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International Experience With Pharmaceutical Policy: Common Challenges and Lessons for Canada


Author Info

  • Donald Willison

    (Department of Clinical Epidemiology & Biostatistics, McMaster University, Centre for Evaluation of Medicines)

  • Mary Wiktorowicz

    (Department of Clinical Epidemiology & Biostatistics, and Political Science, University of Western Ontario)

  • Paul Grootendorst

    (Department of Clinical Epidemiology & Biostatistics, McMaster University, Centre for Evaluation of Medicines)

  • Bernie O'Brien

    (Department of Clinical Epidemiology & Biostatistics, McMaster University, Centre for Evaluation of Medicines)

  • Mitchell Levine

    (Department of Clinical Epidemiology & Biostatistics, McMaster University, Centre for Evaluation of Medicines)

  • Raisa Deber

    (Department of Health Administration, University of Toronto)

  • Jeremiah Hurley

    (Department of Clinical Epidemiology & Biostatistics, Centre for Health Economics and Policy Analysis, McMaster University)


Pharmaceuticals are the focus of increased scrutiny by public insurers. Between 1985 and 1998, drug expenditure in Canada increased by 226% - approximately double the increase in total expenditure on health. Prescribed and non-prescribed drugs now comprise the second-largest share of health care expenditures after hospitals, surpassing physicians’ services. The National Forum on Health called for common strategies across the provinces, to manage pharmaceuticals from a health policy perspective. At the same time, the federal government and several provinces are interested in promoting pharmaceutical research and development (R&D), as part of the advancement of a knowledge-based economy. In the past, debates about pharmaceutical policy centred on the balancing of cost-containment and access to needed pharmaceuticals. The creation of an environment more conducive to attracting pharmaceutical R&D introduces additional tensions that will, no doubt, require concessions in current policies to manage pharmaceutical expenditures. In addition, a significant R&D investment will have predictable “downstream” effects on other sectors, such as academic research. In this study, we describe the experience of 7 Western industrialized countries in controlling pharmaceutical budgets while maintaining access to medically necessary prescription medications. In addition, we describe the potential impact of these policies on pharmaceutical R&D and the efforts of these countries to create a favourable climate for fostering R&D within their borders. We identify tensions that arise between health policy and industrial policy goals, and broad questions of directions and choices.

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Bibliographic Info

Paper provided by Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada in its series Centre for Health Economics and Policy Analysis Working Paper Series with number 2001-08.

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Length: 66 pages
Date of creation: 2001
Date of revision:
Handle: RePEc:hpa:wpaper:200108

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Cited by:
  1. Wright, Donald J., 2004. "The drug bargaining game: pharmaceutical regulation in Australia," Journal of Health Economics, Elsevier, vol. 23(4), pages 785-813, July.
  2. Holst, Jens, 2008. "Kostenbeteiligung für Patienten - Reformansatz ohne Evidenz! Theoretische Betrachtungen und empirische Befunde aus Industrieländern," Discussion Papers, Research Group Public Health SP I 2008-305, Social Science Research Center Berlin (WZB).


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