Public/private partnerships for prescription drug coverage: policy formulation and outcomes in Quebec's universal drug insurance program, with comparisons to the Medicare prescription drug program in the United States

Milbank Q. 2007 Sep;85(3):469-98. doi: 10.1111/j.1468-0009.2007.00496.x.


In January 1997, the government of Quebec, Canada, implemented a public/private prescription drug program that covered the entire population of the province. Under this program, the public sector collaborates with private insurers to protect all Quebecers from the high cost of drugs. This article outlines the principal features and history of the Quebec plan and draws parallels between the factors that led to its emergence and those that led to the passage of the Medicare Prescription Drug, Improvement and Modernization Act (MMA) in the United States. It also discusses the challenges and similarities of both programs and analyzes Quebec's ten years of experience to identify adjustments that may help U.S. policymakers optimize the MMA.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cooperative Behavior*
  • Drug Costs
  • Humans
  • Insurance Coverage
  • Insurance, Pharmaceutical Services*
  • Medicare*
  • National Health Programs
  • Outcome Assessment, Health Care
  • Policy Making*
  • Private Sector*
  • Public Sector*
  • Quebec
  • United States
  • Universal Health Insurance*