In Canada, neither drugs nor pharmacy services are covered by the Canada Health Act. The administration of health services by statute is at the provincial level. Hence, access to drugs may vary from province to province. Provincial benefit plans may differ in the type of patient covered (eg, some cover all patients not covered by other plans and others only those over age 65 years and receiving social assistance), the level and method of costsharing (eg, level of deductible $0 to $1700 per year and level of copayment 0% to 40% of prescription costs) and the availability of the drug (eg, potassium supplements are not uniformly covered) . For example, maximum professional fees for prescriptions for seniors may vary from $3.50 to $9.70 depending on the province . About 12% of the Canadian population has no public or private drug insurance coverage . In addition, pharmacists in different provinces are reimbursed differently, with some provinces using actual acquisition cost and some mark-up with varying professional fees. The pharmaceutical industry in Australia is required to submit data to only one agency instead of to 10 different provincial drug formularies with different requirements. In addition it does not have to gather intelligence on changes in 10 different systems. In Australia, a centralized system for drug utilization review is also possible, and review of utilization and costs occurs at a national level. The Drugs Directorate of Health Canada has created a new licensing framework that examines postmarket assessment of drugs .
In Australia, the PBPA negotiates prices for generic and patented medicines. In Canada, the Patented Medicine Prices Review Board was created in 1987 under Bill C-22 of the Patent Act and is an independent quasijudicial body that “regulates the prices charged by manufacturers of patented medicine to ensure that they are not excessive” . The Patented Medicine Prices Review Board does not apply to generic drugs — buy antibiotics online, nonprescription drugs, pharmacists professional fees or wholesaler mark-ups .