Key principles for Canadian essential medicines list

A study conducted by decision makers and policy makers has found that an essential medicines list in Canada should be evidence-based and independent of conflicting interests.

The research was conducted at the London School of Hygiene & Tropical Medicine, UK.

A national essential medicines list has been proposed to reduce inequitable access, ensure quality and safety of care and improve medicine spending efficiency.

The research found that roughly 21 percent of Canadians are covered by provincial or territorial government drug plans for prescriptions medications, 3 percent by federal public coverage and 70 percent by employer-based cover. Approximately 20 percent of patients are uninsured or underinsured.

“Decision makers and key stakeholders in Canada had different and sometimes sceptical views on the suitability of an essential medicines list in Canada,” writes Jordan Jarvis, lead author of the study. “Nonetheless, there was consensus on three important factors that would need to feature in the policy process of a possible approach to an essential medicines list.”

The three factors are

• An independent, arms-length decision-making body
• Selection criteria to list medications based primarily on clinical and cost-effectiveness
• clear communication with the public and other stakeholders, such as clinicians and policy makers, on the purpose and evidence-based focus of the essential medicines list.

After the study was completed, the Federal Advisory Council on the Implementation of National Pharmacare announced recommendations for universal public pharmacare. This included coverage for a list of essential medicines to be implemented with federal leadership working with provinces and territories.

The authors suggest that engaging all provincial and territorial governments, patients, the public and clinicians in understanding and developing an essential medicines list is necessary.

The study was published in the Canadian Medical Association Journal.