Prices of Prescribed Drugs, Brand Name and Generic (Bimonthly Diary for February, April, June, August, October and December)
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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
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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.
Additional information
Information on data-sharing agreements, record linkages, and fax or e-mail transmission disclosures are on the information sheet that the Statistics Canada interviewer provided to you.
Authority
Collected under the authority of the Statistics Act, Revised Statutes of Canada, 1985, Chapter S19. 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 access www.statcan.gc.ca/survey for more information on 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. Statistics Canada will use the information from this survey for statistical purposes.
Assistance
If you require assistance in completing this questionnaire or if you have any questions or comments, please call 1-800-263-1136 or e-mail infostats@statcan.gc.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).
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Postal code
1. Brand name drugs instructions
1.1 STC RP#, Brand name drug, DIN, Strength, Quantity
Feb. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Apr. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
June 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Aug. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Oct. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Dec. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
1.2 STC RP#, Brand name drug, DIN, Strength, Quantity
Feb. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Apr. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
June 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Aug. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Oct. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Dec. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
1.3 STC RP#, Brand name drug, DIN, Strength, Quantity
Feb. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Apr. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
June 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Aug. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Oct. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Dec. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
1.4 STC RP#, Brand name drug, DIN, Strength, Quantity
Feb. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Apr. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
June 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Aug. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Oct. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Dec. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
1.5 STC RP#, Brand name drug, DIN, Strength, Quantity
Feb. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Apr. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
June 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Aug. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Oct. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Dec. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
2.0 Generic drugs instructions
2.1 STC RP#, Active Ingredient, Strength, Quantity
Feb. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Apr. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
June 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Aug. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Oct. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Dec. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
2.2 STC RP#, Active Ingredient, Strength, Quantity
Feb. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Apr. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
June 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Aug. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Oct. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Dec. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
2.3 STC RP#, Active Ingredient, Strength, Quantity
Feb. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Apr. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
June 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Aug. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Oct. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Dec. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
2.4 STC RP#, Active Ingredient, Strength, Quantity
Feb. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Apr. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
June 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Aug. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Oct. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Dec. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
2.5 STC RP#, Active Ingredient, Strength, Quantity
Feb. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Apr. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
June 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Aug. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Oct. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Dec. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
2.6 STC RP#, Active Ingredient, Strength, Quantity
Feb. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Apr. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
June 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Aug. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Oct. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Dec. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
2.7 STC RP#, Active Ingredient, Strength, Quantity
Feb. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Apr. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
June 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Aug. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Oct. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Dec. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
2.8 STC RP#, Active Ingredient, Strength, Quantity
Feb. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Apr. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
June 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Aug. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Oct. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Dec. 2016
- : Brand drug name
- : DIN
- : Strength
- : Price (including DDF)
- : DDF
Comments
Comments
- : Month
- : DIN number
- : Comments
- : Month
- : DIN number
- : Comments
- : Month
- : DIN number
- : Comments
- : Month
- : DIN number
- : Comments
- : Month
- : DIN number
- : Comments
- : Month
- : DIN number
- : Comments
- : Month
- : DIN Number
- : Comments
- : Month
- : DIN Number
- : Comments
- : Month
- : DIN number
- : Comments
- : Month
- : DIN number
- : Comments
- : Month
- : DIN number
- : Comments
- : Month
- : DIN number
- : Comments
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