Pharmaceutical cost control in Canada: Does it work?

Health Affairs

Volumn 20, Issue 3, 2001, Pages 92-103

  Menon, Devidas ^a  

^a UNIVERSITY OF ALBERTA   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CANADA; COST CONTROL; DRUG COST; ECONOMICS; HEALTH CARE QUALITY; LEGAL ASPECT; PRESCRIPTION; PUBLIC HEALTH; PUBLICATION;

CANADA; COST CONTROL; DRUG COSTS; FORMULARIES; NATIONAL HEALTH PROGRAMS; PRESCRIPTIONS, DRUG; PROGRAM EVALUATION;

EID: 0035346759     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.20.3.92     Document Type: Article

References (28)

1. P.K. Gorecki and I. Henderson, "Compulsory Patent Licensing of Drugs in Canada: A Comment on the Debate," Canadian Public Policy 7, no. 4 (1981): 559-568.
2. J. Lexchin, "Pharmaceuticals, Patents, and Politics," International Journal of Health Services 23, no. 1 (1993): 147-160.
3. Federal/Provincial/Territorial Task Force on Pharmaceutical Prices, "Drug Prices and Cost Drivers 1990 to 1997" (Ottawa: Health Canada, April 1999), 1. An exchange rate of Can$1.4849 for U.S.$1 is used in this paper; this is the rate used by the PMPRB for the period ending December 2000.
4. The federal government in Canada has constitutional responsibility for providing health services to specified populations, such as the First Nations peoples and military veterans. It runs a number of drug benefit programs as a result. Drug costs for these groups are considerably smaller than what provinces pay through their programs.
5. The general powers granted to the PMPRB under the Patent Act include "all such powers, rights and privileges as are vested in a superior court."
6. Patented Medicine Prices Review Board, Annual Report 1999 (Ottawa: Government of Canada, 1999), 28.
7. PMPRB, "A Description of the Laspeyres Methodology Used to Construct the Patented Medicine Price Index (PMPI)," Paper S-9710 (Ottawa: Government of Canada, March 1997).
8. PMPRB, Annual Report 1999, 20.
9. Ibid., 22.
10. The PMPRB uses three-year blocs of time to calculate exchange rates, so that some smoothing of these rates will occur. However, the Canadian dollar fell against many other currencies over the period 1987-1999, and so Canadian prices in U.S. dollars might appear to be low.
11. Report of the Pharmaceutical Inquiry of Ontario, 1990 (Toronto: Government of Ontario, 1990), 17, 18.
12. P. Jacobs and J. Bachynsky, "Public Policies Related to Drug Formularies in Canada: Economic Issues," Institute of Health Economics Working Paper 00-2 (Edmonton: IHE, 2000).
13. D.A. Freund et al., "Outpatient Pharmaceuticals and the Elderly: Policies in Seven Nations," Health Affairs (May/June 2000): 259-266.
14. J.L Glennie et al., "The Revised Canadian Guidelines for the Economic Evaluation of Pharmaceuticals," PharmacoEconomics 15, no. 6 (1999): 459-468.
15. P.R. McLaughlin, "Reference-Based Pricing of Prescription Drugs," Canadian Journal of Cardiology 13, no. 1 (1997): 31-32.
16. Pharmacare Web site, 〈www.hlth.gov.bc.ca/pharme/index.html〉 (10 February 2001).
17. Task Force on Pharmaceutical Prices, "Drug Prices and Cost Drivers."
18. Ibid., 31.
19. R. Livingston, Merck-Frosst Canada Inc., personal communication, 14 February 2000.
20. N. Palmer, "Pharmaceutical Pricing in Canada and the United States," Provincial Reimbursement Advisor 3, no. 1 (2000): 42-47.
21. Canada's Research-Based Pharmaceutical Companies, Annual Review 1999-2000 (Ottawa: Rx&D, December 1999), 17.
22. J.P. Gregoire et al., "Inter-Provincial Variation in Government Drug Formularies," Canadian Journal of Public Health (forthcoming).
23. J.F. Baladi et al., "Use of Economic Evaluation Guidelines: Two Years' Experience in Canada," Health Economics 7, no. 3 (1998): 221-227.
24. University of Victoria Centre on Aging, "BC Seniors Support Reference-Based Pricing," press release, 25 November 1996, 〈www.coag.uvic.ca/sdfp/prsrelse.htm〉 (4 April 2001).
25. C. Bourgault et al., "Reference-Based Pricing of Prescription Drugs: Exploring the Equivalence of Angiotensin-Converting Enzyme Inhibitors," Canadian Medical Association Journal 161, no. 3 (1999): 255-264; L. Narine et al., "Evaluating Reference-Based Pricing: Initial Findings and Prospects," Canadian Medical Association Journal 161, no. 3 (1999): 286-288; and S. Schneeweiss et al., "Intended and Unintended Impacts on Antihypertensive Drug Use by a Policy of Differential Cost Sharing for Angiotensin-Converting Enzyme Inhibitors," Pharmacoepidemiology and Drug Safety 9, Supplement 1 (2000): S65.
26. C. Bourgault et al., "Reference-Based Pricing of Prescription Drugs: Exploring the Equivalence of Angiotensin-Converting Enzyme Inhibitors," Canadian Medical Association Journal 161, no. 3 (1999): 255-264; L. Narine et al., "Evaluating Reference-Based Pricing: Initial Findings and Prospects," Canadian Medical Association Journal 161, no. 3 (1999): 286-288; and S. Schneeweiss et al., "Intended and Unintended Impacts on Antihypertensive Drug Use by a Policy of Differential Cost Sharing for Angiotensin-Converting Enzyme Inhibitors," Pharmacoepidemiology and Drug Safety 9, Supplement 1 (2000): S65.
27. C. Bourgault et al., "Reference-Based Pricing of Prescription Drugs: Exploring the Equivalence of Angiotensin-Converting Enzyme Inhibitors," Canadian Medical Association Journal 161, no. 3 (1999): 255-264; L. Narine et al., "Evaluating Reference-Based Pricing: Initial Findings and Prospects," Canadian Medical Association Journal 161, no. 3 (1999): 286-288; and S. Schneeweiss et al., "Intended and Unintended Impacts on Antihypertensive Drug Use by a Policy of Differential Cost Sharing for Angiotensin-Converting Enzyme Inhibitors," Pharmacoepidemiology and Drug Safety 9, Supplement 1 (2000): S65.
28. G.F. Anderson et al., "Health Spending and Outcomes: Trends in OECD Countries, 1960-1998," Health Affairs (May/June 2000): 150-157.