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National Formulary Policy

Last updated: May 3, 2021
Project Number: ES0354-000
Product Line: Environmental Scans
Result type: Report

Each federal, provincial, and territorial (FPT) public drug plan provides access to prescription medications for specific populations. FPTs rely on guidance from health technology assessment agencies such as CADTH; however, reimbursement decisions for individual medications follow different local processes. This Environmental Scan sought to compare these reimbursement decision-making processes (e.g., drug review processes, decision-making principles and/or frameworks, decision-making committee structures).

Decision-making processes were evaluated for all provinces as well as for Yukon and the Non-Insured Health Benefits (NIHB) program. Decision-making processes were stratified for oncology versus non-oncology medications as well as for CADTH review–eligible versus CADTH review–ineligible products.

There were 2 models of decision-making processes with a geographic divide: local expert committees reviewing all new drug submissions (Western model) versus reviewing only drug submissions out of scope for CADTH (Eastern model). If decision-making processes were to be harmonized across FPTs, there would need to be a balance between local autonomy versus centralization.

Projects listed as “in progress” are at various stages and points of completion. These products have different processes and timelines; therefore, the timing of posting of the final reports varies and expected completion dates may change. Find out more about Projects in Progress.

The “Projects in Progress” page on the CADTH website is updated on a seven- to eight-day cycle. Please be advised that there may be overlap between when a new report is posted online and when the section is updated. View our current Projects in Progress.