Public funding for paediatric medications in Canada.

OBJECTIVES: To describe public funding of paediatric medications across Canada, including variability between jurisdictions and restrictions based on age or medication formulation. METHODS: A scoping review was conducted using a list of paediatric medications that was generated from the World Health Organization Pediatric Essential Medicines List and the British Columbia Children's Hospital Drug Dosage Guidelines. Formularies from 14 federal, provincial, and territorial drug plans were analyzed. Data collected included medication listing status, age, and indication-based restrictions, formulation availability, and special authority requirements. Descriptive statistics were used for analysis. RESULTS: On average, 70% of essential paediatric medications were publicly funded in Canada, with significant interjurisdictional variation (35% in Yukon to 87.2% under the Non-Insured Health Benefits [NIHB]). Approximately 13% of medications required special authority. Age- and indication-specific restrictions were uncommon. Funding for paediatric formulations such as liquids and chewables was less available than for tablet and capsule formulations. Territories with unique formulary structures, such as Yukon and Nunavut, showed more limited coverage than other jurisdictions. CONCLUSIONS: Approximately 20% of paediatric medications lack public funding. There is a geographic disparity in access. Universal pharmacare and mandatory inclusion of paediatric data in drug submissions are needed to ensure equitable access. Findings highlight the urgency for national strategies to close paediatric drug coverage gaps and support consistent, child-friendly medication access across Canada.