Issue link: http://clhia.uberflip.com/i/406567
29 While the largest provinces and private insurers have significant scale, the smaller provinces and private insurers do not have the same capacity to spread risk. Ultimately, the incidence of high costs drug treatments will strain the ongoing sustainability of the system and impact Canadians differently across the country. THEREFORE, THE CLHIA RECOMMENDS THAT: • FROM A SOCIAL POLICY PERSPECTIVE THAT IT WOULD BE IN THE INTEREST OF GOVERNMENTS AND PRIVATE INSURERS TO ENTER INTO A DIALOGUE TO DEVELOP A NATIONAL, COMPREHENSIVE, HIGH COST DRUG STRATEGY IN ORDER TO ENSURE THE SUSTAINABILITY OF DRUG COVERAGE GOING FORWARD. D. IMPROVING COLLABORATION WITH KEY STAKEHOLDERS Canada's health care system is currently made up of a number of siloed delivery systems whose actions nevertheless have significant impacts on each other from a cost and patient care perspective. This leads to inefficiencies and waste. Greater collaboration among health care professionals has the potential to deliver significant patient benefits and cost savings. d.1 Introduction of Prescribing Committees Prescribers are the start of the reimbursement process. While the vast majority of prescriptions are written by physicians, increasingly, other providers are able to do limited prescribing – including nurse practitioners and pharmacists. Decisions by prescribers have significant cost implications, particularly when they prescribe higher cost drugs where lower cost and equally effective alternatives are available. It would, therefore, be beneficial for Canada to develop processes and standards to help to ensure consistent high quality and cost effective prescribing of prescription drugs across Canada.