International Experience With Pharmaceutical Policy: Common Challenges and Lessons for Canada
Bibliographic record
Abstract
Pharmaceuticals are the focus of increased scrutiny by public insurers. Between 1985 and 1998, drug expenditure in Canada increased by 226% - approximately double the increase in total expenditure on health. Prescribed and non-prescribed drugs now comprise the second-largest share of health care expenditures after hospitals, surpassing physicians’ services. The National Forum on Health called for common strategies across the provinces, to manage pharmaceuticals from a health policy perspective. At the same time, the federal government and several provinces are interested in promoting pharmaceutical research and development (R&D), as part of the advancement of a knowledge-based economy. In the past, debates about pharmaceutical policy centred on the balancing of cost-containment and access to needed pharmaceuticals. The creation of an environment more conducive to attracting pharmaceutical R&D introduces additional tensions that will, no doubt, require concessions in current policies to manage pharmaceutical expenditures. In addition, a significant R&D investment will have predictable “downstream” effects on other sectors, such as academic research. In this study, we describe the experience of 7 Western industrialized countries in controlling pharmaceutical budgets while maintaining access to medically necessary prescription medications. In addition, we describe the potential impact of these policies on pharmaceutical R&D and the efforts of these countries to create a favourable climate for fostering R&D within their borders. We identify tensions that arise between health policy and industrial policy goals, and broad questions of directions and choices.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".