Table 1 Description of each funding scenario

Pay for Drugs

Provincial decision-makers fund new expensive drugs. They do not consider alternative uses of funds but argue that ANY improvement for patient care must be funded, even if that means that new programs cannot be started. This gives high priority to all benefits to patients with rare diseases, at the expense of funding to other programs and patients. It does not address health care budgets or provincial differences.

Prioritize Other Programs

Provincial decision-makers do not fund access to new expensive drugs. Instead, funding is allocated to programs that target reduced sickness and death in underserved populations, often through access to basic health care. Treatment for patients with rare diseases are only funded when they are highly effective and not too expensive. Health care budgets are contained. Provincial differences are not equalized.

Fund Drug if Justified

Fund the drug ONLY if the extra expense is well justified. Effective health care and cost containment are promoted. Priorities related to patients with rare diseases are promoted only when they compare well to other uses of funds and significantly improve treatments that are currently available. Provincial differences in funding are not changed.

Canadawide Equality

All provincial and territorial Ministries of Health are required by a new law to use recommendations of a federal drug assessment agency. Canadians receive the same access across the provinces and territories. Benefits for patients with rare diseases are promoted when they compare well to alternative use of the funds and are significant improvements over current treatments. This supports assessing cost containment and effective health care on a national level.