For a long time now, spending on prescription medicine has outshined spending on doctors in Canada. This has been increasing over the years, and it is projected to continue going by 7-8 percent every year. This chapter explores the fundamentals of these issues and how decisions about them are made and interplay between the key players. To start with, the Canada government and the pharmaceutical industry have enjoyed a long term relationship called clientele pluralism. A situation like this usually occurs when the state has lots of power concentrated in one agency (TPD) but a low degree of power. This because TPD has been entrusted with the responsibility of regulation of drug safety, efficacy, and quality, but the state does not undertake the intricate clinical and preclinical trial to ensure safety and effectiveness of the medicine. For the last 10 years, the financing of TPD has shifted from coming entirely from the government. This has raised many concerns on whether TPD’s main commitment is still the public health.
Companies have been spending considerably on promotion than they do on development and research. This money is not ill spent as doctors are mainly reliant on sources of promotion information. Despite the fact that, this process makes good returns on investments, this does not take in the health of the public. This is because any prescription that is driven by promotion needs to be avoided. In addition, when these drugs reach the market, they are only tested on a small number of patients who are highly selected without putting into consideration how people will react to the drug. In conclusion, pharmaceutical companies are mainly interested in making money, but this drugs do not offer any significant help to the people. On the other hand, instead of the government looking out to the public interest, their main concern has been reoriented to reflect the industry. Doctors instead of doing what is right, they have been only relying on promotion information. This has, therefore, created a “dance” between the pharmaceutical industry, government and the doctors.