Mina Tadrous1, Diana Martins2, Muhammad M Mamdani2, Tara Gomes2. 1. Women's College Hospital Research Institute (Tadrous); Leslie Dan Faculty of Pharmacy (Tadrous, Mamdani, Gomes), University of Toronto; Li Ka Shing Knowledge Institute (Martins, Gomes) and Li Ka Shing Centre for Healthcare Analytics Research and Training (Mamdani), St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Mamdani, Gomes), University of Toronto; Department of Medicine (Mamdani), Faculty of Medicine, University of Toronto, Toronto, Ont. mina.tadrous@wchospital.ca. 2. Women's College Hospital Research Institute (Tadrous); Leslie Dan Faculty of Pharmacy (Tadrous, Mamdani, Gomes), University of Toronto; Li Ka Shing Knowledge Institute (Martins, Gomes) and Li Ka Shing Centre for Healthcare Analytics Research and Training (Mamdani), St. Michael's Hospital; Institute of Health Policy, Management and Evaluation (Mamdani, Gomes), University of Toronto; Department of Medicine (Mamdani), Faculty of Medicine, University of Toronto, Toronto, Ont.
Abstract
BACKGROUND: Drugs are the fastest growing cost in the Canadian health care system, owing to the increasing number of high-cost drugs. The objective of this study was to examine the characteristics of high-drug-cost beneficiaries of public drug plans across Canada relative to other beneficiaries. METHODS: We conducted a cross-sectional study among public drug plan beneficiaries residing in all provinces except Quebec. We used the Canadian Institute for Health Information's National Prescription Drug Utilization Information System to identify all drugs dispensed to beneficiaries of public drug programs in 2016/17. We stratified the cohort into 2 groups: high-drug-cost beneficiaries (top 5% of beneficiaries based on annual costs) and other beneficiaries (remaining 95%). For each group, we reported total drug costs, prevalence of high-cost claims (> $1000), median number of drugs, proportion of beneficiaries aged 65 or more, the 10 most costly reimbursed medications and the 10 medications most commonly reimbursed. We reported estimates overall and by province. RESULTS: High-drug-cost beneficiaries accounted for nearly half (46.5%) of annual spending, with an average annual spend of $14 610 per beneficiary, compared to $1570 among other beneficiaries. The median number of drugs dispensed was higher among high-drug-cost beneficiaries than among other beneficiaries (13 [interquartile range (IQR) 7-19] v. 8 [IQR 4-13]), and a much larger proportion of high-drug-cost beneficiaries than other beneficiaries received at least 1 high-cost claim (40.9% v. 0.6%). Long-term medications were the most commonly used medications for both groups, whereas biologics and antivirals were the most costly medications for high-drug-cost beneficiaries. INTERPRETATION: High-drug-cost beneficiaries were characterized by the use of expensive medications and polypharmacy relative to other beneficiaries. Interventions and policies to help reduce spending need to consider both of these factors. Copyright 2020, Joule Inc. or its licensors.
BACKGROUND: Drugs are the fastest growing cost in the Canadian health care system, owing to the increasing number of high-cost drugs. The objective of this study was to examine the characteristics of high-drug-cost beneficiaries of public drug plans across Canada relative to other beneficiaries. METHODS: We conducted a cross-sectional study among public drug plan beneficiaries residing in all provinces except Quebec. We used the Canadian Institute for Health Information's National Prescription Drug Utilization Information System to identify all drugs dispensed to beneficiaries of public drug programs in 2016/17. We stratified the cohort into 2 groups: high-drug-cost beneficiaries (top 5% of beneficiaries based on annual costs) and other beneficiaries (remaining 95%). For each group, we reported total drug costs, prevalence of high-cost claims (> $1000), median number of drugs, proportion of beneficiaries aged 65 or more, the 10 most costly reimbursed medications and the 10 medications most commonly reimbursed. We reported estimates overall and by province. RESULTS: High-drug-cost beneficiaries accounted for nearly half (46.5%) of annual spending, with an average annual spend of $14 610 per beneficiary, compared to $1570 among other beneficiaries. The median number of drugs dispensed was higher among high-drug-cost beneficiaries than among other beneficiaries (13 [interquartile range (IQR) 7-19] v. 8 [IQR 4-13]), and a much larger proportion of high-drug-cost beneficiaries than other beneficiaries received at least 1 high-cost claim (40.9% v. 0.6%). Long-term medications were the most commonly used medications for both groups, whereas biologics and antivirals were the most costly medications for high-drug-cost beneficiaries. INTERPRETATION: High-drug-cost beneficiaries were characterized by the use of expensive medications and polypharmacy relative to other beneficiaries. Interventions and policies to help reduce spending need to consider both of these factors. Copyright 2020, Joule Inc. or its licensors.
Authors: Alexander H Flannery; Komal Pandya; Melanie E Laine; Philip J Almeter; Jeremy D Flynn Journal: Pharmacotherapy Date: 2016-12-20 Impact factor: 4.705
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Authors: Justin Lee; Sergei Muratov; Jean-Eric Tarride; J Michael Paterson; Kednapa Thavorn; Lawrence Mbuagbaw; Tara Gomes; Wayne Khuu; Hsien Seow; Lehana Thabane; Anne Holbrook Journal: CMAJ Open Date: 2021-01-11