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The article explores the problem in the pricing and procurement of orphan drugs using an old orphan drug, trientine, for the treatment of Wilson disease, as an example. Topics covered include the aim of the traditional laws for orphan drugs in Canada, the regulatory status of D-penicillamine and trientine as oral treatments for Wilson disease, in Canada, and the reason pharmaceutical firm Valeant Canada announced that the price of Syprine would match the U.S. price.

The article discusses the impact of price negotiation through rebates to the drug expenditure of the patients. It highlights the development of publicly funded prescription insurance plans with a co-insurance payment structure for the patients. It also cites the confidentiality of pricing agreements between the government and pharmaceutical manufacturers.