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38 40 Clinical leadership is essential; however, an evidence-based national formulary can help to stem overuse and inappropriate use of prescription medications. 41 , 42 Furthermore, improved integration of medications into Canadas universal public health care system should increase not decrease incentives and opportunities to promote their appropriate use. We were unable to account for confidential rebates paid by drug manufacturers to public drug plans in comparator countries or to existing provincial drug plans. 27 However, private insurers and patients without insurance in Canada generally

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