Canada’s emerging national systems of pharmacare and public funding for drugs for rare diseases (DRDs) had key developments last week. On December 4, the Minister of Health (Minister) asked Canada’s Drug Agency-L’Agence des médicaments du Canada (CDA-AMC) for advice on a national formulary and a bulk purchasing strategy for pharmacare. The following day, on December 5, the federal government and the Province of Alberta announced an agreement for public funding of DRDs.

CDA-AMC to advise on national formulary and bulk purchasing strategy

Background: As we reported, on October 10, 2024, the Pharmacare Act came into force, introducing a program of national universal drug coverage in Canada.

New developments: On December 4, 2024, the Minister requested the CDA-AMC’s “expert advice” by October 10, 2025 on two key aspects of pharmacare:

  • National formulary. The Minister asked the CDA-AMC to prepare “an initial list of essential prescription drugs, and related products where appropriate, to inform the development of a national formulary.” As a starting point, the Minister recommended the CLEAN Meds List (approximately 130 medications in 12 therapeutic classes). The CLEAN Meds List was developed by researchers and clinicians at St. Michael’s Hospital in Toronto, including Dr. Nav Persaud, who now chairs the federal government’s Committee of Experts for pharmacare (see our report here).
  • National bulk purchasing strategy. The Minister also asked the CDA-AMC to advise on a national bulk purchasing strategy for prescription drugs and related products. The Minister’s “expectation” is that the strategy would “strengthen the collective purchasing power of Canada’s pharmaceutical management system” and “work in conjunction with two existing system features”: the pan-Canadian Pharmaceutical Alliance and the Patented Medicine Prices Review Board. The strategy should consider the impact on all stakeholders, including private drug insurance plan beneficiaries, and the impact on the management or mitigation of drug shortages.

Alberta strikes funding deal for drugs for rare diseases

Background: As we reported, in March 2023, the federal government announced a National Strategy for Drugs for Rare Diseases, including up to $1.4 billion for the provinces and territories provided through bilateral agreements. A “common list” of new DRDs is being developed, of which 5 have been publicly announced.

New developments: On December 5, 2024, Alberta became the third province to reach a bilateral funding agreement with the federal government. Alberta will receive $162 million over three years (beginning in 2024-2025) to improve access to selected new DRDs, and to support enhanced access to existing DRDs, early diagnosis, and screening. British Columbia and Newfoundland and Labrador were the first two provinces to sign bilateral funding agreements, on July 23, 2024 and November 15, 2024, respectively. Alberta has initially elected to make 3 of the 5 “common list” drugs available, as compared to 5 for British Columbia and 2 for Newfoundland and Labrador.

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