Prices of Prescribed Drugs, Brand Name and Generic (Bimonthly Diary for February, April, June, August, October and December)

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Purpose

The Consumer Price Index (CPI) is an indicator of changes in consumer prices experienced by Canadians. It is obtained by comparing, over time, the cost of a fixed basket of goods and services purchased by consumers.

Authority

This survey is collected under the authority of the Statistics Act, Revised Statutes of Canada, 1985, Chapter S-19. Completion of this questionnaire is a legal requirement under this Act.

Purpose

This survey is being conducted every second month to collect the prices of prescribed drugs. The prices you report are essential to the production of the Consumer Price Index (CPI), an important indicator of how the Canadian economy is performing. This index, used by governments, businesses and private citizens, affects interest rates, taxes, wages, pensions and many other monetary transfers. Your information may also be used by Statistics Canada for other statistical and research purposes. Please visit www.statcan.gc.ca/survey for more information about this survey.

Confidentiality

The Statistics Act protects the confidentiality of information collected by Statistics Canada. Statistics Canada is prohibited by law from releasing any information it collects which could identify any person, business, or organization, unless consent has been given by the respondent or as permitted by the Statistics Act.

Data-sharing agreements

To reduce respondent burden, Statistics Canada has entered into data-sharing agreements with provincial and territorial statistical agencies and other organizations, which have agreed to keep the data confidential and use them only for statistical purposes. Statistics Canada will only share data from this survey with those organizations that have demonstrated a requirement to use the data.

Section 11 of the Statistics Act provides for the sharing of information with provincial and territorial statistical agencies that meet certain conditions. These agencies must have the legislative authority to collect the same information, on a mandatory basis, and the legislation must provide substantially the same provisions for confidentiality and penalties for disclosure of confidential information as the Statistics Act. Because these agencies have the legal authority to compel businesses to provide the same information, consent is not requested and businesses may not object to the sharing of the data.

For this survey, there are Section 11 agreements with the provincial and territorial statistical agencies of Newfoundland and Labrador, Nova Scotia, New Brunswick, Quebec, Ontario, Manitoba, Saskatchewan, Alberta, British Columbia, and the Yukon.

The shared data will be limited to information pertaining to business establishments located within the jurisdiction of the respective province or territory.

Section 12 of the Statistics Act provides for the sharing of information with federal, provincial or territorial government organizations. Under Section 12, you may refuse to share your information with any of these organizations by writing a letter of objection to the Chief Statistician and returning it with the completed questionnaire. Please specify the organizations with which you do not want to share your data.

For this survey, there are Section 12 agreements with the statistical agencies of Prince Edward Island, the Northwest Territories and Nunavut.

The shared data will be limited to information pertaining to business establishments located within the jurisdiction of the respective province or territory.

Record linkage

To enhance the data from this survey, Statistics Canada may combine it with information from other surveys or from administrative sources.

Security of emails and faxes

Statistics Canada advises you that there could be a risk of disclosure during facsimile or other electronic transmission. However, upon receipt, Statistics Canada will provide the guaranteed level of protection afforded all information collected under the authority of the Statistics Act.

Assistance

If you require assistance in completing this questionnaire or if you have any questions or comments, please call 1-800-263-1136 (TTY 1-800-363-7629) or e-mail STATCAN.infostats-infostats.STATCAN@canada.ca.

Note

A Statistics Canada representative will pick up the completed questionnaire within 48 hours.

CONFIDENTIAL when completed.

If necessary, please make address label corrections in the boxes below (please print).

Business name

Address (number and street)

City

Province/territory

Postal code

Brand name drugs - Instructions

1.1 STC RP#, Brand name drug, DIN, Strength, Quantity

Feb. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Apr. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

June 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Aug. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Oct. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Dec. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

1.2 STC RP#, Brand name drug, DIN, Strength, Quantity

Feb. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Apr. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

June 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Aug. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Oct. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Dec. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

1.3 STC RP#, Brand name drug, DIN, Strength, Quantity

Feb. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Apr. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

June 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Aug. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Oct. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Dec. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

1.4 STC RP#, Brand name drug, DIN, Strength, Quantity

Feb. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Apr. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

June 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Aug. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Oct. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Dec. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

1.5 STC RP#, Brand name drug, DIN, Strength, Quantity

Feb. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Apr. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

June 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Aug. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Oct. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Dec. 20XX

  • : Brand name drug
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Generic drugs - Instructions

2.1 STC RP#, Active Ingredient, Strength, Quantity

Feb. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Apr. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

June 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Aug. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Oct. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Dec. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

2.2 STC RP#, Active Ingredient, Strength, Quantity

Feb. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Apr. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

June 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Aug. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Oct. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Dec. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

2.3 STC RP#, Active Ingredient, Strength, Quantity

Feb. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Apr. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

June 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Aug. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Oct. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Dec. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

2.4 STC RP#, Active Ingredient, Strength, Quantity

Feb. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Apr. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

June 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Aug. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Oct. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Dec. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

2.5 STC RP#, Active Ingredient, Strength, Quantity

Feb. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Apr. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

June 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Aug. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Oct. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Dec. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

2.6 STC RP#, Active Ingredient, Strength, Quantity

Feb. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Apr. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

June 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Aug. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Oct. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Dec. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

2.7 STC RP#, Active Ingredient, Strength, Quantity

Feb. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Apr. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

June 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Aug. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Oct. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Dec. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

2.8 STC RP#, Active Ingredient, Strength, Quantity

Feb. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Apr. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

June 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Aug. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Oct. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Dec. 20XX

  • : Generic drug name
  • : DIN
  • : Strength
  • : Quantity
  • : Price (including DDF)
  • : DDF

Comments

Comments

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