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. Community pharmacists, however, do not have access to diagnoses and medical records. This limits the scope of their therapeutic advice and all incentives to question physician prescribing practices or consumer choices of nonprescription drugs. Governments play a major role in the pharmaceutical industry as regulators and providers of drug benefits. The government of Canada is responsible for product safety, efficacy and regulations on pharmaceutical patents.