Download Date - Government of Nova Scotia

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ACDR Template Letter for
Authorizing Unrestricted Sharing of Information
Date
Atlantic Common Drug Review
c/o Drug Evaluation Unit
Pharmacy Department
Rm 2416 Halifax Infirmary
1796 Summer Street
Halifax, Nova Scotia B3H 3A7
Dear Atlantic Common Drug Review:
Reference: [Brand name/generic name]
This letter authorizes unrestricted communication regarding drug name between
the Atlantic Provincial Drug Plans and the following:
1.
2.
3.
4.
5.
Other federal, provincial and territorial (F/P/T) drug programs
F/P/T health authorities and related facilities
Health Canada
Patented Medicine Prices Review Board (PMPRB)
Canadian Agency for Drugs and Technologies in Health (CADTH)
Sincerely,
Drug Company Information
(including E-mail contact)
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