This project evaluated the current processes for listing medications in provincial formularies, paying particular attention to the drug’s cost-effectiveness as it applied to the process of acceptance of five new drugs in five provinces (Alberta, British Columbia, New Brunswick, Ontario, and Quebec). A drug was chosen for each of the following five categories: innovative, innovative but somewhat controversial, expensive on a daily basis, expensive on the basis of a large number of patients, and expensive, for uncommon conditions. The evaluation was a cross-sectional observation survey of government and drug company representatives. The survey instruments were four questionnaires in two categories: general objectives about organization, procedures, and data; and drug-specific questions about the experience with the index drugs. The surveys included open-ended questions. The report found that the approach to listing drugs on the provincial formularies is rather unscientific, not evidence-based, not transparent, and inconsistent across the provinces. It makes many recommendations to improve the manner in which provinces list drugs on their formularies.
This project was supported by the Health Transition Fund, which was created in 1997 to provide support for evidence-based decision-making in health care reform by supporting pilot and evaluation projects which test innovative approaches to health care delivery. The views expressed herein do no necessarily represent the official policy of federal, provincial, or territorial governments.