Mina Tadrous1, Simon Greaves1, Diana Martins1, Muhammad M Mamdani1, David N Juurlink1, Tara Gomes1. 1. Affiliations: Li Ka Shing Knowledge Institute (Tadrous, Gomes), St. Michael's Hospital; Institute for Clinical Evaluative Sciences (Tadrous, Greaves, Martins, Mamdani, Juurlink, Gomes); Leslie Dan Faculty of Pharmacy (Tadrous, Mamdani, Gomes), University of Toronto; Institute of Health Policy, Management and Evaluation (Mamdani, Juurlink, Gomes), University of Toronto; Li Ka Shing Centre for Healthcare Analytics Research and Training (Mamdani), St. Michael's Hospital; Sunnybrook Research Institute (Juurlink), Toronto, Ont.
Abstract
BACKGROUND: Catastrophic drug coverage programs help those with high drug-costs to reduce the burden of out-of-pocket expenses. We set out to measure changes in utilization, spending and demographic profiles of people accessing Ontario's catastrophic drug program, the Trillium Drug Program. METHODS: We conducted a cross-sectional time-series analysis examining quarterly utilization and spending trends among medications reimbursed by the Trillium Drug Program in Ontario, Canada from Jan. 1, 2000, to Dec. 31, 2016. In each of 2000, 2005, 2010 and 2015, we described the population of beneficiaries, including demographic information, health care utilization and medication utilization. RESULTS: Over our study period, use of the Trillium Drug Program increased threefold from 3.6 beneficiaries per 1000 to 10.9 beneficiaries per 1000 Ontarians, and total government spending on the program increased by over 700%, reaching $487 million in 2016. Between 2000 and 2015, there was an increase in the number of beneficiaries who were under the age of 35 years (19.6% to 25.3%; p < 0.0001), did not have a hospital admission (68.3% to 80.5%; p < 0.0001) and had medium to high deductibles (2.3% to 8.0%; p < 0.0001). Further, there was a large increase in the percentage of users with drug claims greater than $1000 (3.4% to 10.4%; p < 0.0001) and those dispensed a high-cost biologic drug (1.6% to 5.5%; p < 0.0001). INTERPRETATION: Increasing use of Ontario's catastrophic drug program highlights the growing burden of high drug prices for Canadians. With a growing number of expensive drugs being approved in Canada, we anticipate that spending and use of the catastrophic drug program will continue to expand. Copyright 2018, Joule Inc. or its licensors.
BACKGROUND: Catastrophic drug coverage programs help those with high drug-costs to reduce the burden of out-of-pocket expenses. We set out to measure changes in utilization, spending and demographic profiles of people accessing Ontario's catastrophic drug program, the Trillium Drug Program. METHODS: We conducted a cross-sectional time-series analysis examining quarterly utilization and spending trends among medications reimbursed by the Trillium Drug Program in Ontario, Canada from Jan. 1, 2000, to Dec. 31, 2016. In each of 2000, 2005, 2010 and 2015, we described the population of beneficiaries, including demographic information, health care utilization and medication utilization. RESULTS: Over our study period, use of the Trillium Drug Program increased threefold from 3.6 beneficiaries per 1000 to 10.9 beneficiaries per 1000 Ontarians, and total government spending on the program increased by over 700%, reaching $487 million in 2016. Between 2000 and 2015, there was an increase in the number of beneficiaries who were under the age of 35 years (19.6% to 25.3%; p < 0.0001), did not have a hospital admission (68.3% to 80.5%; p < 0.0001) and had medium to high deductibles (2.3% to 8.0%; p < 0.0001). Further, there was a large increase in the percentage of users with drug claims greater than $1000 (3.4% to 10.4%; p < 0.0001) and those dispensed a high-cost biologic drug (1.6% to 5.5%; p < 0.0001). INTERPRETATION: Increasing use of Ontario's catastrophic drug program highlights the growing burden of high drug prices for Canadians. With a growing number of expensive drugs being approved in Canada, we anticipate that spending and use of the catastrophic drug program will continue to expand. Copyright 2018, Joule Inc. or its licensors.
Authors: Sobia Khan; Julia E Moore; Tara Gomes; Ximena Camacho; Judy Tran; Glenn McAuley; David N Juurlink; Michael Paterson; Andreas Laupacis; Muhammad M Mamdani Journal: Health Policy Date: 2014-07-08 Impact factor: 2.980
Authors: David N Juurlink; Tara Gomes; Dennis T Ko; Paul E Szmitko; Peter C Austin; Jack V Tu; David A Henry; Alex Kopp; Muhammad M Mamdani Journal: CMAJ Date: 2009-01-28 Impact factor: 8.262
Authors: Tara Gomes; Daniel McCormack; Sophie A Kitchen; J Michael Paterson; Muhammad M Mamdani; Laurie Proulx; Lorraine Bayliss; Mina Tadrous Journal: CMAJ Open Date: 2021-11-23