One of the first priorities and most critical steps of a successful national Pharmacare plan is the development and implementation of an EML.
Canada is an outlier as the only country with a universal health care system that excludes universal coverage of prescription drugs. The introduction of a national Pharmacare program in Canada, as recommended by the Hoskins report, that incorporates universal access to essential medicines at a very low or significantly reduced cost, is a key pillar in Canada's fulfillment of its universal health care journey. One of the first priorities and most critical steps of a successful national Pharmacare plan is the development and implementation of an EML.
This article examines where might be a good place to start in developing a national EML. Provincial and other formularies which already exist could be used as a foundation from which to build upon, complimented by experience from other jurisdictions. In addition the article emphasizes an EML that encompasses a patient centric approach, specifically reflecting on the requirements of a diverse population, use of generics and switching costs, limited use criteria, list length and over-the-counter medications and devices. Consideration is also given to how an EML for rare diseases should be addressed and how downward pressure on drug prices could affect drug innovation in Canada.
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