Opportunity lost: a frontline view of reference-based pricing.

The introduction in October 1995 of reference-based pricing as a cost-saving measure for British Columbia's drug benefit program represented an opportunity for collaboration between frontline practitioners and the bureaucracy that supports some of their work. If well-established principles of continuing education, quality improvement and modern management had been followed, practitioners in the field could have focused their individual and collective talents effectively and constructively on the task of improving cost-effectiveness in drug prescribing. Although the reference-based pricing program may well achieve its purpose of saving money, it is sad that it was not used to build bridges of common interest and mutual trust between two camps that are often in conflict.