Following the February 2003 First Ministers Health Accord, the Canadian Government created a five-year $16 billion Health Reform Fund targeted to primary health care, home care and catastrophic drug coverage. The drug coverage is intended to ensure that Canadians with serious health conditions have reasonable access to necessary drug therapy. Standards for catastrophic coverage will be determined in the coming years, yet there is little evidence to guide the choice of standards. Dr. Steven Morgan is evaluating two possible options for basing standards: mixed pharmacare and income-based pharmacare. Dr. Morgan is studying the change in BC from a mixed program, which covered drug costs for low income seniors and social assistance recipients and charged a $1,000 deductible to all other residents, to an income-based system that enables people to pay a sliding scale based on income levels. Dr. Morgan is comparing data from both systems to results in Manitoba, which also has an income-based program. He is assessing the impact of both systems on cost, access and equity for people across the spectrum of socio-economic status, age and health status. The results could help guide the development of provincial and national policies for drug coverage programs.