They often seek doctors' advice on drugs and treatment due to a lack of knowledge of medicine. Public insurance is provided for people without the means to pay for drugs, and a large percentage of consumers are insured for prescription drugs through extended health care coverage offered by employers and unions. For all these reasons, the demand for pharmaceuticals is highly insensitive to price change. Canada represents about two per cent of the world market for pharmaceuticals. The manufacturing industry in Canada consists of large, multiproduct, research-oriented firms that are foreign owned, with Canadian generic drug manufacturers and a number of smaller firms competing in niche markets.
Physicians make decisions on behalf of the consumer about which therapies are required.
Two systemic factors seem to adversely affect the prescribing practices of physicians. First, time constraints make it difficult for physicians to keep up with clinical evidence on the appropriate use of new drugs. Doctors therefore rely heavily on pharmaceutical companies, whose primary interest is to sell their products, as sources of information. Pharmacists hold a monopoly over the retailing of both prescription and nonprescription drugs. It has long been acknowledged that pharmacists are the professionals best trained in pharmacology and that these skills have been grossly under-used.