A new study published in CMAJ
discovered that, since the 2003 introduction of Canada`s Common Drug
Review, the number of drugs
covered by public drug plans has considerably decreased.
There are 19 public drug plans in Canada. In 2010, these plans accounted for approximately 39% of the projected $31 billion in drug-related costs. The plans include the costs of a variety of drugs prescribed to individuals. Prior to 2003, each of the 19 plans independently analyzed evidence and cost-effectiveness for novel medications that were considered for being listed in the plans. The Canada Common Drug Review, managed by the Canadian Agency for Drugs and Technologies in Health
, was launched in order to standardize the process, improve effectiveness by grouping resources and expertise as well as to terminate duplication. Quebec does not participate in the Common Drug Review.
Investigators from the University of Alberta discovered that the amount of drugs listed for coverage decreased considerably. Drug plans who participated in the study, listed between 47% and 66% of novel medications in the five years prior to the introduction of the Common Drug Review and between 12% and 40% in the five years after. In addition, they discovered that the time from being recommended for listing to actual listed date varied between 99 to 358 days, in comparison with a mean time-to-listing of 778 days (over 2 years), prior to the Common Drug Review.
Furthermore, they found that listing decisions of public drug plans and recommendations of the Common Drug Review varied significantly.
Dr. Dean Eurich, School of Public Health, University of Alberta, and team, explained:
"The proportion of drugs listed decreased significantly after the introduction of the Common Drug Review for all participating drug plans included in our analysis. Time-to-listing decreased for a number of the smaller provinces."
According to the researchers numerous factors may explain the decrease, such as uncertainty regarding how effective the medications submitted by pharmaceutical companies for review are in clinical trials.
"Our findings suggest that the Common Drug Review may have contributed to a streamlining of the process for reviewing drugs for certain jurisdictions. Specifically, patients in the provinces of New Brunswick, Prince Edward Island, and Newfoundland and Labrador may have benefited with earlier access to new drugs. Any substantial gains in savings or in the efficiency of publicly funded drug plans to make listing decisions are important factors in maintaining the health and safety of Canadian patients."
Written by Grace Rattue
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