Few new medicines are available to those who depend on provincial drug benefit programs.

Nearly 8 million Canadians depend on provincial drug benefit programs for drug coverage. In 1999 this included 3.2 million seniors, 3.2 million people with low incomes, and 1.5 million others. An examination of provincial drug plans shows that there is significant disparity among the provinces in terms of products that are approved for reimbursement. In fact, as of January 15, 1999, only 18 of 148 new drug products approved for use by health Canada were reimbursed by all provinces. The percentage of new drugs reimbursed by provinces range from a high of 83 percent in Quebec to less than 50% in Ontario, Prince Edward Island, New Brunswick, and Newfoundland.

As the number of Canadians suffering from chronic conditions increases dramatically with the aging of the population (see Access to Innovation, September 9 2002), new medicines will play an increasingly important role in providing efficient and cost-effective treatments. Unfortunately many provincial drug plans are driven by cost-containment rather than by patient access considerations. Drug plans are often managed in isolation of the other major components of health care spending. As provincial governments consider embracing a common drug review system, a key issue will be the extent to which drug reviews are driven by the financial considerations of containing health costs or by the clinical considerations of improving patient health.