Commentary

Growth in prescription drug costs since 1996 has seta new record. Not since World War II has drugspending escalated so rapidly for such a prolonged period. The latest figures published by the Canadian Insti-tute of Health Information (CIHI) show that prescription-only medicines cost $18 billion in 2004.1 Growing at a pace of over $1.5 billion per year, prescription costs have sailed well past the payments for all services provided by physi-cians ($16 billion). Given that the annual increase in pre-scription drug costs could finance the services of 3500 new physicians every year, patterns of drug utilization and spending deserve careful scrutiny. Fig. 1 illustrates trends in expenditures on pharmaceuti-cal products from 1944 to 2004. After a brief post-war con-traction in drug manufacturing, Canada experienced accel-erated pharmaceutical spending during the “therapeutic revolution ” that brought newly patented anti-infectiv