THE VALUE OF MEDICINES IN CANADA
Main Article Content
Keywords
pharmaceuticals, drugs, cost-effectiveness, burden of illness, health care costs
Abstract
Spending on drugs has become a target for cost-containment measures because of its continual growth, both in absolute terms and as a proportion of overall healthcare expenditures. However, considering drug spending in isolation from other healthcare components neglects the benefit of drugs to Canada’s healthcare system, society and economy. Drugs, when used appropriately as part of overall disease management, have increased life expectancy and quality of life, have avoided more costly alternatives such as hospitalisation and surgery, and have decreased worker absenteeism and increased their productivity. Current evidence suggests that drugs represent good value for money and are an integral part of a cost-effective and sustainable healthcare system. Cost-containment measures should focus on appropriate use of medications and improving adherence to therapeutic regimens for optimal patient outcomes.
References
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17. Olfson M, Marcus SC, Druss B, Elinson L, Tanielian T, Pincus HA. National trends in the outpatient treatment of depression. JAMA
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18. Greenberg PE, Kessler RC, Birnbaum HG, et al. The economic burden of depression in the United States: how did it change between 1990 and 2000? J.Clin.Psychiatry 2003;64(12):1465-75.
19. Stagnitti MN. Trends in outpatient prescription drug utilization and expenditures: 1997-2000. (2003) http://www.meps.ahrq.gov/papers/st21/stat21.pdf (Aug. 7, 2003).
20. Palumbo FB, Mullins CD. The development of direct-to-consumer prescription drug advertising regulation. Food Drug Law J 2002;57(3):423-43.
21. Silversides A. Direct-to-consumer prescription drug ads getting bolder. CMAJ 2001;165(4):462
22. Mintzes B, Barer ML, Kravitz RL, et al. How does direct-to-consumer advertising (DTCA) affect prescribing? A survey in primary care environments with and without legal DTCA. CMAJ 2003;169(5):405-12.
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29. Lichtenberg FR. Are the benefits of newer drugs worth their cost? Evidence from the 1996 MEPS. Health Aff (Millwood) 2001;20(5):241-51.
30. Mathias SD, Colwell HH, Miller DP, Moreland LW, Buatti M, Wanke L. Health-related quality of life and functional status of patients with rheumatoid arthritis randomly assigned to receive etanercept or placebo. Clin Ther 2000;22(1):128-39.
31. Murawski MM, Mychaskiw MA, Surdej J. Exploration of the relationship between health- related quality of life and the price of pharmaceutical products. Drug Information Journal 2003;37:221-31.
32. Statistics Canada. Days lost per worker by cause, Canada and provinces. (Sept. 22, 2003) www.statcan.ca/english/Pgdb/labor60b.htm (December 8, 2003).
33. Walker, J, Cox, M, Thomas, S, Gedhill, N, Salmon, A. Canada life 10: corporate fitness ten years after. Ontario Ministry of Tourism & Recreation and Canada Life, 1991.
34. Institute of Health Economics. A national list of provincial costs for health care: Canada 1997/8. Version 1.0. 2000.
35. Statistics Canada. The Daily: Employment, earnings and hours, May 2003. (July 28, 2003) http://www.statcan.ca/Daily/English/030728/d030728a.htm (December 8, 2003).
36. Murray CJL and Lopez AD, editors. The Global Burden of Disease. The Harvard School of Public Health on behalf of The World Health Organisation, 1996.
37. Wells KB; Sturm R; Sherbourne CD, et al. Caring for depression. 1999 ed. Cambridge, MA: Harvard University Press, 1996. 1p.
38. Health Canada Editorial Board Mental Illnesses in Canada. A report on mental illnesses in Canada. 2002.
39. Statistics Canada. Canadian Community Health Survey: Mental health and well-being. (Sept. 3, 2003) http://www.statcan.ca/english/freepub/82-
617-XIE/index.htm (Sept. 4, 2003).
40. Kessler RC, Barber C, Birnbaum HG, et al. Depression in the workplace: effects on short-term disability. Health Aff (Millwood) 1999;18(5):163-71.
41. Stewart WF, Ricci JA, Chee E, Hahn SR, Morganstein D. Cost of lost productive work time among US workers with depression. JAMA
2003;289(23):3135-44.
42. Stephens T, Joubert N. The economic burden of mental health problems in Canada. Chronic Dis Can 2001;22(1):18-23.
43. Canadian Psychiatric Association and the Canadian Network for Mood and Anxiety Treatments (CANMAT): CANMAT Depression Work Group. Clinical guidelines for the treatment of depressive disorders. Can J Psychiatry 2001;46(Suppl 1):5S-92S.
44. Rizzo JA, Abbott TA, Pashko S. Labour productivity effects of prescribed medicines for chronically ill workers. Health Econ. 1996;5:249-65.
45. Adapted from Brogan Inc. Rx Dynamics™ Reports. 11 Nov 2003.
46. IMS, CompuScript - based on New Prescriptions -the last 6 months October 2003. Based on USC 64340 Serotonin Reuptake Inhibitor. 1 Dec 2003.
47. Canadian Institute for Health Information. Hospital discharges and age-standardized discharge rates (ASDR) for Canada, Provinces and Territories,
1995/96 to 2000/01. (2003)http://secure.cihi.ca/cihiweb/en/media_26jun2002_tab2_e.html (Aug. 28, 2003).
48. Lichtenberg FR. Do (more and better) drugs keep people out of hospitals? Am Econ Rev 1996;86(2):384-8.
49. Tamblyn R, Laprise R, Hanley JA, et al. Adverse events associated with prescription drug cost- sharing among poor and elderly persons. JAMA
2001;285(4):421-9.
50. Soumerai SB, Avorn J, Ross-Degnan D, Gortmaker S. Payment restrictions for prescription drugs under Medicaid. Effects on therapy, cost, and equity. N Engl J Med 1987;317(9):550-6.
51. Martin BC, McMillan JA. The impact of implementing a more restrictive prescription limit on Medicaid recipients. Effects on cost, therapy, and out-of-pocket expenditures. Med Care 1996;34(7):686-701.
52. Huskamp HA, Deverka PA, Epstein AM, Epstein RS, McGuigan KA, Frank RG. The effect of incentive-based formularies on prescription-drug utilization and spending. N Engl J Med 2003;349(23):2224-32.
53. Soumerai SB, McLaughlin TJ, Ross-Degnan D, Casteris CS, Bollini P. Effects of limiting Medicaid drug-reimbursement benefits on the use of psychotropic agents and acute mental health services by patients with schizophrenia. N Engl J Med 1994;331(10):650-5.
54. Soumerai SB, Ross-Degnan D, Avorn J, McLaughlin T, Choodnovskiy I. Effects of Medicaid drug-payment limits on admission to
hospitals and nursing homes. N Engl J Med 1991;325(15):1072-7.
55. McGlynn EA, Asch SM, Adams J, et al. The quality of health care delivered to adults in the United States. N Engl J Med 2003;348(26):2635-45.
56. Coambs, RB, Jensen, P, Jarry, JL, et al. A preliminary review of the causes of inappropriate prescribing and its costs in Canada. Toronto, ON: Health Promotion Research, 1997.
57. MacKinnon NJ. Early warning system: How vigilant pharmacists can prevent drug-related morbidity in seniors. Pharmacy Practice
2002;18(8):40-4.
58. World Health Organization. Adherence to long- term therapies: evidence for action. (2003) World Health Organization. http://www.who.int/chronic_conditions/en/adheren ce_report.pdf (Aug. 13, 2003).
59. Avorn J. Healthcare and the tooth fairy. A merger that won't result in 'smarter' medicine. Pharmaco Economics 1998;14 Suppl 1:33-6.
60. Avorn J. Balancing the cost and value of medications: the dilemma facing clinicians. Pharmaco Economics 2002;20 Suppl 3:67-72.
61. Redwood H. Pharmaceutical cost containment and quality care. Conflict or compromise? Pharmaco Economics 1998;14 Suppl 1:9-13.
2. Kleinke JD. The price of progress: prescription drugs in the health care market. Health Aff (Millwood) 2001;20(5):43-60.
3. Romanow RJ, and the Commission on the Future of Health Care in Canada. Building on values: the future of health care in Canada - Final Report. (Nov. 28, 2002) National Library of Canada. http://www.hc- sc.gc.ca/english/care/romanow/hcc0086.html (Aug. 29, 2003).
4. Neumann PJ, Sandberg EA, Bell CM, Stone PW, Chapman RH. Are pharmaceuticals cost- effective? A review of the evidence. Health Aff
(Millwood) 2000;19(2):92-109.
5. Canadian Institute for Health Information. National health expenditure trends, 1975-2002. Ottawa, ON: Canadian Institute for Health Information, 2002.
6. Guyatt G, Yalnizyan A, Devereaux PJ. Solving the public health care sustainability puzzle. CMAJ 2002;167(1):36-8.
7. Health Policy and Communications Branch. Health expenditures in Canada by age and sex, 1980-81 to 2000-01. (Aug. 2001) Minister of Public Works and Government Services Canada. http://www.hc- sc.gc.ca/english/care/expenditures/exp_age_sex. html (Aug. 29, 2003).
8. Canada's Research-Based Pharmaceutical Companies (Rx&D). Information Guide, Second Edition. (July 28, 2003) http://www.canadapharma.org/Industry_Publicat ions/Information_Guide/english.pdf (Dec. 9, 2003).
9. Chaplin R, Earl L. Household spending on health care. Health Rep 2000;12(1):57-65.
10. Policy Research Division, Strategic Policy Directorate, Population and Public Health Branch, Health Canada. Economic burden of illness in Canada, 1998. 2002.
11. Federal/Provincial/Territorial Working Group on Drug Prices. Cost driver analysis of Provincial drug plans: Ontario 1992/93 - 1998/99. (April,
2000)http://www.pmprb-cepmb.gc.ca/CMFiles/on- e14HNL-492003-4413.pdf (Oct. 3, 2003).
12. Patented Medicine Prices Review Board, for the Federal/Provincial/Territorial Working Group on Drug Prices. Pharmaceutical trends 1995/96 - 1999/00: provincial drug plans overview report. (Sept. 2001) http://www.pmprb- cepmb.gc.ca/CMFiles/overview-e14IRL-492003-6326.pdf (Aug. 21, 2003).
13. Mullins CD, Wang J, Palumbo FB, Stuart B. The impact of pipeline drugs on drug spending growth. Health Aff (Millwood) 2001;20(5):210-5.
14. Patented Medicine Prices Review Board. PMPRB Annual report 2002. Ottawa, ON: The Patented Medicine Prices Review Board, 2003.
15. Statistics Canada. Consumer Price Index, historical summary. (Aug. 13, 2003) http://www.statcan.ca/english/Pgdb/econ46.htm (Aug. 20, 2003).
16. Dubois RW, Chawla AJ, Neslusan CA, Smith MW, Wade S. Explaining drug spending trends: does perception match reality? Health Aff (Millwood)
2000;19(2):231-9.
17. Olfson M, Marcus SC, Druss B, Elinson L, Tanielian T, Pincus HA. National trends in the outpatient treatment of depression. JAMA
2002;287(2):203-9.
18. Greenberg PE, Kessler RC, Birnbaum HG, et al. The economic burden of depression in the United States: how did it change between 1990 and 2000? J.Clin.Psychiatry 2003;64(12):1465-75.
19. Stagnitti MN. Trends in outpatient prescription drug utilization and expenditures: 1997-2000. (2003) http://www.meps.ahrq.gov/papers/st21/stat21.pdf (Aug. 7, 2003).
20. Palumbo FB, Mullins CD. The development of direct-to-consumer prescription drug advertising regulation. Food Drug Law J 2002;57(3):423-43.
21. Silversides A. Direct-to-consumer prescription drug ads getting bolder. CMAJ 2001;165(4):462
22. Mintzes B, Barer ML, Kravitz RL, et al. How does direct-to-consumer advertising (DTCA) affect prescribing? A survey in primary care environments with and without legal DTCA. CMAJ 2003;169(5):405-12.
23. Graham JR. DTCA survey leads to different conclusion (electronic letter published by CMAJ). (Sept. 23, 2003) http://www.cmaj.ca/cgi/eletters/169/5/405#452 (Oct. 7, 2003).
24. Reinhardt UE. Proper benchmark for drug prescribing needs to be found. BMJ 2002;324(7344):1039
25. World Health Organization. WHO definition of health: Preamble to the Constitution of the World Health Organization. (2003)
http://www.who.int/about/definition/en/ (July 11,
2003).
26. World Health Organization. The world health report 1999: making a difference. (1999) http://www.who.int/whr2001/2001/archives/199 9/en/pdf/whr99.pdf (Nov. 4, 2003).
27. Miller Jr RD, Frech HE. Is there a link between pharmaceutical consumption and improved health in OECD countries? Pharmaco Economics 2000;18 Suppl 1:33-45.
28. Crémieux P-Y, Meilleur M-C, Ouellette P, Petit P, Zelder M, Potvin K. Public and private pharmaceutical spending as determinants of health outcomes in Canada Health Economics.2004 Aug 31 [Epub ahead of print].
29. Lichtenberg FR. Are the benefits of newer drugs worth their cost? Evidence from the 1996 MEPS. Health Aff (Millwood) 2001;20(5):241-51.
30. Mathias SD, Colwell HH, Miller DP, Moreland LW, Buatti M, Wanke L. Health-related quality of life and functional status of patients with rheumatoid arthritis randomly assigned to receive etanercept or placebo. Clin Ther 2000;22(1):128-39.
31. Murawski MM, Mychaskiw MA, Surdej J. Exploration of the relationship between health- related quality of life and the price of pharmaceutical products. Drug Information Journal 2003;37:221-31.
32. Statistics Canada. Days lost per worker by cause, Canada and provinces. (Sept. 22, 2003) www.statcan.ca/english/Pgdb/labor60b.htm (December 8, 2003).
33. Walker, J, Cox, M, Thomas, S, Gedhill, N, Salmon, A. Canada life 10: corporate fitness ten years after. Ontario Ministry of Tourism & Recreation and Canada Life, 1991.
34. Institute of Health Economics. A national list of provincial costs for health care: Canada 1997/8. Version 1.0. 2000.
35. Statistics Canada. The Daily: Employment, earnings and hours, May 2003. (July 28, 2003) http://www.statcan.ca/Daily/English/030728/d030728a.htm (December 8, 2003).
36. Murray CJL and Lopez AD, editors. The Global Burden of Disease. The Harvard School of Public Health on behalf of The World Health Organisation, 1996.
37. Wells KB; Sturm R; Sherbourne CD, et al. Caring for depression. 1999 ed. Cambridge, MA: Harvard University Press, 1996. 1p.
38. Health Canada Editorial Board Mental Illnesses in Canada. A report on mental illnesses in Canada. 2002.
39. Statistics Canada. Canadian Community Health Survey: Mental health and well-being. (Sept. 3, 2003) http://www.statcan.ca/english/freepub/82-
617-XIE/index.htm (Sept. 4, 2003).
40. Kessler RC, Barber C, Birnbaum HG, et al. Depression in the workplace: effects on short-term disability. Health Aff (Millwood) 1999;18(5):163-71.
41. Stewart WF, Ricci JA, Chee E, Hahn SR, Morganstein D. Cost of lost productive work time among US workers with depression. JAMA
2003;289(23):3135-44.
42. Stephens T, Joubert N. The economic burden of mental health problems in Canada. Chronic Dis Can 2001;22(1):18-23.
43. Canadian Psychiatric Association and the Canadian Network for Mood and Anxiety Treatments (CANMAT): CANMAT Depression Work Group. Clinical guidelines for the treatment of depressive disorders. Can J Psychiatry 2001;46(Suppl 1):5S-92S.
44. Rizzo JA, Abbott TA, Pashko S. Labour productivity effects of prescribed medicines for chronically ill workers. Health Econ. 1996;5:249-65.
45. Adapted from Brogan Inc. Rx Dynamics™ Reports. 11 Nov 2003.
46. IMS, CompuScript - based on New Prescriptions -the last 6 months October 2003. Based on USC 64340 Serotonin Reuptake Inhibitor. 1 Dec 2003.
47. Canadian Institute for Health Information. Hospital discharges and age-standardized discharge rates (ASDR) for Canada, Provinces and Territories,
1995/96 to 2000/01. (2003)http://secure.cihi.ca/cihiweb/en/media_26jun2002_tab2_e.html (Aug. 28, 2003).
48. Lichtenberg FR. Do (more and better) drugs keep people out of hospitals? Am Econ Rev 1996;86(2):384-8.
49. Tamblyn R, Laprise R, Hanley JA, et al. Adverse events associated with prescription drug cost- sharing among poor and elderly persons. JAMA
2001;285(4):421-9.
50. Soumerai SB, Avorn J, Ross-Degnan D, Gortmaker S. Payment restrictions for prescription drugs under Medicaid. Effects on therapy, cost, and equity. N Engl J Med 1987;317(9):550-6.
51. Martin BC, McMillan JA. The impact of implementing a more restrictive prescription limit on Medicaid recipients. Effects on cost, therapy, and out-of-pocket expenditures. Med Care 1996;34(7):686-701.
52. Huskamp HA, Deverka PA, Epstein AM, Epstein RS, McGuigan KA, Frank RG. The effect of incentive-based formularies on prescription-drug utilization and spending. N Engl J Med 2003;349(23):2224-32.
53. Soumerai SB, McLaughlin TJ, Ross-Degnan D, Casteris CS, Bollini P. Effects of limiting Medicaid drug-reimbursement benefits on the use of psychotropic agents and acute mental health services by patients with schizophrenia. N Engl J Med 1994;331(10):650-5.
54. Soumerai SB, Ross-Degnan D, Avorn J, McLaughlin T, Choodnovskiy I. Effects of Medicaid drug-payment limits on admission to
hospitals and nursing homes. N Engl J Med 1991;325(15):1072-7.
55. McGlynn EA, Asch SM, Adams J, et al. The quality of health care delivered to adults in the United States. N Engl J Med 2003;348(26):2635-45.
56. Coambs, RB, Jensen, P, Jarry, JL, et al. A preliminary review of the causes of inappropriate prescribing and its costs in Canada. Toronto, ON: Health Promotion Research, 1997.
57. MacKinnon NJ. Early warning system: How vigilant pharmacists can prevent drug-related morbidity in seniors. Pharmacy Practice
2002;18(8):40-4.
58. World Health Organization. Adherence to long- term therapies: evidence for action. (2003) World Health Organization. http://www.who.int/chronic_conditions/en/adheren ce_report.pdf (Aug. 13, 2003).
59. Avorn J. Healthcare and the tooth fairy. A merger that won't result in 'smarter' medicine. Pharmaco Economics 1998;14 Suppl 1:33-6.
60. Avorn J. Balancing the cost and value of medications: the dilemma facing clinicians. Pharmaco Economics 2002;20 Suppl 3:67-72.
61. Redwood H. Pharmaceutical cost containment and quality care. Conflict or compromise? Pharmaco Economics 1998;14 Suppl 1:9-13.
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Han, D., & Wang, E. C. Y. (2018). THE VALUE OF MEDICINES IN CANADA. Journal of Population Therapeutics and Clinical Pharmacology, 12(1). https://mail.jptcp.com/index.php/jptcp/article/view/88
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Han, D., & Wang, E. C. Y. (2018). THE VALUE OF MEDICINES IN CANADA. Journal of Population Therapeutics and Clinical Pharmacology, 12(1). https://mail.jptcp.com/index.php/jptcp/article/view/88