Association for Public Policy Analysis & Management

Short lists of essential medicines have been associated with more appropriate prescribing and use of medicines, potentially because clinicians are better able to learn about medicines and because patients have better access to information about medicines. An essential medicines list for Canada has been recommended by the National Advisory Council on the Implementation of Pharmacare in 2019. We conducted a randomized controlled trial of eliminating out-of-pocket expenses for only a short list of essential medicines and found reductions in the rate of potentially inappropriate prescriptions (as well as increased adherence and other benefits). We also compared national essential medicines lists used in 137 countries and identified strengths including rational selection of cardiovascular disease treatments and weaknesses including listing medicines that have been withdrawn due to excess mortality. Together our findings can help inform how short lists of publicly funded medicines may facilitate more appropriate medicine use in Canada and elsewhere.