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Table 2 – Pan-Canadian Pharmacare Models and Associated Fiscal Projections

From: Prescription drug coverage in Canada: a review of the economic, policy and political considerations for universal pharmacare

  Data Sources Type of Coverage Model Assumptions Financing Source Net Difference in Total System Expenditures
Morgan et al. (2015) [40] -Canada Rx Atlas 2012/2013 for drug utilisation data [94]
-International drug pricing data from PMPRB
-Public Universal ‘First Dollar’ -Competitive pricing estimates as per singe-payer bulk-purchasing arrangement -Federal/Provincial/Territorial (F/P/T) Government funding (tax based)
-Small patient co-payments based on tiered national formulary
-Annual expense reduction of $4.2 to $9.4 billion
Gagnon and Canadian Federation of Nurses Unions (2014) [43]a -Canada Rx Atlas for drug utilisation data
-International drug pricing data from PMPRB
-Public Universal ‘First-Dollar’ -Competitive generic pricing estimates as per singe-payer bulk-purchasing arrangement
−10% increase in base-expenditures due to higher utilisation
-Improved evidence-based formulary management
−2% reduction in dispensing fees
-PMPRB pricing reform
-F/P/T Government (tax-based)
-Small patient co-payments based on tiered national formulary
-Annual expense reduction of
$2.7 to $11.5 billion
PDCI Market Access inc. (2016) [41]a -Canadian Drug Claims Database
-International pricing data from PMPRB
-Varies ranging from fully public to fully private -Numerous assumptions dependent upon model -F/P/T Government funding (tax-based)
-Private plan premiums
-Patient co-payments
-$1.92 billion in annual expense reductions or up to $350 million in increased annual expenses
Canadian Centre for Policy Alternatives & Canadian Doctors for Medicare (2017) [38]a Canadian Institute for Health Information (CIHI) and previous studies -Public Universal ‘First-Dollar’ -Unclear
-Data derived from various sources for approximate calculation
-F/P/T Government funding (tax-based) -approximately $30 billion in total savings (unspecified time period)
Parliamentary Budget Officer (2017) [18] -CIHI datasets
-Quintile IMS datasets
-Public Universal ‘First-Dollar’ -Competitive generic pricing estimates as per singe-payer bulk-purchasing arrangement
-Quebec drug formulary
-F/P/T Government funding (tax-based)
-$5 co-payments (on patented products)
-annual expense reduction:
$4.2 billion
  1. aCommissioned report from external stakeholder