The pan-Canadian Pharmaceutical Alliance (pCPA) brings together provincial, territorial, and federal governments for the purpose of increasing and managing access to clinically relevant and cost-effective medicines. Through collective negotiations, the pCPA has realized overall savings (as of April 1, 2023) for governments of $3.14 billion annually for brand name drugs and $750 million annually for generic drugs totaling $3.89 billion annually. Ten years after its creation - and supported by a new strategic plan launched in April 2022 - the pCPA is now evolving into a more formal organization with a new governance model, an expanded staffing structure and improved decision-making processes.