OBJECTIVES: The Common Drug Review (CDR), a pan-Canadian program at the Canadian Agency for Drugs and Technologies in Health (CADTH), assesses the clinical effectiveness, cost effectiveness and patient evidence of new drugs to provide formulary listing recommendations to publicly funded drug plans. This study aims to determine the implications of implementing CDR recommendations.  METHODS: CDR reviews from December 2010 to December 2012, for which an economic evaluation was submitted by the manufacturer, were assessed. A framework was developed where templates were created in Microsoft Excel for each drug submission to consider two scenarios: an uptake scenario (CDR recommendation implemented), and a counterfactual scenario (CDR recommendation not implemented). Drug costs and quality adjusted life years (if applicable) for both scenarios were determined at the population level using patient numbers reported in the manufacturer’s budget impact analyses. The incremental net benefit was calculated, based on a willingness-to-pay of $50,000. In addition, sensitivity analyses were conducted to consider variation around the counterfactual scenario. RESULTS: Based on the results for the 55 drugs for which cost-utility or a cost-minimization analysis was submitted, the total incremental net benefit of implementing a CDR recommendation was calculated to be over 1 billion dollars over a 1-year time frame for participating provincial drug plans. Detailed sensitivity analysis explored the uncertainty around these estimates. CONCLUSIONS: Overall, the 10 drug plans included for this analysis would realize significant benefit by implementing CDR recommendations. Based on this research, a framework to assess the impact of CDR recommendations is being developed. Next steps include, consideration of disease specific estimates of net benefit and the inclusion of all participating drug plans to provide broader implications of overall CDR impact in Canada.