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


  • 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.

Suggested Citation

  • Donald Willison & Mary Wiktorowicz & Paul Grootendorst & Bernie O'Brien & Mitchell Levine & Raisa Deber & Jeremiah Hurley, 2001. "International Experience With Pharmaceutical Policy: Common Challenges and Lessons for Canada," Centre for Health Economics and Policy Analysis Working Paper Series 2001-08, Centre for Health Economics and Policy Analysis (CHEPA), McMaster University, Hamilton, Canada.
  • 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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