Canada continues to have cost containment strategies in place - denying the best medical treatments for those living with HIV/AIDS.

At the provincial level, governments may describe these schemes as “reference-based pricing”, “therapeutic substitution” or even “maximum allowable cost”. Essentially these policies allow for the cheapest drug in place of the best drug and also medication rationing.

In actuality, when patients are not receiving the best-fitted treatment due to cost containment strategies, other health care costs can be incurred including extra health care visits including doctors and hospital visits.

The Common Drug Review (CDR) acts as a federal level cost-containment strategy as it is the single process for reviewing new drugs and providing formulary recommendations for most of Canada.

Despite its intention to speed up the process of reviewing drugs, the CDR has actually slowed things down. It also rarely ever approves a drug that costs more than other drugs, in the same class, even where there is a clear need for the new drug among people currently taking antiretroviral regimens. The process is also highly non-transparent.