I have a couple of points. One is that the difference in numbers typically comes from having many more of a certain class of drug in a formulary in one place than in another. New Zealand is a case in point, where there are fewer of a certain type of drug on the formulary.
The advantage of having choice is that one could use that to differentiate in prices among products in a class, and I think that's done now in places in Canada. I'm not totally familiar with it, but generics only go onto formularies at a certain percentage of the price of the original patented medicine of which it is a generic. So there may be an advantage in that choice.
One has to be careful about simply comparing numbers of drugs on formularies. That is quite often equated, particularly by the industry, as access. However, these formularies all have different formulary coverage policies. A jurisdiction could quite easily list a larger number of drugs than another, but include a high co-payment, so that there is a shift.
On that question of access, I think one has to include affordability as well because there is a cost-shifting from the public to the individual. And is that desirable in order to have more access, or is that discriminatory against those who can't afford it?