee to reduce its price thereby preventing the patentee from
continuing to charge a price which the Board considers excessive. This was
described as an important part of the Board’s mandate when the Act was further
amended in 1993 (see Celgene Corp v Canada (Attorney
General), 2011
SCC 1 at para 27).
[19]
In
contrast, subsection 83(2)
is retrospective and allows the Board to make an order requiring the patentee or
former patentee to offset (“compenser” in French) the amount of the excess
revenues a patentee derived from the sale of the medicine at an excessive
price.
[20]
The
Act also provides at subsection 83(4) that the Board may issue an order
directing a patentee to offset (“compenser” in French) no more than twice the
amount of the excess revenues estimated by it to have been derived by the
patentee or former patentee from the sale of the medicine at an excessive price
where it has been established that the said person has engaged in a policy
of selling the medicine at an excessive price.
[21]
The
main arguments before the Board related to whether, in the particular
circumstances of this case, the application of the factors set out in
subsection 85(1) of the Act would warrant applying a CPI-Adjustment Methodology
different from the one set out in the then-current Guidelines and to apply
instead a methodology based, at least in part, on the Guidelines applicable
prior to 1994. This included various concepts put forward by Sanofi’s expert,
Dr. Martyszenko, such as banking cumulative deficiencies. This expert’s
presentation included an opinion that Sanofi should be entitled to a credit when
the ATP was lower than the MNE, such as in 2007 and 2008 in particular, thereby
offsetting any cumulative excess revenues recorded for the period between 2002
and 2006.
This was submitted as the second material difference between Board Staff’s
position and Sanofi’s position on whether or not there were excess revenues at
all.
[22]
In
its written submissions to the Board, Sanofi’s brief comments dealing with the
issue of remedy (Applicant’s Record, Vol 9, Tab 26 at 73, section D) address
the general principles and then expressly refer back to their submissions on
the calculation of excessive revenues, using the methodology advocated by Dr.
Martyszenko and state why this method should be adopted (see, for example, Applicant’s
Record, Vol 9, Tab 26 at para 286 referring to earlier paras 171-186). This may
explain why this application was argued before the Court by reference to the
reasons (paragraphs 54-57) found in the middle of the Board’s decision under
the heading “Off-setting excessive revenues with sales below the MNE” as
opposed to those under the heading “Remedy”.
[23]
In
fact, in the section entitled “Remedy” (paragraph 84), the Board simply states
that it requires Sanofi to:
[…] offset the excessive revenues that
were earned by [Sanofi], as determined by the conclusions in this decision. The
calculation of excessive revenues for the sales of Quadracel and Pentacel
should be undertaken on the basis advocated by the Board Staff, but with the
ATP and MNE of Quadracel and Pentacel calculated as if Ontario discounts had not occurred.
[Amended decision, dated March 2010]
[24]
The
panel did not say in its reasons that payment should be made to Her Majesty the
Queen. Rather, the panel requested the parties to present it with a draft order
that implements the terms of the decision and that it would remain seized and
willing to assist in the event of disagreement.
[25]
It
is important to mention, however, that the above quoted “Remedy” paragraph 84
in its original form reads as follows:
The Panel considers that the most
appropriate remedy in this case, given the stability of the customer base for
Quadracel and Pentacel, is that the Respondent reduce the price at which it
sells Quadracel and Pentacel (to any customers) during the term of the
Respondent’s current contract with the Government of Canada, to a level that
offsets the excessive revenues that were earned by the Respondent, as
determined by the conclusions in this decision. […]
[Original decision, dated December 2009]
[26]
At
paragraph 41 of its written submissions, the respondent indicates (and this was
not disputed by Sanofi) that Sanofi subsequently submitted, and the Board staff
agreed, “that paragraph 84 of the Decision should be amended to provide for a
lump sum payment to Her Majesty as opposed to a price reduction. The Board
accepted these submission[s] and amended paragraph 84 accordingly […].” As a
result, on March 16, 2010, the Board ordered a payment of the amount mentioned above
to Her Majesty in Right of Canada to be paid on or before April 15, 2010.
[27]
To
complete the picture, one must have in mind the main arguments put forward to
the Board with respect to the remedy sought by Board Staff, i.e. disgorgement
of the excess revenues made by Sanofi.
[28]
First,
as before me, Sanofi argued that the Board has discretion not to issue an order
at all pursuant to subsection 83(2) of the Act. It said that the Board
should exercise its discretion in this case because all excess revenues
(whatever method was chosen by the Board) were effectively compensated for or
offset by the lower prices set out in 2007 to the benefit of the very same
customers
that paid the excessive prices in 2002-2006. Thus, in Sanofi’s view, to order a
payment or a further price reduction would amount to a penalty or a punitive
order which was outside the jurisdiction of the Board pursuant to subsection
83(2) of the Act. In that respect, it referred to and quoted (see Applicant’s
Record, Vol 9, Tab 26 at 77) the following extract of the evidence given by Mr.
Kreker of Public
Works and Government Services Canada in an answer to a question as to whether
he was aware that the Board was reviewing the prices paid in the 2002-2006
period:
Furthermore, the 2007 pricing, because we
were going competitively, would not have been impacted, or a contract would not
have been impacted by the results of that particular Board. Because we fully
expected the prices to drop significantly from what we were paying before, so
if there was an issue of excessive pricing it would have disappeared as a
result of the competition.[]
[emphasis added by the applicant]
[29]
Second,
relying mostly on this Court decision in Leo Pharma Inc v Canada (Attorney
General), 2007 FC 306 [Leo Pharma] at paragraphs 56 and 69, Sanofi
argued that “[t]o require a patentee to prove that it reduced its price for the
purpose of complying with the Current Guidelines before a price reduction can
be considered to address alleged excessive revenues is contrary to the Patent
Act and the Board’s mandate under it” (Applicant’s record, Vol 9, Tab 26 at
para 180).
[30]
This
argument was apparently put forth as a complete answer to Board Staff’s
argument that, in the particular circumstances of this case, the factual
scenario was so different in 2007 from the one in the period from 2002-2006
that the lower price paid by the customers in 2007 had nothing to do with the
concept of compensation for the excessive prices paid in the previous four
years or disgorgement of the revenues made, the patentee’s obligations under
this legislation. It certainly did not compensate these customers for the
excess they paid in the past.
[31]
It
is not disputed that, in 2007, Sanofi, as mentioned by Mr. Kreker above, was in
a competitive tender with another potential Canadian supplier (GlaxoSmithKline
[GSK]) and that therefore, naturally, the price of the vaccines would be
substantially lower than what it was before.
[32]
In
2002-2006, Sanofi was in a monopoly situation where its main clients, the governments
– like any other customer, relied on the Board’s oversight to ensure that
prices set in their contracts were not excessive. It is
not disputed that Mr. Kreker also confirmed that, in those days, the
governments were essentially price-takers.
[33]
Thirdly,
(Sanofi did not insist much on this argument at the hearing before me) the
applicant argued that, in 2007, when it reduced its prices, it acted on the
legitimate expectation that it could offset its excessive revenues by reducing
its price below the MNE for 2007-2008. This belief was allegedly based on some
correspondence with Board Staff
and the two previous VCUs where, as mentioned, the Board approved the price
reduction already conceded by the patentees before – and not as a result of –
entering into the VCUs. Moreover, Sanofi’s expert stated that there is nothing
in the Act that restricts the patentee’s ability to offset the price
through price reductions below the MNE for reasons other than compliance with
the Act and the Guidelines (Applicant’s record, Vol 8 at
2366-2368).
[34]
With
all this in mind, it is now worth reproducing the five paragraphs of the
decision on which the parties have argued this judicial review.
53. The Respondent, assisted by the
evidence of Mr. Martyszenko, proposed that revenues from the sale of Quadracel
and Pentacel at prices that exceeded its MNE in a given year should be offset
by sales during other years at prices that were below the MNEs of Quadracel and
Pentacel.
54. The Guidelines, implementing
paragraph 85(1)(a) of the Act, allow for price averaging on an annual basis. In
other words, within each calendar year, the price of the medicine in Canada is determined by price
averaging that results in sales above the MNE being averaged with sales below
the MNE. Patentees report average prices for the January-June and July-December
periods, and these two periods are themselves averaged to determine the annual
average transaction price. This gives patentees a reasonable level of
flexibility without exposing purchasers, on average over the course of the
year, to increases beyond those in line with annual CPI increases. The
patentees of virtually all of the medicines under the Board’s jurisdiction
operate within these bounds.
55. The Panel believes that the
Board would not be fulfilling its mandate to protect consumers from excessive
prices of patented medicines if it allowed patentees to average price excesses
and prices below the MNE over periods of time greater than one year, and
especially over periods of time chosen by the patentee. Such an approach would
allow a patentee to charge excessive prices for a period of years without
regulation by the Board, with the patentee relying on lower prices in a
subsequent period chosen by the patentee to avoid sanction for the excessive
prices. There would be no protection for consumers during the periods that the
patentee chose to charge excessive prices. The later reduction in prices
cannot be presumed, or even expected, to remedy the potential harm done during
the period of excessive pricing. This is true whether or not the customer
base remains the same throughout the two periods, because the effect of the
excessive prices on the purchasing decisions made by the customer base will
likely be a matter for speculation only.
56. The Respondent noted a prior
occasion on which the Respondent was permitted by Board Staff to offset a small
amount of excess revenue in one year by price reductions in a subsequent year.
Two panels of the Board in other proceedings (regarding the medicines Nicoderm
and Copaxone) have disapproved of price averaging outside of individual
calendar years, and, for the reasons stated by those panels and in this
decision, this Panel concurs in that disapproval.
57. The Guidelines provide that
Board Staff will not initiate an investigation of excessive pricing if the
quantum of excess revenues is at a de minimus level, the excess pricing
was inadvertent, and the patentee reverses the excess in the following year.
This latitude is not a departure from the overall structure of the Guidelines,
which is to limit price averaging to reporting periods in a calendar year. The
Panel finds that this approach in the Guidelines is appropriate and was well
understood by the Respondent, which approached Board Staff when it realized it
was outside its bounds.
[emphasis added]
[35]
For reasons that will be further detailed later on, the
Court is not convinced that these paragraphs were intended by the Board to deal
with the remedy aspect of Sanofi’s argument. It seems these paragraphs sought
to address Sanofi’s representation that a credit should be given for the sales
at prices below the MNE in 2007-2008 to determine if there were indeed excessive
revenues
(the first issue to be dealt with by the Board under s. 83(2)). The fact that
the Board’s decision includes a section dealing expressly with remedies
(especially the original version of paragraph 84) could support the view that,
in fact, the Board simply did not deal with this aspect of Sanofi’s arguments. Obviously, this could be
problematic for, in such circumstances, it may have been quite difficult for
the respondent to argue that the decision meets a reasonableness standard. At
best, I believe that these comments should be read keeping in mind that the
Board had to deal with “the two faces of this coin”.
[36]
That said, both parties argued the case on the basis that the
above-cited paragraphs were the reasons on which I should determine the
validity of the Board’s conclusion with respect to the remedy it ordered. I
will therefore do so.
Analysis
A. Did the Board exceed
its jurisdiction by imposing a penalty on Sanofi?
[37]
By characterizing the decision to impose a price reduction
or a payment as an excess of jurisdiction, Sanofi can argue that the standard
of review is correctness (Dunsmuir v New
Brunswick, 2008 SCC 9 at para 50; Pfizer, above, at para 51).
[38]
The respondent submits that the question before the Board
was not a true question of jurisdiction, but rather whether, on a proper
analysis of all the facts and the power granted under subsection 83(2) of the Act,
it was appropriate for it to order that the excessive revenues be offset though
one of the methods set out in that provision.
[39]
In its written submissions, Sanofi indicated at paragraph
43 that Board Staff had argued that “subsection 83(2) of the Act did in
fact grant the Board punitive powers and the ability to ‘fine’ a patentee for a
‘past wrong’”. It appears, however, from a review of the transcript that the Board Staff’s
position about the whole provision was more nuanced than that. In effect, this
comment was made only with respect to an order providing for payment to Her
Majesty as opposed to an order for a reduction in price which was described as
purely remedial. The respondent then clarified that it was not looking for a
punitive order but rather for a remedy for a past wrong because they felt here that
consumers had not been compensated for the excessive pricing. That said, it is
not clear to the Court that the parties at this stage were using the word
“punitive” in the same sense.
[40]
At the hearing before me, the respondent clearly had time
to reflect further on the matter and confirmed that any order under subsection
83(2) was clearly meant to be restorative in the sense that the purpose
of the order is to put the patentee in the position it would have been in but
for the excessive prices. None of the options set out in paragraphs 83(2)(a)(b)
and (c) of the Act are meant to be “punitive”, in the sense used
by Sanofi.
[41]
Generally, I would agree with the respondent that there
should be, in fact, only one issue here and that is, whether or not the
decision to issue an order for a payment or a price reduction in the amount of
the excessive revenues as determined by the Board in the particular
circumstances of this case was reasonable or not, for under this standard of
review the Court could deal with all the issues raised by the applicant.
[42]
However, I understand that the distinction made by Sanofi’s
counsel between its first and second issues is that if, as a matter of fact,
the order issued can only be described as a punitive award, and the
imposition of a penalty is outside of the Board’s powers, there is no reason to
ask oneself the further question of whether the decision falls within a range
of possible, acceptable outcomes which are defensible on the facts and the law.
Simply put, for Sanofi, it is clear that the Board was bound to conclude that
no order could be issued because there had already been an “offset” of the
maximum amount allowed by subsection 83(2) – its excess revenues.
[43]
Although the Court recognizes that, as suggested by the
respondent, this may well be a clever way to circumvent the application of more
deferential standard of review. I have decided to deal with it in the manner
proposed by the applicant, since this is not in any way determinative of this
application.
[44]
As
mentioned and confirmed during the hearing before me, it appears that the
parties have no real dispute
as to the meaning of subsection 83(2) of the Act that would impact on
the determination of the questions raised in this application, for I understand
that the respondent maintains that if indeed the Board imposed a penalty or a
punitive award then it acted outside its jurisdiction.
[45]
Thus,
to address this question of excess of jurisdiction, I must assess if the
factual premise on which Sanofi relies has been established – that is, if
Sanofi has established on a balance of probabilities that the imposition of any
payment or further price reduction was or ought to be considered punitive.
[46]
First,
Sanofi submits that the use of the word “sanction” in paragraph 55 of the
Board’s reasons clearly indicates that the Board believed it had punitive
powers under subsection 83(2) of the Act and purported to exercise such
powers in this case.
[47]
Although
the Court recognizes that, in certain circumstances, the use of that expression
may be sufficient to infer that a decision maker intended to impose a penalty
(see Thibeault v Canada (Minister of Fisheries and Oceans) (1996), 7
Admin LR (3d) 70 (FCTD) at paras 27-35 and Matthews v Canada (Attorney
General) (1996), 43 Admin LR (2d) 143 (FCTD) at paras 11-13, 21, aff’d [1999] FCJ No 830
(CA))
the Court must be careful to look at this wording in its proper context. In
this instance, in my view, considering the general statements set out in the
first part of paragraph 55, the Board is still dealing with the issue of
excessive prices (first aspect of the argument put forth by Sanofi). In that
context, it may well be referring to its powers generally, which do include the
power to punish as was acknowledged by Sanofi who referred to subsection 83(4)
of the Act as but one example of this. But, more importantly, this
statement is followed a few lines down by a more specific reference to “the
later reduction in prices cannot be presumed, or even expected, to remedy the
potential harm done […]” [my emphasis]. Would this not suggest compensation
for harm done as opposed to punishment? As a whole, the convoluted wording used
in this paragraph, read in context, makes it extremely difficult, if not
impossible, for the Court to understand exactly the Board’s intention with
respect to its order under subsection 83(2) of the Act.
[48]
Also
considering that the Board had determined that the proper remedy was a price
reduction (original paragraph 84) and that neither party had advocated before
the Board that such an order was intended to punish, I am not willing to infer,
as suggested, that the simple use of the word “sanction” is sufficient here to
conclude that the Board purported to issue a punitive award.
[49]
Second,
Sanofi says that like in Leo Pharma above, whatever its intent, the
simple fact that its price was reduced below the MNE for a number of units,
which covered the excessive revenues established by the Board in respect of the
preceding five year period, is sufficient to establish that any further order
pursuant to subsection 83(2) of the Act ought to be penal in nature. In
effect, as the Board’s mandate was fulfilled, it simply ought not to have
intervened.
[50]
In
my view, the decision of this Court in Leo Pharma is not particularly
helpful here. In effect, in that case, Justice Blais had to determine whether
the Board’s finding with respect to excessive pricing was reasonable or not. In
that context, he had to consider the factors set out in section 85 of the Act
as well as the Patented Medicine Regulations, 1994 SOR/94-688 [the Regulations],
particularly subsection 4(4) which clearly stated that the price to be
used in calculating the average price per package of medicine, was the actual
price after any reduction given as a promotion or in the form of
rebates, discounts, refunds, free goods.... The Court’s conclusion that
the patentee’s intent in giving out free goods was irrelevant to determine if
such free goods should be included in the calculation of the average price was
based on the fact that through the Regulations, Parliament had provided
very clear directives on the assessment of the average price of the medicine.
If it had intended to limit the “free goods” to be included in the calculation
to those distributed in the context of charitable campaigns, it would have done
so.
[51]
It
is of interest that at paragraph 55 of its decision, the learned judge notes
that in other respects, Parliament may have been rather vague in setting out
the considerations that should apply thereby giving the Board more leeway to
determine these issues.
[52]
In
the present case, the legislator could have simply provided that the patentee
had to disgorge the excessive revenues it earned, leaving it to the patentee to
determine when and how this should be done. Instead, in 1993, it chose to give
the Board a strengthened mandate and the power to intervene with respect to
offsetting/compensation to protect consumers’ interests by adding, among other
things, subsection 83(2) in the Act.
[53]
The
Court agrees with Sanofi, that this does not mean that in this regime, which
favours voluntary compliance, a patentee cannot voluntarily take steps to
offset excessive revenues earned as soon as they wish to do so. If patentees
choose this route, without seeking the Board’s or the chairperson of the
Board’s approval through a VCU, for example, they do so at their own peril
since the Board, who is accountable to Parliament to fulfill its mandate, can always
review their actions to ensure that they have indeed provided proper
compensation.
[54]
Sanofi
says that this is a special case because its client base remained the same
throughout. Thus, price reductions conceded to these customers should be an
appropriate means of offsetting or compensating for the harm done. Although in
other cases this may well be so, in the particular circumstances of this case,
I cannot agree with the applicant. In effect, here, regardless of Sanofi’s
intention
and focussing only on the factual scenario, there is simply no evidence
establishing that, on a balance of probabilities, this customer base actually
benefited of a price reduction that properly compensated them for the amount
they paid in excess had Sanofi not charged them excessive prices in 2002-2006.
[55]
The
Court asked the parties to provide, in writing, a list of the evidence that
could be relevant to the issues before it.
[56]
As
mentioned earlier, although the prices in 2007 and 2008 were substantially
lower than in 2006 and were below their MNE, Sanofi presented no evidence that would
definitely establish that, on a balance of probabilities, such reduction was in
any way different – let alone substantially different – than the reductions
that normally occur when a patented pharmaceutical product like theirs is put
to tender in a competitive environment for the first time. Mr.
Kreker was quite clear that he expected a significant drop in price and this
clearly had nothing to do with the excessive revenues earned by Sanofi.
[57]
Having
carefully reviewed the material provided, the Court cannot agree with Sanofi
that, in the circumstances, the Board’s order was or ought to be considered a
punitive award.
[58]
This
means that there is a range of possible, acceptable outcomes which were
defensible on law and the facts. I must, thus, consider if what the Board did falls
in this range.
B. Did the Board exceed its jurisdiction by
abusing its discretion?
[59]
Sanofi
argues that the Board ordered it to offset its excessive revenues based on pure
speculation and conjecture and while ignoring the evidence. It says that it
never meaningfully considered the circumstances of the case before it. Thus, it
is fair to reframe this question simply as whether or not the decision made was
reasonable. In effect, both parties agree that however one frames the question
it involves a question of fact or mixed fact and law which must be reviewed on
the standard of reasonableness. Considering the decisions of this Court in Hoechst
Marion Roussel Canada Inc v Canada (Attorney General), 2005 FC 1552 and in Leo
Pharma, above, where the Court reviewed the nature of the review mechanisms
available, the relative expertise of the Board, the purpose of the Act
in the context of mixed questions of fact and law, I cannot but agree with the
parties that this standard should also apply to pure questions of fact (Dunsmuir,
above, at para 57).
[60]
This
leaves the issue of the fettering of discretion as Sanofi argues that the Board
blindly followed its Guidelines and past Board decisions. Although in Thamotharem
v Canada (Minister of Citizenship and Immigration), 2007 FCA 198 at para 33
the Federal Court of Appeal applied a correctness standard to determine whether
the application of a particular guideline was an unlawful fettering of
discretion, in the more recent case of Waycobah First Nation v Canada
(Attorney General), 2010 FC 1188 at para 23, the
Court applied the reasonableness standard to this question of law, which is not
of central importance to the legal system and is not outside the specialized
area of the administrative decision-maker.
[61]
In
the present case, I am far from convinced that the question before me is truly
one of law and in any event I would have concluded that I should apply the
standard of reasonableness considering that Sanofi’s real concern is not that
the Board felt compelled to apply the Guidelines and follow its previous
decisions, but rather that its approach in determining whether to apply them
was deficient.
[62]
In
effect, the Court agrees with the Respondent that the Board clearly appreciated
that the Guidelines were not binding on it as it rejected some arguments by
Board Staff and made significant findings that departed from the Guidelines,
based on its consideration of the particular facts of the case. The Board
mentions at the end of paragraph 57, that it finds the approach taken in the
Guidelines appropriate and in paragraph 56 that it concurs with the reasoning
of the two panels in the Nicoderm and Copaxone proceedings as opposed to simply
their conclusions.
[63]
The
real problem if the Board was truly directing itself to the issue of
compensation under subsection 83(2) of the Act in these paragraphs (53
to 57), is to determine how the Guidelines and the cited Board decisions deal
with the particular issue facing the Board. Also, once this is done, whether it
is a reasonable answer in this particular case.
[64]
For
example, in paragraphs 56 and 57 did the Board mean to say that any
remedial action taken by a patentee under investigation, outside of a VCU and
without a prior Board order, should be disregarded and considered inappropriate
to compensate or offset excessive revenues, whatever the circumstances?
[65]
If
this were so, considering my comments in para 53 above, it would likely not be
an acceptable outcome justifiable on the law.
[66]
On
the other hand, were these paragraphs simply intended to deal with Sanofi’s
argument that its position with respect to compensation and offsetting, was in
line with the Board’s past practice (including for example, the VCUs in the
Forteo and Aromacin proceedings),
and to address its argument that they genuinely had a legitimate expectation
that the method they chose to offset their excessive revenues was acceptable
(based on the general wording of the Guidelines and correspondence with Board
Staff)?
[67]
Considering the
parameters of the doctrine of legitimate expectations (see Canada (Attorney
General) v Mavi, 2011 SCC 30 at para 68) it may well be open to the
Board to find that the previous VCUs and the fact that the Board had already
issued two decisions contradicting Sanofi’s interpretation of these VCUs, combined
with the Guidelines (as understood by Sanofi) cannot constitute clear,
unambiguous and unqualified representations on which Sanofi could base its
legitimate expectation.
[68]
What did the Board
mean when it said that “the later reduction in prices cannot be presumed, or
even expected, to remedy the potential harm done […] this is true whether
or not the customer base remained the same throughout the two periods […]”?
Could this really be intended to deal with this particular case when one
considers that in its original paragraph 84, the Board decided that it was
appropriate to remedy the harm done in this case through a price reduction
because the customer base remained essentially the same?
[69]
When it notes, in the
last two sentences of para 55, “because the effect of excessive prices on the
purchasing decisions made by the customer base will likely be a matter for
speculation only”, was the Board making a finding based on the evidence it
heard or was it making a general statement? If the former, was this conclusion
reached because of the lack of credibility of a particular witness or was it
because the probative value of the evidence produced was simply insufficient?
[70]
The
standard of review applicable here requires that the Court inquires into the
justification, transparency and intelligibility of the decision.
[71]
In
Vancouver International Airport Authority v Public Service Alliance of
Canada, 2010 FCA 158 [Vancouver] recently followed in Holmes v Canada
(Minister of Public Safety and Emergency Preparedness), 2011 FC 112 at
paragraph 43, the Federal Court of Appeal revisited the issue of adequacy of
reasons setting out some very fundamental purposes this obligation seeks to
achieve. It is worth reproducing paragraph 16 of Vancouver, above:
Where, as here, an administrative
decision-maker, acting under a procedural duty to receive and consider full
submissions, is adjudicating on a matter of significance, what sort of reasons
must it give? From the above authorities, and bearing in mind a number of
fundamental principles in the administrative law context, the adequacy of the
decision-maker's reasons in situations such as this must be evaluated with four
fundamental purposes in mind:
(a) The substantive purpose. At
least in a minimal way, the substance of the decision must be understood, along
with why the administrative decision-maker ruled in the way that it did.
(b) The procedural purpose. The
parties must be able to decide whether or not to invoke their rights to have
the decision reviewed by a supervising court. This is an aspect of procedural
fairness in administrative law. If the bases underlying the decision are
withheld, a party cannot assess whether the bases give rise to a ground for
review.
(c) The accountability purpose.
There must be enough information about the decision and its bases so that the
supervising court can assess, meaningfully, whether the decision-maker met
minimum standards of legality. This role of supervising courts is an important
aspect of the rule of law and must be respected: Crevier v. Attorney General
of Quebec, [1981] 2 S.C.R. 220; Dunsmuir, supra at paragraphs 27 to
31. In cases where the standard of review is reasonableness, the supervising
court must assess "whether the decision falls within a range of possible,
acceptable outcomes which are defensible in respect of the facts and law":
Dunsmuir, supra at paragraph 47. If the supervising court has been
prevented from assessing this because too little information has been provided,
the reasons are inadequate: see, e.g., Canadian Association of Broadcasters,
supra at paragraph 11.
(d) The "justification,
transparency and intelligibility" purpose: Dunsmuir, supra at
paragraph 47. This purpose overlaps, to some extent, with the substantive
purpose. Justification and intelligibility are present when a basis for a
decision has been given, and the basis is understandable, with some discernable
rationality and logic. Transparency speaks to the ability of observers to
scrutinize and understand what an administrative decision-maker has decided and
why. In this case, this would include the parties to the proceeding, the
employees whose positions were in issue, and employees, employers, unions and
businesses that may face similar issues in the future. Transparency, though, is
not just limited to observers who have a specific interest in the decision. The
broader public also has an interest in transparency: in this case, the Board is
a public institution of government and part of our democratic governance
structure.
[72]
The
Court also sets out a number of important principles established in prior
authorities that must be kept in mind when determining whether these
fundamental purposes are met. The first principle is that extraneous material
can be relevant to understand why a decision-maker ruled the way he or she did.
Second, “[t]he adequacy of reasons is not measured by the pound”. Thirdly, a
judge ruling on adequacy of reasons must not be allowed to frustrate
Parliament’s intention to remit decisions to specialized administrative
tribunals and “should make allowance for the ‘day-to-day realities’ of
administrative tribunals”. Finally, judges should practice judicial restraint
and ensure only that legal minimums are met (see paragraph 17).
[73]
Having
read and re-read the relevant portions this decision a number of times, the
Court simply cannot decipher on what basis the Board discarded, in the unique
circumstances of this case, Sanofi’s argument that it had, either totally, if
not at least in part, compensated for its excessive revenues. The respondent
insisted at the hearing before me, that in the particular circumstances,
considering that Sanofi was engaged in a competitive bidding process, the
decision made sense. However, nowhere does the Board refer to this circumstance
which was at the core of Board Staff’s position. Where does it fit in the
reasons expressed in paragraphs 53-57? Was it even considered?
[74]
The
Court is simply not in a position to exercise its duty to review the legality of
the Board’s decision and to determine if it was within the range of possible
and acceptable outcomes. The decision does not meet the applicable standard. It
is not reasonable because of its lack of transparency, intelligibility and
justification. It must be set aside and the matter remitted for reconsideration.
[75]
The
parties have agreed that the costs in this matter should be fixed at $12,000.00
(inclusive of disbursements and GST).
[76]
Since
the Board’s order of March 16, 2010 is now a nullity, the payment made by
Sanofi in the amount of $2,512,878.74 to the Consolidated Revenue Fund should
be returned promptly to the Applicant together with appropriate interest. The
Respondent is requested to give prompt attention to this matter.
POSTSCRIPT
[1]
These
Reasons for Judgment are un-redacted from confidential Reasons for Judgment
which were issued on July 8, 2011.
[2]
The
Court canvassed counsel for the parties whether they had concerns if the
reasons were issued to the public without redactions and they confirmed they
had none.
JUDGMENT
THIS COURT’S JUDGMENT
is that
this application is allowed with costs to the
applicant fixed in the amount of $12,000.00 which is inclusive of all fees,
disbursements and GST. The order dated March 16, 2010 is declared null and void
and the respondent is requested to give prompt attention to the matter of the
return to the applicant of the sum of $2,512,878.74 together with appropriate
interest.
“Johanne
Gauthier”
APPENDIX “A”
Patent Act, RSC 1985, c P-4
Excessive
Prices
Order re
excessive prices
83. (1)
Where the Board finds that a patentee of an invention pertaining to a
medicine is selling the medicine in any market in Canada at a price that, in
the Board’s opinion, is excessive, the Board may, by order, direct the patentee
to cause the maximum price at which the patentee sells the medicine in that
market to be reduced to such level as the Board considers not to be excessive
and as is specified in the order.
Idem
(2) Subject
to subsection (4), where the Board finds that a patentee of an invention
pertaining to a medicine has, while a patentee, sold the medicine in any
market in Canada at a price that, in the Board’s opinion, was excessive, the
Board may, by order, direct the patentee to do any one or more of the
following things as will, in the Board’s opinion, offset the amount of the
excess revenues estimated by it to have been derived by the patentee from the
sale of the medicine at an excessive price:
(a) reduce the
price at which the patentee sells the medicine in any market in Canada, to such extent and for such period as is specified in
the order;
(b) reduce the
price at which the patentee sells one other medicine to which a patented
invention of the patentee pertains in any market in Canada, to such extent
and for such period as is specified in the order; or
(c) pay to Her
Majesty in right of Canada an amount specified in the order.
Idem
(3) Subject
to subsection (4), where the Board finds that a former patentee of an
invention pertaining to a medicine had, while a patentee, sold the medicine
in any market in Canada at a price that, in the Board’s opinion, was
excessive, the Board may, by order, direct the former patentee to do any one
or more of the following things as will, in the Board’s opinion, offset the
amount of the excess revenues estimated by it to have been derived by the
former patentee from the sale of the medicine at an excessive price:
(a) reduce the
price at which the former patentee sells a medicine to which a patented
invention of the former patentee pertains in any market in Canada, to such
extent and for such period as is specified in the order; or
(b) pay to Her
Majesty in right of Canada an amount specified in the order.
Where policy
to sell at excessive price
(4) Where
the Board, having regard to the extent and duration of the sales of the
medicine at an excessive price, is of the opinion that the patentee or former
patentee has engaged in a policy of selling the medicine at an excessive
price, the Board may, by order, in lieu of any order it may make under
subsection (2) or (3), as the case may be, direct the patentee or former
patentee to do any one or more of the things referred to in that subsection
as will, in the Board’s opinion, offset not more than twice the amount of the
excess revenues estimated by it to have been derived by the patentee or
former patentee from the sale of the medicine at an excessive price.
Excess
revenues
(5) In
estimating the amount of excess revenues under subsection (2), (3) or (4),
the Board shall not consider any revenues derived by a patentee or former
patentee before December 20, 1991 or any revenues derived by a former
patentee after the former patentee ceased to be entitled to the benefit of
the patent or to exercise any rights in relation to the patent.
Right to
hearing
(6) Before
the Board makes an order under this section, it shall provide the patentee or
former patentee with a reasonable opportunity to be heard.
Limitation
period
(7) No
order may be made under this section in respect of a former patentee who,
more than three years before the day on which the proceedings in the matter
commenced, ceased to be entitled to the benefit of the patent or to exercise
any rights in relation to the patent.
[…]
Factors to be
considered
85. (1)
In determining under section 83 whether a medicine is being or has been sold
at an excessive price in any market in Canada, the Board shall take into
consideration the following factors, to the extent that information on the
factors is available to the Board:
(a) the prices
at which the medicine has been sold in the relevant market;
(b) the prices
at which other medicines in the same therapeutic class have been sold in the
relevant market;
(c) the prices
at which the medicine and other medicines in the same therapeutic class have
been sold in countries other than Canada;
(d) changes in
the Consumer Price Index; and
(e) such other
factors as may be specified in any regulations made for the purposes of this
subsection.
Additional
factors
(2) Where,
after taking into consideration the factors referred to in subsection (1),
the Board is unable to determine whether the medicine is being or has been
sold in any market in Canada at an excessive price, the Board may take into
consideration the following factors:
(a) the costs
of making and marketing the medicine; and
(b) such other
factors as may be specified in any regulations made for the purposes of this
subsection or as are, in the opinion of the Board, relevant in the
circumstances.
Research costs
(3) In
determining under section 83 whether a medicine is being or has been sold in
any market in Canada at an excessive price, the Board shall not take into
consideration research costs other than the Canadian portion of the world
costs related to the research that led to the invention pertaining to that
medicine or to the development and commercialization of that invention,
calculated in proportion to the ratio of sales by the patentee in Canada of
that medicine to total world sales.
|
Prix
excessifs
Ordonnance
relative aux prix excessifs
83. (1)
Lorsqu’il estime que le breveté vend sur un marché canadien le médicament à
un prix qu’il juge être excessif, le Conseil peut, par ordonnance, lui
enjoindre de baisser le prix de vente maximal du médicament dans ce marché au
niveau précisé dans l’ordonnance et de façon qu’il ne puisse pas être
excessif.
Idem
(2) Sous
réserve du paragraphe (4), lorsqu’il estime que le breveté a vendu, alors
qu’il était titulaire du brevet, le médicament sur un marché canadien à un
prix qu’il juge avoir été excessif, le Conseil peut, par ordonnance, lui
enjoindre de prendre l’une ou plusieurs des mesures suivantes pour compenser,
selon lui, l’excédent qu’aurait procuré au breveté la vente du médicament au
prix excessif :
a)
baisser, dans un marché canadien, le prix de vente du médicament dans la
mesure et pour la période prévue par l’ordonnance;
b)
baisser, dans un marché canadien, le prix de vente de tout autre médicament
lié à une invention brevetée du titulaire dans la mesure et pour la période
prévue par l’ordonnance;
c)
payer à Sa Majesté du chef du Canada le montant précisé dans l’ordonnance.
Idem
(3) Sous
réserve du paragraphe (4), lorsqu’il estime que l’ancien breveté a vendu,
alors qu’il était titulaire du brevet, le médicament à un prix qu’il juge
avoir été excessif, le Conseil peut, par ordonnance, lui enjoindre de prendre
l’une ou plusieurs des mesures suivantes pour compenser, selon lui,
l’excédent qu’aurait procuré à l’ancien breveté la vente du médicament au
prix excessif :
a)
baisser, dans un marché canadien, le prix de vente de tout autre médicament
lié à une invention dont il est titulaire du brevet dans la mesure et pour la
période prévue par l’ordonnance;
b)
payer à Sa Majesté du chef du Canada le montant précisé dans l’ordonnance.
Cas de
politique de vente à prix excessif
(4) S’il
estime que le breveté ou l’ancien breveté s’est livré à une politique de
vente du médicament à un prix excessif, compte tenu de l’envergure et de la
durée des ventes à un tel prix, le Conseil peut, par ordonnance, au lieu de
celles qu’il peut prendre en application, selon le cas, des paragraphes (2)
ou (3), lui enjoindre de prendre l’une ou plusieurs des mesures visées par ce
paragraphe de façon à réduire suffisamment les recettes pour compenser, selon
lui, au plus le double de l’excédent procuré par la vente au prix excessif.
Excédent
(5) Aux
fins des paragraphes (2), (3) ou (4), il n’est pas tenu compte, dans le
calcul de l’excédent, des recettes antérieures au 20 décembre 1991 ni, dans
le cas de l’ancien breveté, des recettes faites après qu’il a cessé d’avoir
droit aux avantages du brevet ou d’exercer les droits du titulaire.
Droit
à l’audition
(6) Avant
de prendre une ordonnance en vertu du présent article, le Conseil doit donner
au breveté ou à l’ancien breveté la possibilité de présenter ses
observations.
Prescription
(7) Le
présent article ne permet pas de prendre une ordonnance à l’encontre des
anciens brevetés qui, plus de trois ans avant le début des procédures, ont
cessé d’avoir droit aux avantages du brevet ou d’exercer les droits du
titulaire.
[…]
Facteurs
de fixation du prix
85. (1)
Pour décider si le prix d’un médicament vendu sur un marché canadien est
excessif, le Conseil tient compte des facteurs suivants, dans la mesure où
des renseignements sur ces facteurs lui sont disponibles :
a)
le prix de vente du médicament sur un tel marché;
b)
le prix de vente de médicaments de la même catégorie thérapeutique sur un tel
marché;
c)
le prix de vente du médicament et d’autres médicaments de la même catégorie
thérapeutique à l’étranger;
d)
les variations de l’indice des prix à la consommation;
e)
tous les autres facteurs précisés par les règlements d’application du présent
paragraphe.
Facteurs
complémentaires
(2) Si,
après avoir tenu compte de ces facteurs, il est incapable de décider si le
prix d’un médicament vendu sur un marché canadien est excessif, le Conseil
peut tenir compte des facteurs suivants :
a)
les coûts de réalisation et de mise en marché;
b)
tous les autres facteurs précisés par les règlements d’application du présent
paragraphe ou qu’il estime pertinents.
Coûts
de recherche
(3) Pour
l’application de l’article 83, le Conseil ne tient compte, dans les coûts de
recherche, que de la part canadienne des coûts mondiaux directement liée à la
recherche qui a abouti soit à l’invention du médicament, soit à sa mise au
point et à sa mise en marché, calculée proportionnellement au rapport entre
les ventes canadiennes du médicament par le breveté et le total des ventes
mondiales.
|
Patented
Medicines Prices Preview Board, Compendium of Guidelines, Policies and
Procedures (updated to 2009), online: Patented Medicines Prices Review
Board <http://www.pmprb-cepmb.gc.ca/english/View.asp?x=1034>.
7. Voluntary
Compliance Undertakings (VCUs)
7.1 A patentee
may make a VCU to adjust its price and to take other remedial action as may be
appropriate at any time.
7.2 It is the
policy of the Board that only the Chairperson or the Board itself may approve a
VCU.
7.3 The Chairperson
is authorized to approve a VCU in lieu of issuing a Notice of Hearing if
satisfied that it meets the objectives of the Act and conforms to the policies
of the Board which may b established from time to time. If the undertaking is
made after the issuance of a Notice of Hearing, it may only be approved by the
Hearing Panel of the Board as a basis for terminating or adjourning the
proceeding following an opportunity for submissions by all parties.
7.4 The
Chairperson is not authorized to negotiate the terms of a VCU with a patentee.
In deciding whether to accept a VCU, the Chairperson will be guided by section
83 of the Act and the policy of the Board that the price should be adjusted to
conform to the Guidelines and that the patentee offset any excess revenues
received since the price first exceeded the Guidelines.
7.5 The proposed
VCU should include a statement as to the maximum price the patentee proposes to
charge for the drug product, and the relevant dates, to be consistent with the
Guidelines and policies of the Board, and where appropriate, the means by which
it proposes to, offset the excess revenues it received during the period the
price was outside the Guidelines.
7.6 In most
cases, the VCU should specify a payment to Her Majesty in Right of Canada as
the means to offset excess revenues.
7.7 The proposal
of a VCU does not constitute an admission by the patentee that the price of the
drug product is or was excessive.
7.8 The Board
will report publicly on all VCUs accepted by the Chairperson or the Board. The
information reported will ordinarily include the names of the drug product and
the patentee and such other information as it considers appropriate. This
information will be included in the PMPRB´s Annual Report and may also be published
in the NEWSletter, on the PMPRB Web site or other publications. Privileged or
confidential information will not be included in the report except to the
extent that such information has been made public in a proceeding.
8. Remedial
Orders
8.1 If the Chairperson
is of the view that the investigation has revealed that the price exceeded the
Guidelines or otherwise may be or has been excessive, the Chairperson may
commence a formal proceeding by issuing a Notice of Hearing and establishing a
Hearing Panel of the Board for that proceeding.
8.2 The
determination by the Board of the appropriate remedy, if any, in any case will
be made by the Board in light of the evidence available to it.
8.3 Where the
Board finds, following a public hearing, that the price of a patented drug
product is excessive, it may make an order pursuant to subsection 83(1)
requiring the patentee to reduce the price of the drug product to a level the
Board considers not to be excessive.
8.4 In addition,
the Board may order the price to be further reduced, pursuant to subsection
83(2), for a specified period of time to offset any excess revenues received by
the patentee. The Board will take into consideration any submissions as to why
it may be inappropriate to order such a reduction given the facts of the case.
8.5 In the
alternative, or in addition to a price reduction order, the Board may order a
price reduction with respect to one other patented medicine being sold by the
patentee.
8.6 In the case
of a former patentee, the Board may order, pursuant to subsection 83(3), a
reduction in the price of another patented medicine to offset the excess
revenues received by the former patentee.
8.7 If the above
remedies are not considered appropriate, or if there are no medicines with
respect to which the Board may make an order, the Board may order the payment
by the patentee to Her Majesty in Right of Canada under subsection 83(2), or by
the former patentee, under subsection 83(3), as the case may be, of an amount
equal to the excess revenues.
8.8 If the Board
finds that there has been a policy of selling the drug product at an excessive
price, for example if the patentee has failed to comply with a previous price
reduction order, the Board may, pursuant to subsection 83(4), order further price
reductions or monetary payments to recover twice the excess revenues received
by the patentee.
8.9 All orders
by the Board, under section 83, will be registered with the Federal Court of
Canada pursuant to section 99, and may be enforced thereafter, in the
discretion of the Board, as an order of the Federal Court.
8.10 Evidence
that a patentee has failed to comply with an order of the Board under section
83 respecting price will be brought to the attention of the Chairperson who may
decide to issue a Notice of Hearing.
8.11 If the
Board finds that a patentee has failed to comply with an order of the Board
respecting price under section 83 it may issue a further order including an
order to recover double the excess revenues if it finds that there has been a
policy of selling at an excessive price.
8.12 At any
time, in lieu of or in addition to the Board´s own proceeding, the Board will
refer any evidence that the patentee intentionally failed to comply with an
order respecting price to the Attorney-General of Canada for proceedings under
subsection 76(1) or contempt of court as may be appropriate.
Schedule 5 –
Criteria for Commencing an Investigation
The PMPRB's
Compliance and Enforcement Policy provides that the Board may establish
criteria for identifying cases for investigation from time to time. The
criteria, which are subject to change, may include the amount by which a price
exceeds the Guidelines and the amount of excess revenues along with other
factors.
The criteria
balance the need for pricing flexibility on the part of patentees with the
PMPRB's mandate of protecting consumers by ensuring that the prices of patented
drug products are not excessive. The Board publishes its criteria for
commencing an investigation to improve transparency and to provide patentees
with greater certainty as to their responsibilities in the regulatory process.
A price is
considered to be within the Guidelines unless it meets the criteria for
commencing an investigation. The criteria represent the standards the Board
applies in order to allocate its resources to investigations as efficiently as
possible. Their existence should not be construed as indicating that the Board
accepts any deviation from the Guidelines. The Board is satisfied that its
criteria assure all significant cases of pricing outside the Guidelines will be
subject to an investigation. In most instances where a price exceeds the
maximum allowable price by an amount too small to trigger an investigation in
one year, it is offset by a price below that which is permitted by the
Guidelines the following year. The Board expects the prices of all patented
medicines to be within the Guidelines and evidence of persistent pricing
outside the Guidelines, even by a small amount, may be used as a criterion for commencing
an investigation.
Should the price
of a patented drug product, or its cumulative excess revenues ever meet the
criteria, an investigation will be initiated in conformity with the Compliance
and Enforcement Policy. If the investigation confirms that the price exceeds
the Guidelines, the patentee may choose to voluntarily adjust its price and
offset the excess revenues through a Voluntary Compliance Undertaking (VCU).
Patentees will
be advised of cumulative excess revenues for each of their DIN´s as part of the
compliance reports they receive from the PMPRB. Excess revenues below the
amount specified in the criteria can be reduced voluntarily by the patentees in
subsequent years by pricing below the maximum non-excessive price. However,
cumulative excess revenues cannot fall below zero.
Criteria
for Commencing an Investigation
|
Board Staff
will commence an investigation into the price of a patented drug product when
any of the following criteria are met:
New Drug
Products
- The
introductory price is 5% or more above the maximum non-excessive price;
- Excess
revenues in the introductory period are $25,000 or more; or
- Complaints
with significant evidence.
Existing
Drug Products
- A price is
5% or more above the maximum non-excessive price and there are cumulative
excess revenues of $25,000 or more over the life of the patent after
January 1, 1992;
- Cumulative
excess revenues are $50,000 or more over the life of the patent after
January 1, 1992; or
- Complaints
with significant evidence.
|
Patented
Medicines Prices Preview Board, Compendium of Guidelines, Policies and
Procedures (current version), online: Patented Medicines Prices Review
Board <http://www.pmprb-cepmb.gc.ca/english/View.asp?x=1206&mp=73>.
C.12 Review of Prices of Existing Patented Drug Products
C.12.1 The
price of an existing patented drug product will be presumed to be excessive if
the National Average Transaction Price exceeds the National Non-Excessive
Average Price as determined by the lower of:
• The change in the CPI as per
the CPI-Adjustment Methodology (see Schedule 9); or
• The result
of the Highest International Price Comparison test (see Schedule 6).
C.12.2 If
the National Average Transaction Price exceeds the National Non-Excessive
Average Price by an amount which triggers the investigation criteria (see
Schedule 11), Board Staff shall review the Market-Specific Average Transaction
prices. Board Staff shall also review the prices in these markets, if a
complaint is the trigger for the commencement of an investigation.
• The price in each of three
classes of customer (hospital, wholesaler, pharmacy) and in each
province/territory will be presumed to be excessive if the Market-Specific
Average Transaction Price exceeds the Market-Specific Non-Excessive Average
Price as determined by the change in the CPI as per the CPI-Adjustment
Methodology (see Schedule 9).
• In addition, the price in each
of two classes of customer (hospital and pharmacy) and in each
province/territory will be presumed to be excessive if the Market-Specific
Average Transaction Price exceeds the Market-Specific Non-Excessive Average
Price as determined by the Highest International Price Comparison test (see
Schedule 6).
C.12.3 In
the event that the actual change in the CPI is less than the forecast CPI and
an apparent excessive price arises solely due to the patentee’s reliance on the
forecast CPI, the price will not be presumed to be excessive. The patentee is
expected to comply with the actual CPI in all subsequent reporting periods, and
the application of the CPI-Adjustment Methodology for the forecasted year will
be based on the actual change in the CPI for that year. The result for
patentees that took price increases based on the forecast inflation will be
that the actual change in the CPI for the forecasted year will be used to
calculate the next year’s National and Market-Specific Non-Excessive Average
Prices.
C.12.4 In
addition, when a patentee can demonstrate that an increase in the National
Average Transaction Price is due solely to a sales-mix shift and none of the
Market-Specific Average Transaction Prices for each class of customer and in
each province/territory exceed their respective Market-Specific Non-Excessive
Average Prices as determined by the CPI-Adjustment Methodology, the National
Average Transaction Price will not be presumed to be excessive.
C.12.5 When
the National Average Transaction Price or a Market-Specific Average Transaction
Price of a drug product increases from a previous year due to the reduction or
end of a benefit(s) and the patentee provides evidence to demonstrate that the
price increase was due solely to the reduction or termination of the
benefit(s), it may be appropriate to adjust the Non-Excessive Average Prices
(national and market-specific) through the DIP Methodology, as described in
Schedule 10.
C.12.6 The
Board recognizes that there may be cost of making and marketing arguments,
whereby it may be appropriate to adjust the Non-Excessive Average Price(s) of a
patented drug product (e.g., once a Notice of Compliance has been obtained and
the drug product was first sold on a compassionate basis as an Investigational
New Drug, through a Clinical Trial Application or under the Special Access
Programme).
C.12.7 The
PMPRB may review the price of any existing patented drug product in any market
in Canada (e.g., by class of customer in a province/territory).
Investigations
C.13
Introduction
C.13.1 When
the price of a patented drug product appears to exceed the Guidelines but not
by an amount that triggers the investigation criteria (Schedule 11), the
patentee will be notified and the patented drug product will be reported on the
PMPRB’s Web site as “Does Not Trigger Investigation”. The patentee will be
expected to reduce its National Average Transaction Price and Market-Specific Average
Transaction Prices and to offset any excess revenues that may have accrued (see
Schedule 13), but no immediate action will be taken by Board Staff.
C.13.2 When
the National Average Transaction Price of a patented drug product appears to
exceed the National Non-Excessive Average Price and the circumstances are
within the criteria established by the Board (Schedule 11), the patentee will
be notified of the commencement of an investigation and the patented drug
product will be reported on the PMPRB’s Web site as “Under Investigation.”
C.13.3 The
examination will include an analysis of the pricing history of the patented
drug product from introduction for both the National Average Transaction Price
and Market-Specific Average Transaction Prices (i.e., for each class of
customer (hospital, pharmacy, wholesaler) and each province/territory).
C.13.4 The
International Therapeutic Class Comparison (ITCC) test compares the price of
the patented drug product with the publicly available ex-factory prices in the
comparator countries listed in the Regulations of comparable drug products
identified in the domestic price test (i.e., the RR or TCC test). The ITCC test
will only be conducted on a case-by-case basis if it appears it might provide
information in the context of an investigation into apparent excessive prices.
It will not be used as a primary price test. This test is described in Schedule
7.
C.13.5 The
period of time available to the patentee to respond to Board Staff following a
notification that an investigation has been commenced is ordinarily brief. For
example, if the patentee should have known that a price would appear excessive
based on its own filings (e.g., where the price increased by more than would be
permitted under the CPI-Adjustment Methodology), the period of time may be as
short as seven calendar days. A longer period of time, 30 calendar days, may be
available if it is reasonable to believe that the patentee might have been
unaware that the National Average Transaction Price or Market-Specific Average
Transaction Prices may appear to be excessive (e.g., if HDAP has recommended
the use of different drug products for comparison purposes or dosage regimens
from those which were proposed by, and may have been reasonably anticipated by,
the patentee).
C.13.6 There
are three possible outcomes to an investigation:
• The National Average
Transaction Price and/or Market-Specific Average Transaction Prices do not
appear to be excessive; or
• The National Average
Transaction Price and/or Market-Specific Average Transaction Prices appear to
be excessive and the patentee submits an acceptable Voluntary Compliance
Undertaking (VCU); or
• The National Average
Transaction Price and/or Market-Specific Average Transaction Prices appear to
be excessive and the patentee does not submit an acceptable VCU in which case
Board Staff will refer the matter to the Chairperson and recommend the issuance
of a Notice of Hearing.
Schedule 13 – Offset of Excess Revenues
Approaches to offset excess revenues
1.1 Subject
to section 1.3.1 below, if the investigation criteria have not been triggered,
patentees will be given the opportunity to take a voluntary price reduction to
offset excess revenues.
1.2 Once
the investigation criteria have been triggered, patentees will only be
permitted to offset cumulative excess revenues pursuant to the specific terms
of an approved VCU or a Board Order.
Timeframes to offset excess revenues
1.3 Patentees
are expected to offset excess revenues in a timely manner. The following
parameters will generally be applied in the determination of repayment terms.
1.3.1 Excess
revenue balances below the amount sufficient to trigger the investigation
criteria that are carried for six consecutive six month reporting periods (3
years) will be expected to be offset through a VCU. Failing this, Board Staff
will refer the matter to the Chairperson.
1.3.2 In
the context of a VCU, and subject to the specific terms of the VCU, patentees
will generally be allowed:
• 30 days following the Board’s
acceptance of the VCU to make payment; or
• Until the end of the following
reporting period to offset excess revenues through a price reduction. Any
excess revenues remaining at the end of the specified period would be due in
payment.