Governments face enormous challenges in managing escalating expenditures under their prescription drug plans while providing access to new, cost effective therapies. Strategies to address cost pressures must be considered carefully, however, to ensure the achievement of optimum health outcomes. Alberta has adopted an inclusive approach in addressing utilization and cost issues through a variety of advisory processes and initiatives supported by the Minister of Health and Wellness. The Expert Committee on Drug Evaluation and Therapeutics advises the Minister on Alberta's government-sponsored drug programs and related policy matters. The Alberta Management Committee on Drug Utilization, co-chaired by the Alberta Medical Association and the Pharmacists Association of Alberta, is mandated to oversee the implementation of a number of drug utilization initiatives. The Pharmaceutical Information Network is the cornerstone project of Alberta Wellnet, supported by a unique multistakeholder task force that includes physicians, pharmacists, representatives from health regions and government. Recent successful program launches in Alberta include a palliative drug program, trial prescription program and the multiple sclerosis drug program. Successes in Alberta reinforce the importance of government's role in achieving optimum pharmacotherapy. This role can only be undertaken in collaboration with key stakeholders.