ABSTRACT
Canadian healthcare is mainly handled through the publicly funded Medicare. Pharmaceutical spending is funded through public programs, private health insurance and patient out-of-pocket contributions. Marketing authorization for new drugs is handled by the Federal Ministry of Health or "Health Canada" through the Health Products and Food Branch (HPFB). HPFB has two branches. The Therapeutics Products Directorate (TPD) handles pharmaceuticals and medical devices. The PCPA has been a natural answer to the many Provincial Listing Agreements (PLAs) that have been closed as confidential agreements since the institution of the Common Drug Review (CDR). The CDR reviews drugs through expert committees and is managed by the Canadian Agency for Drugs and Technologies in Health (CADTH). Comparative drug effectiveness and safety are evaluated, but of particular focus is the drug's cost-effectiveness. In fear of large drug price increases, the Patented Medicines Price Review Board (PMPRB) was charged to ensure that price premiums over comparable products are restricted to highly innovative pharmaceuticals.
