The power of "principles" in a national pharmaceuticals strategy.

The role of principles in shaping the development of public policy has garnered increasing attention. The authors explore the role of underlying principles in the development of a Canadian National Pharmaceuticals Strategy (NPS), an area in which practical policy development has been disappointing. In analyzing proposed principles for a NPS identified in government documents and by a set of major stakeholder coalitions, they find broad agreement on principles underlying a NPS, particularly regarding equity, accessibility, safety and effectiveness. However, the identification of principles for a NPS has not motivated practical policy progress in this crucial area. Some reasons for this failure are rooted in the current state of ethics and principles in health policy and some in the value-laden, interest-dominated nature of pharmaceutical policy itself.