Areas to Watch Closely
April 8, 2026
These ongoing developments could help move the needle on drug access
Timely access to novel medications depends not only on access pathways, but on wider social and political forces. Here, we call out three new developments that will likely cause ripples in Canada’s access landscape. We’re in for some interesting times.
A new order
On May 12, 2025, US president Donald Trump introduced the Most Favored Nation (MFN) drug pricing policy by executive order, with the stated objective of ending a “purposeful scheme in which drug manufacturers deeply discount their products to access foreign markets, and subsidize that decrease through enormously high prices in the United States.”23
This puts countries like Canada in a bind: on the one hand, the US’s pricing shift will put pressure on Canada to increase prescription drug prices in compensation.24 On the other hand, Canada’s own policies call for strong pricing restraint. For example, the Patented Medicine Prices Review Board (PMPRB) recently introduced new guidelines that set Canadian pricing thresholds based on prices in 11 other countries (not including the US).24 Exceeding these thresholds can trigger pricing delays and financial penalties. The possible expansion of Canada’s recently enacted Pharmacare program could put further downward pressure on pricing.
Amid these disparate forces, Patrick Dicerni, Assistant Deputy Minister of the Health Programs and Delivery Division and Executive Officer of the Ontario Public Drug Programs at the Ontario Ministry of Health, has expressed interest in using tools such as outcomes-based agreements (OBAs) to ensure the public purse provides the best value for medicines.25 While acknowledging the complexity of implementing OBAs, notably the lack of infrastructure and the difficulty agreeing on outcomes to measure, Dicerni maintains that “at some point, necessity starts eliminating some of these barriers… I’m not suggesting these are easy problems to solve, but I do think they are solvable.”
Further suggested reading: Walking a tightrope: Navigating US most-favored-nation prescription drug pricing in Canada.
Integrated health datasphere
The much-touted “health information highway” got a new shot in the arm on February 4 of this year, when the Government of Canada introduced Bill S-5, the Connected Care for Canadians Act, to facilitate crosstalk between different digital health data systems.26 The bill seeks to boost Canada’s digital healthcare standards to internationally competitive levels, while enhancing both the security and accessibility of individual medical records.
With only 47% of Canadians able to call up their digital health information and 29% of physicians exchanging such information beyond their own practices, Bill S-5 comes not a moment too soon27 If approved into law, the Bill will require all companies providing digital health services in Canada to harmonize their standards to enable secure data transfer.
“When personal health information can travel freely and securely between patients, clinics, hospitals and labs, people will have better health outcomes and doctors will have more time to focus on care,” says Dr. Margot Burnell, president of the Canadian Medical Association.26“It also makes it easier for patients to manage their own care in partnership with doctors and other health professionals.”
“When personal health information can travel freely and securely between patients, clinics, hospitals and labs, people will have better health outcomes, doctors will have more time to focus on care, and patients can more easily partner with doctors to manage their own care.”
Dr. Margot Burnell
President, Canadian Medical Association
A more connected health datasphere will enable us to quantify the value that innovative medicines are generating and tailor our access pathways accordingly. Pan-Canadian data will also help us assess the performance of novel market access tools and identify disparities in access equity.
Proposed CDA-AMC reimbursement review process improvements
CDA-AMC recently held a consultation for interested parties to weigh in on a number of proposed changes, with a focus on increasing the predictability of review timelines, integrating clinician and patient input, and streamlining resubmission processes.28,29 At the heart of these changes is a new schedule that would commit the Agency to post a final recommendation within 180 days of initiating a reimbursement review, largely by collapsing the time between draft and final recommendation (currently 60 days) to an “embargo period” of 40 days.27,28 Another suggested change would extend the application screening period from 10 to 20 days to give sponsors additional time to address deficiencies in an application without risking their place in the queue. (A diagram contrasting the current and proposed reimbursement review schedules appears in this video presentation28at 33:05 minutes.) While the outcome of the consultation process has yet to be published, the changes signal a continued flexibility and a political will to make timely drug access a priority.
References
23. Delivering most-favored-nation prescription drug pricing to American patients. The White House. May 12, 2025. https://www.whitehouse.gov/presidential-actions/2025/05/delivering-most-favored-nation-prescription-drug-pricing-to-american-patients/
24. Wall K, Pennington S. Norton Rose Fullbright. February 2026. https://www.nortonrosefulbright.com/en-ca/knowledge/publications/64f59794/walking-a-tightrope-navigating-us-most-favored-nation
25. Drug Pricing in Canada: Navigating Potential U.S. MFN Implications (webinar). Fasken. Feb. 6, 2026. https://www.youtube.com/watch?v=kEWl1OqDYYo
26. The Government of Canada introduces legislation to build a more connected health care system. Health Canada. Feb. 4, 2026. https://www.canada.ca/en/health-canada/news/2026/02/the-government-of-canada-introduces-legislation-to-build-a-more-connected-health-care-system.html
27. Canadian Cancer Society applauds introduction of Connected Care for Canadians Act. Canadian Cancer Society. Feb. 4, 2027. https://cancer.ca/en/about-us/media-releases/2026/connected-care-for-canadians-act
28. Improvements to the Drug Reimbursement Reviews Process. Canada’s Drug Agency. Jan. 29, 2026. https://www.cda-amc.ca/sites/default/files/Drug_Review_Process/Proposed_Improvements_to_the_Reimbursement_Review_Process.pdf
29. Improvements to the Drug Reimbursement Reviews Process. Pre-consultation webinar. Canada’s Drug Agency. Jan. 28, 2026. https://www.youtube.com/watch?v=5OirG5CP8Ho