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Lisa Barbera, Rinku Sutradhar, Anna Chu, Hsien Seow, Doris Howell, Craig C Earle, Mary Ann O'Brien, Deb Dudgeon, Clare Atzema, Amna Husain, Ying Liu, Carlo DeAngelis
BACKGROUND: Opioid prescribing has been increasingly scrutinized among non-cancer patients. As an unintended consequence, opioids may be under-prescribed for cancer patients. The purpose of this study was to compare trends in opioid prescribing in younger adults with and without cancer. METHODS: From 2004 to 2013, Ontario residents 18-64 years eligible for government paid pharmacare were annually stratified into 3 groups: no cancer history, cancer diagnosis >5 years ago and cancer diagnosis ≤5 years ago...
March 13, 2018: Journal of Pain and Symptom Management
Nigel Rawson
A publicly-funded pharmacare program (OHIP+) was announced in the 2017 Ontario budget for all children and young adults that will begin in January 2018 and cover drugs in the Ontario Public Drug Programs (OPDP) formulary. In this commentary, drugs indicated for rare disorders commonly occurring in childhood that were reviewed by the Common Drug Review (CDR) between 2004 and 2016 are examined to assess the Ontario reimbursement situation. OPDP reimburse few of these drugs and only about half of those covered are accessible with consistency and without onerous conditions...
December 1, 2017: Journal of Population Therapeutics and Clinical Pharmacology
Katherine Boothe
Canada is the only country with a broad public health system that does not include universal, nationwide coverage for pharmaceuticals. This omission causes real hardship to those Canadians who are not well-served by the existing patchwork of limited provincial plans and private insurance. It also represents significant forgone benefits in terms of governments' ability to negotiate drug prices, make expensive new drugs available to patients on an equitable basis, and provide integrated health services regardless of therapy type or location...
February 1, 2018: Health Economics, Policy, and Law
Kanika Anand, Ingrid Sketris, Ying Zhang, Adrian Levy, John-Michael Gamble
INTRODUCTION: Between 2010 and 2012, the US Food and Drug Administration and Health Canada issued warnings to healthcare professionals emphasizing the increased risk of muscle problems with high-dose simvastatin. OBJECTIVE: To measure the impact of the Health Canada safety warning regarding dose-dependent adverse effects of simvastatin on prescribing of low, medium, and high doses of simvastatin. METHODS: An interrupted time-series design was used to evaluate the impact of a Health Canada safety warning on 7 November 2012 regarding the safety of high-dose simvastatin...
December 2017: Drugs—Real World Outcomes
Gail Attara
Canada is the only country in the world with a national healthcare plan that does not include drug coverage. Coverage of necessary medications is a patchwork of inconsistent programs that does not always serve the very individuals it was created to help-those patients who need prescribed medicines. Our system needs radical, intuitive changes.
July 2017: Healthcare Management Forum
Lisa Barbera, Rinku Sutradhar, Anna Chu, Hsien Seow, Craig C Earle, Mary Ann O'Brien, Deborah Dudgeon, Carlo DeAngelis, Clare Atzema, Amna Husain, Ying Liu, Doris Howell
PURPOSE: Previous work in Ontario demonstrated that 33% of patients with cancer with severe pain did not receive opioids at the time of their pain assessment. With efforts to increase symptom screening and management since then, the objective of this study was to examine temporal trends in opioid prescribing. METHODS: The cohort was comprised of Ontario residents ≥ 65 years of age with a cancer history who were eligible for the government pharmacare program and had a pain assessment using the Edmonton Symptom Assessment System...
November 2017: Journal of Oncology Practice
Lauren Vogel
No abstract text is available yet for this article.
September 11, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Anne Purcell, Thomas Buckley, Judith Fethney, Jennie King, Wendy Moyle, Andrea P Marshall
OBJECTIVE: To evaluate the effectiveness of the eutectic mixture of local anesthetics (EMLA; Aspen Pharmacare, St. Leonards, New South Wales, Australia) as a primary dressing on painful chronic leg ulcers. DESIGN: A pilot randomized controlled trial. SETTING: The study was conducted across 6 community nursing procedure clinics located in a community nursing service in New South Wales, Australia. PARTICIPANTS: Sixty participants with painful chronic leg ulcers of varied etiology were recruited into the study...
August 2017: Advances in Skin & Wound Care
Russell Christie, Ingrid Sketris, Pantalis Andreou, Anne Holbrook, Adrian Levy, Hala Tamim
BACKGROUND: We hypothesized that medication adherence is affected by the number of pharmacies a patient frequents. OBJECTIVES: The objective was to estimate the strength of association between the number of pharmacies a patient frequents and adherence to statins. METHODS: Using administrative data from the Nova Scotia Seniors' Pharmacare program, a retrospective cohort study was conducted among subjects aged 65 years and older first dispensed statin between 1998 and 2008...
May 6, 2017: Journal of Population Therapeutics and Clinical Pharmacology
Roger Collier
No abstract text is available yet for this article.
May 29, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Michael R Law, Lucy Cheng, Heather Worthington, Muhammad Mamdani, Kimberlyn M McGrail, Fiona K I Chan, Sumit R Majumdar
BACKGROUND: Income-based deductibles are present in several provincial public drug plans in Canada and have been the subject of extensive debate. We studied the impact of such deductibles in British Columbia's Fair PharmaCare plan on drug and health care utilization among older adults. METHODS: We used a quasi-experimental regression discontinuity design to compare the impact of deductibles in BC's PharmaCare plan between older community-dwelling adults registered for the plan who were born in 1928 through 1939 (no deductible) and those born in 1940 through 1951 (deductible equivalent to 2% of household income)...
May 15, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Steven G Morgan, Emilie J Gladstone, Deirdre Weymann, Nadia Khan
BACKGROUND: In recent years, some provinces have implemented income-based catastrophic drug coverage in an effort to provide universal drug coverage while limiting government liability for the escalating costs of medicines needed for an aging population. We sought to examine the effects of income-based deductibles under British Columbia's Fair PharmaCare system on older patients' use of cardiovascular medicines in 2013, 10 years after the province's policy change. METHODS: Using linked administrative databases, we studied rates of hypertension and cholesterol medication used by 2 cohorts of older, married women who had different levels of public drug subsidy based solely on their spouses' ages...
January 2017: CMAJ Open
Steven G Morgan, Winny Li, Brandon Yau, Nav Persaud
BACKGROUND: Canada's universal health care system does not include universal coverage of prescription drugs. We sought to estimate the effects of adding universal public coverage of an essential medicines list to existing public drug plans in Canada. METHODS: We used administrative and market research data to estimate the 2015 shares of the volume and cost of prescriptions filled in the community setting that were for 117 drugs on a model list of essential medicines for Canada...
February 27, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Roger Collier
No abstract text is available yet for this article.
January 23, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Sara Guilcher, Sarah Munce, James Conklin, Tanya Packer, Molly Verrier, Connie Marras, Tarik Bereket, Joan Versnel, Richard Riopelle, Susan Jaglal
This paper describes the current situation in Canada concerning the availability and use of prescription drugs for neurological conditions. We conducted semi-structured qualitative interviews with health care providers, administrators, community organization representatives, opinion leaders and policy makers. The analysis revealed three primary themes related to the availability of and access to prescription drugs to treat neurological conditions. First, we learned that across Canada there is significant vulnerability and a need for advocacy on behalf of people living with these conditions...
April 2017: Health Policy
Heidi J Deal, Charmaine A Cooke, Ethel M Langille Ingram, Ingrid S Sketris
BACKGROUND: Pharmacists conduct medication reviews to optimize drug therapy. Each jurisdiction implements and funds these programs differently. OBJECTIVE: To describe the uptake of the first year of a community pharmacy medication review program reimbursed by the publically insured seniors' drug benefit program in Nova Scotia, Canada. METHODS: This retrospective analysis included 294 pharmacies and 105,000 beneficiaries enrolled in the Nova Scotia Seniors' Pharmacare Program...
February 1, 2017: Journal of Population Therapeutics and Clinical Pharmacology
Carlo DeAngelis, Craig Earle, Clare Atzema, Deborah Jane Dudgeon, Tara Gomes, Doris Howell, Amna Husain, Mary Ann O'Brien, Hsien Seow, Jonathan Sussman, Rinku Sutradhar, Anna Chu, Ying Liu
298 Background: Opioid prescribing has been increasingly scrutinized in the non-cancer patient population due to concerns with morbidity, mortality and diversion. Resulting regulatory changes have decreased prescribing. As an unintended consequence, we hypothesized that cancer patients might be similarly impacted. METHODS: All Ontario residents ≥ 65 years are eligible for government paid pharmacare. For each year from 2004 to 2013, Ontarians ≥ 65 years were stratified into 3 groups: no cancer history, cancer diagnosis > 5 years ago and cancer diagnosis ≤ 5 years ago...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Steven G Morgan, Katherine Boothe
Canada's universal public healthcare system is unique among developed countries insofar as it does not include universal coverage of prescription drugs. Universal, public coverage of prescription drugs has been recommended by major national commissions in Canada dating back to the 1960s. It has not, however, been implemented. In this article, we extend research on the failure of early proposals for universal drug coverage in Canada to explain failures of calls for reform over the past 20 years. We describe the confluence of barriers to reform stemming from Canadian policy institutions, ideas held by federal policy-makers, and electoral incentives for necessary reforms...
November 2016: Healthcare Management Forum
Samina Raza Abidi, Jafna Cox, Ashraf Abusharekh, Nima Hashemian, Syed Sibte Raza Abidi
Atrial Fibrillation (AF) is the most common cardiac arrhythmia. Generally, the therapeutic options for managing AF include the use of anticoagulant drugs that prevent the coagulation of blood. New Oral Anticoagulants (NOACs) are not optimally prescribed to patients, despite their efficacy. In Canada, NOAC medications are not directly available to patients who belong to provincial benefits programs, rather a NOAC special authorization process establishes the eligibility of a patient to receive a NOAC and be paid by the provincial Pharmacare program...
2016: Studies in Health Technology and Informatics
Laura V Minard, Amber Corkum, Ingrid Sketris, Judith Fisher, Ying Zhang, Ahmed Saleh
PURPOSE: To examine HMG-CoA reductase inhibitor (statin) drug dispensing patterns to Nova Scotia Seniors' Pharmacare program (NSSPP) beneficiaries over a 14-year period in response to: 1) rosuvastatin market entry in 2003, 2) JUPITER trial publication in 2008, and 3) generic atorvastatin availability in 2010. METHODS: All NSSPP beneficiaries who redeemed at least one prescription for a statin from April 1, 1999 to March 31, 2013 were included. Aggregated, anonymous monthly prescription counts were extracted by the Nova Scotia Department of Health and Wellness (Nova Scotia, Canada) and changes in dispensing patterns of statins were measured...
2016: PloS One
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