According to a recently published study, “poor diet and physical inactivity may soon overtake tobacco as the leading cause of death.” The study authors estimate that in 2000 tobacco use caused 430,000 or 18.1 % of all deaths in the U.S. and poor diet and physical inactivity caused 400,000 or 16.6 % of all deaths that year. ⁱ

According to the Canadian Institute for Health Information, institutional care continues to drive provincial health spending growth. The Preliminary Provincial and Territorial Government Health Expenditures 1974-1975 to 2004-2005 released in November of 2004 reveals more than half of the annual health care spending is attributable to increased spending on institutional care.

Drug utilization in Canada increased 37 percent from 228 million prescriptions in 1995 to nearly 313 million prescriptions in 2001 As Canada’s population ages this trend is likely to continue as more Canadians will rely on medicines to manage and treat chronic conditions. With increased drug utilization, one would expect the potential for adverse effects from prescription drug use to increase. Yet, the percentage of hospital stays in Canada attributable to the adverse effects of medical agents has remained relatively constant from 1995 to 2001 accounting for only approximately 0.6 percent of all hospitalizations annually.

On December 16, 2004, the province of Quebec released a Drug Policy Report with recommendations in four major areas: (i) access to medication, (ii) reasonable pricing, (iii) optimal drug utilization, and (iv) ongoing support for the pharmaceutical industry. The report includes thirty-four ministerial suggestions within these four areas.

The Common Drug Review (CDR), announced in September 2001, began reviewing drugs in December 2003. The CDR was set up to review new drugs that have been approved for Canadian use by Health Canada and to provide recommendations for coverage and reimbursement by publicly-funded federal, provincial and territorial (F/P/T) drug benefit plans in Canada. The CDR process involves two steps: (i) a systematic review of the available clinical evidence and a review of the pharmacoeconomic data for the drug, and (ii) a listing recommendation by the Canadian Expert Drug Advisory Committee (CEDAC). Each of the drug benefit plans that participate in CDR then makes its own formulary listing and benefit coverage decisions based on the CEDAC recommendation and the plan's mandate, priorities and resources.