TABLE 1.

Details concerning suggested elements of a renewed strategy for pharmaceutical policy in Canada

Guiding vision: Coordinated federal, provincial and territorial pharmaceutical policies that work with other healthcare policies to promote equitable and sustainable improvements in the health of Canadians
Policy objectives	Strategic policy actions	Policy actors
Access: All Canadians have equitable access to medically necessary prescription drugs without financial or other barriers	Universal, public coverage of medically necessary prescription drugs by 2020 Fair, transparent and evidence-based system of determining which drugs are covered under a universal drug plan Coordinated procurement policies as per value objective of renewed National Pharmaceuticals Strategy	Provinces as administrators Federal government to enable and ensure national standards Relevant agencies (e.g., Canadian Agency for Drugs and Technologies in Health)
Appropriateness: Medications are always prescribed and used in accordance with best evidence concerning risks and benefits	Government to take direct responsibility for enforcing regulations concerning the promotion of medicines Completion of population-based electronic prescribing and drug-information systems in all provinces by 2020 Establish or designate a national organization to coordinate initiatives regarding quality of medicine use	Health Canada for regulatory enforcement Canada Health Infoway and provincial and federal governments for electronic prescribing and information systems New national agency or mandate expansion for existing agency for coordination of initiatives
Value: Prescription drugs are competitively priced and represent value for money as used within Canada's universal healthcare system	Pan-Canadian price and supply contracts for patented drugs covered under the universal public drug plan Streamline market entry for generics and biosimilars Modernization of pharmaceutical price regulations to include non-patented medicines and reasonable price limits based on economic fundamentals	Arm's-length agency for supply contracts, with representation of patients, health professionals and governments Federal government for streamlining generic and biosimilar entry Regulatory and mandate changes for Patented Medicine Prices Review Board
Safety: Prescription drugs are only licensed when proven to offer benefits that outweigh harms for the patients that use them	Publication of all relevant scientific data concerning both positive and negative regulatory decisions Lifecycle approach to collection, assessment and application of scientific evidence	Health Canada for regulatory policy and transparency Provincial governments for collecting and making available real-world data Federal government for enabling timely analysis and publication of real-world data
Governance principle:Pharmaceutical policies should be made and implemented in a transparent fashion, based on routinely collected and reported data on system performance, by decision-makers who are accountable to the public