Pharmaceutical Outcomes and Policy Innovation

Canada is facing one of the highest growth rates for drug costs among developed nations. As a result, cost is the primary factor leading public policy decisions for drug insurance programs. Researchers in this unit will conduct studies to systematically assess the effectiveness and safety of prescription drugs in tandem with cost-effectiveness. Their studies will help provide an evidence-based platform upon which policy-makers can make rational decisions about drug plan coverage.

Canada is facing one of the highest growth rates for drug costs among developed nations. As a result, cost is the primary factor leading public policy decisions for drug insurance programs. Researchers in this unit will conduct studies to systematically assess the effectiveness and safety of prescription drugs in tandem with cost-effectiveness. Their studies will help provide an evidence-based platform upon which policy-makers can make rational decisions about drug plan coverage.

New prescription medications have produced important health benefits, including better disease management and reduced need for some surgeries. But like many developed nations, Canada is facing a crisis in rising drug costs. In BC current Pharmacare costs of $110 million a year are increasing 16 per cent annually. Public demand and the supply of new drug therapies continue to grow but government funding for drug benefits insurance can no longer keep pace.

Cost concerns are now a primary driver of drug policy development in Canada. This has made it increasingly important for government drug plans to expand their focus to equally consider drug safety and effectiveness in policy decision making.

To address this issue, the Pharmaceutical Outcomes and Policy Innovation (POPI) Research Unit at the University of BC will study drug effectiveness, safety and costs to provide decision makers with cost effective drug coverage strategies that produce the best health outcomes. Much of the work has a focus on pharmaceutical use by children and seniors, two populations particularly at risk for adverse drug reactions.

The POPI unit has access to the largest prescription database in Canada: BC’s PharmaNet system has captured all prescription drug purchases by BC residents since 1995, and can be linked to other databases with information on physician services, hospital care and vital statistics. POPI has three research themes:

• Drug effectiveness
  POPI will recommend improvements in clinical and public policy through several projects. These include studying trends and regional variations in asthma care and patient compliance with treatment; examining how to assess “real life” drug effectiveness in patients who may have multiple medical conditions, especially seniors; evaluating five provincial drug plans to determine optimal policies; evaluating the impact of academic detailing, or educational outreach, on drug prescribing across Canada to identify best practices in detailing programs; and identifying trends, safety concerns and research priorities regarding the dispensing of prescription medication to BC children.
• Drug safety
  Using data on adverse drug reactions collected from 2,300 pediatricians across Canada, POPI will focus on surveillance and prevention of adverse drug reactions in children, reviewing the data quarterly and making recommendations to minimize the risk of adverse reactions in future. The same data will allow researchers to identify genetic predictors that predispose children for adverse drug reactions, develop potential screening procedures, and analyze the implications of publicly funding such screening.
• Drug cost management
  Research will support decision makers in establishing evidence-based drug cost policies. Studies will include: an evaluation of prescribing improvement strategies; an examination of whether combining the different drug pricing systems used in BC and Germany can both save money and avoid adverse health effects; a study of the impact of the recent change in the Pharmacare deductible on BC seniors, who are now required to pay drug costs up to a deductible based on income; and research on heavy users of asthma-related care to provide evidence on drug safety and cost effectiveness.

Award term completed September 2009.