Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
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<strong>Health</strong> systems in transition <strong>Canada</strong> 109<br />
deeper coverage than residents living in the four Atlantic provinces (Romanow,<br />
2002). In response to this policy problem, some experts have long argued<br />
<strong>for</strong> a single national drug plan and <strong>for</strong>mulary as well as a single agency to<br />
regulate pharmaceutical pricing. However, such an approach is challenged by<br />
two opposing imperatives: that of provincial governments, especially Quebec,<br />
which wish to retain control over provincial drug policies including prescription<br />
drug plans, and that of the federal government, which has resisted assuming the<br />
financial burden and future fiscal risk of a federally financed and administered<br />
pharmaceutical coverage programme (Marchildon, 2007).<br />
With the exception of Quebec, governments agreed to allow CADTH to<br />
establish a pan-Canadian process to review the clinical and cost-effectiveness<br />
of new prescription drugs the CDR, which began in 2003. However, the CDR<br />
makes only recommendations, and provincial governments ultimately decide<br />
whether or not to consider CDR analyses in determining whether or not to<br />
include specific pharmaceuticals in their respective <strong>for</strong>mularies. In 2004, as<br />
part of the 10-Year Plan to Strengthen <strong>Health</strong> Care signed by first ministers,<br />
all P/T governments, except <strong>for</strong> Quebec, established a task <strong>for</strong>ce of ministers<br />
of health to develop and implement a “National Pharmaceuticals Strategy” that<br />
encompassed the following nine action items (CICS, 2004):<br />
• in response to ongoing concerns about the financial insecurity caused<br />
by poor and inconsistent coverage of expensive drugs (Phillips, 2009), to<br />
develop, assess and cost the options <strong>for</strong> catastrophic coverage;<br />
• establish a common national drug <strong>for</strong>mulary <strong>for</strong> participating jurisdictions<br />
based on safety and cost-effectiveness;<br />
• accelerate access to breakthrough drugs <strong>for</strong> unmet health needs through<br />
improvement to the federal drug approval process;<br />
• strengthen evaluation of drug safety and effectiveness;<br />
• pursue purchasing strategies to obtain best prices <strong>for</strong> Canadians <strong>for</strong> drugs<br />
and vaccines;<br />
• enhance action to influence the prescribing behaviour of health care<br />
professionals so that drugs are used only when needed and the right drug<br />
is used <strong>for</strong> the right problem;<br />
• broaden the practice of e-prescribing through accelerated development<br />
and deployment of EHRs;<br />
• accelerate access to non-patented drugs and achieve international parity<br />
on prices of generic drugs; and