In the current issue of Health Affairs, a detailed interview with the Honourable Allan Rock, federal Minister of Health, elicits his commitment to moving toward a system where national objectives are set, while latitude is left for local decision making . Such a process draws much from the provincial experience with drug benefit plans over the past quarter century and suggests that the national government recognizes the importance of optimal treatment decisions being made as close to home as possible. Such an approach is entirely in keeping with that outlined for Ontario by Ms Lindberg and is probably the only possible mechanism by which universal drug insurance could be brought into the Canada Health Act. Events since the 1997 release of a call by the National Health Forum for Pharmacare have made it abundantly clear that Canadian provinces will not accept a ‘made in Ottawa’ solution to concerns about delivery of drug therapy to their citizens.
Ms Lindberg’s remarks deserve a close reading by those interested in cialis professional provincial attitudes on drug insurance. It is notable that Ontario has managed to maintain a ‘compassionate drug insurance system’ for its most vulnerable citizens, even at a time when the numbers of beneficiaries over 65 years of age are increasing rapidly . The Ontario government has recognized the need for new drug therapies to be made available in a timely fashion and has actively experimented with new procedures that would see a new openness in the formulary system accompanied by increasing levels of accountability for health professionals. Within Ontario’s Limited Use Program, the government intends to provide prescribing feedback to prescribers on a confidential basis. Such profiles will allow individual prescribers to make decisions about the appropriateness of their own prescribing behaviour and to adapt, where necessary, on the basis of educational materials that will be provided from nongovernmental sources such as academic centres and professional organizations. It is noteworthy that this novel approach, which emphasizes clinical governance, has the endorsement of the Ontario Medical Association and the Ontario Pharmacists Association. Many will follow with interest the outcomes of the initial profiling and educational initiatives underway since April 1, 2000 in Ontario.