Posts Tagged ‘Prescription Drug Policy’
Good read at BenefitsCanada.com
The current wave of prescription drug reform across Canada could result in a range of benefits for plan sponsors, but the process is still in its infancy and the outcome is far from clear.
According to a panel of experts, organizations that are proactive and ready to cut a deal will fare much better than those which choose to let the government set the rules for them.
A recent International Foundation of Employee Benefit Plans webinar entitled Law & Order: the case for drug reform in Canada featured Marc Kealey, president of ArcisRx and principal with Kealey & Associates, Inc, and Murray Gold, a partner Koskie Minsky LLP. They explained that as Canada tires of its dubious distinction of paying the highest prices in the world for generic drugs, provincial governments have taken—or will be taking—action to bring costs down.
Quebec, Ontario and Alberta have either proposed or tabled drug reform legislation and British Columbia and Atlantic Canada are expected to do so shortly. The benefits of such reforms—should they be passed—are enhanced affordability for plan sponsors, clinical expertise for drug plan re‐design and analytics, and an alternative distribution process to get medications to plan members with assurances of high levels of service and cost savings.
Read the rest – http://www.benefitscanada.com/benefit/health/article.jsp?content=20100514_171312_11656
Pharmacists are Canada’s most accessible health professionals.
Pharmacists are Canada’s most accessible health professionals and play an important role in promoting, maintaining and improving the health of the communities they serve. Health promotion is now firmly on Ontario’s healthcare agenda and there is both an opportunity and a need for community pharmacists to become more involved in delivering public health services.
Every day Ontario pharmacists work as advocates for health. They support self help. They are local and accessible and provide patients with important health advice. Pharmacists promote health not just by advising on the proper use of medicine but also by counseling patients in areas such as diet, sexual health, and reducing tobacco and alcohol consumption.
Health spending is increasing at a rate far greater than other provincial government spending. As the population ages and the prevalence of chronic conditions increases the growth in new diagnoses for chronic conditions such as hypertension, diabetes, and arthritis actually exceeds Ontario’s population growth. The increase in diagnoses of chronic conditions is a key driver of health spending growth in Ontario.
As front-line health care providers, Ontario pharmacists are uniquely positioned to help the Ontario government achieve its objectives to improve health outcomes and control costs in our healthcare system. By helping patients comply with treatment regimens, by providing counseling on lifestyle changes, by helping to reduce the complications associated with chronic conditions and by ensuring symptoms are properly managed, Ontario pharmacists can make a big difference in improving the health of Ontarians.
Patient health management is a health care intervention that allows patients to be more involved in managing their own health outcomes. By engaging in patient health management both public and private health insurers can commit healthcare resources to keep people well and to manage diseases and conditions in a manner that avoids the costly complications associated with chronic conditions. Effective patient health management programs contain health costs by reducing the need for other more costly health care interventions. It also helps the elderly maintain independence and keeps our aging population as healthy as possible through prevention, early detection, and proper management of symptoms.
Physicians know what needs to be done to provide appropriate care consistent with clinical practice guidelines, but often lack the tools, the resources, or the time to do it. Pharmacy-based patient health management addresses this issue with significant health care delivery advantages. Involving patients in their own health management increases the patient’s sense of ownership and control (patient centered care). Patients are able to remain healthy, active & productive members of society for longer through greater disease control. There is increased compliance and adherence to treatment and, with improved patient health outcomes health care costs are contained.
In many jurisdictions pharmacists are recognized as key members of primary care teams. In the United Kingdom, the Department of Health recently launched a program for pharmaceutical public health by publishing Choosing Health Through Pharmacy. The U.K Minister of Health describes this as “a commitment to publish a strategy for pharmaceutical public health in 2005 which will expand the contribution that pharmacists, their staff and the premises in which they work can make to improving health and reducing health inequalities.” In North Carolina, the City of Asheville took a proactive approach to contain its rapidly rising employee health costs by instituting a pharmacy-driven patient health management program that was so successful in improving health outcomes and containing costs that it is now being replicated in major cities across the country
Community pharmacists in Ontario are ready, willing and able to increase their involvement and contribution to public health in collaboration with government, physicians and other health professionals. Pharmacist-based patient health management can achieve better health outcomes. The results are healthier patients, and more cost-effective use of precious health care resources.
Remarks from Solutions in Drug Plan Management Discussions
Here is my speech entitled “A Challenge for Innovation”, the entire document is reproduced below.
Adam Radwanski in the Globe – “Drugstores poised to become true health-care hubs”
Another interesting article by Adam Radwanski in today’s Globe and Mail.
But now Dalton McGuinty’s government is positioned to leap to the front of the pack in transforming the profession.
Not only has it empowered pharmacists to perform certain services traditionally restricted to doctors – such as giving vaccinations and prescribing some medications – but it has the chance to provide a groundbreaking incentive to take on those tasks, turning pharmacies into health-care hubs.
Before Christmas, the Ontario legislature unanimously passed Bill 179, which permits pharmacists (along with nurses and nurse practitioners) to perform services normally limited to doctors – services they have already begun to provide in other provinces, including British Columbia, Quebec, Alberta and New Brunswick.
Pharmacists have been poised to assume a leadership role in healthcare in Ontario for decades. The lure of rebates has been the single biggest reason why community pharmacists (either independent or part of a chain) have never really fully engaged in a scope of practice that would sincerely garner public trust in their role as part of the health team.
The McGuinty government has done more for the profession in the past 6 years through landmark legislation like the passage of Bill 102, which gives pharmacists the opportunity to assume a rung in the ladder of primary care through Meds Check. It also passed Bill 171 which increased the scope of practice for Pharmacist techs which has opened the door for pharmacists to assume an even greater role as Mr. Radwanski points out through the recent passage of Bill 179.
There is much more work to do. Long Term Care and Specialty Pharmacists play a vital role in the health care of patients and their issues need to be addressed. Hospital pharmacists have long been a part of primary care teams among health professionals. Moving pharmacists out of the basement of hospitals and onto floors, so to speak, has been a boon for patient care.
The opportunity exists through all the drug reform initiatives that are occurring across the country for pharmacists to rise to the occasion and fill a role that patients want for them to be a competent part of their health care team.
Adam Radwanski on Pharmacy in the Globe.
Here is a link to an interesting article written by Adam Radwanski in Sunday’s Globe and Mail.
The Truth about Cross Border Drug Importation
There was a time when Canadians thought that a free flow of goods and services between Canada and the United States was the sign of prosperity and good neighbourliness. There was a time when free trade was a battle worth fighting because some might have thought that Canada would be the net loser in a battle between the richest and most powerful nation on earth who would never yield sovereignty on trade to any country. And now, as Canadians, we face a challenge equal to the election fight in 1988 on Free Trade and that is the little understood issue of cross border re-importation of drugs from Canada to the United States.
To add perspective, in the past 10 years or so, there has been the proliferation of mail-order and internet sales of prescription medications from Canada to the United States. On the surface, this might appear to be a good way for enterprising Canadians to make good on the sale of what is widely known as ‘cheaper’ Canadian prescription medications to Americans. This occurs ostensibly because Canada’s Patented Medications Prices Review Board (PMPRB) regulates prices in this country at a level that is about fifty percent cheaper for the same patented medications in the United States. In short, the practice of selling these drugs to the United States has made some people in Canada very wealthy. And what’s wrong with that? Well plenty if you consider what the ramifications are.
The United States has a problem with its prescription drug policy. It can’t seem to fix it at home, so lawmakers in Congress and in many States across their Union are looking outside the United States to fix that problem. In the summer 2006, a piece of Legislation was introduced in the US that allowed a 90 day supply of prescription medications to be purchased by American patients and brought back to the United States without any problem. That was just the start. Recently a bi-partisan piece of Legislation was introduced in the US that will allow the bulk re-importation of prescription medications to the United States compliments of enterprising Canadian supply companies who can source the medications that Americans want at the expense of Canadian patients.
Let’s delve into this deeper. The highly regulated world prescription drug business is based on population. Canada is 2% of the world’s business, so, it is allotted a 2% quota per se on the amount of prescription medications. Consider for a moment that the United States legislation on the free flow of cheaper Canadian meds can make their way to the US through bulk re-importation and we, as Canadians, are faced with the potential for supply shortages on chronic or other meds.
If you don’t think its real, think again.. Recently supply shortages for oral contraceptives in Canada are being realized. Consider that US Internet Pharmacy Global Americana has increased its profitability to 34% based largely on imports from Canadian sources and that the fastest growing target group is no seniors as you might have suspected, but young people wanting cheaper priced pharmaceuticals – you get the picture.
Canadian pharmacy organizations are quite rightly concerned about this issue and have weighed in on this matter loudly. Our reasons are based on our obligations to our patients in Canada and, frankly, on the right thing – to ensure an adequate supply of Canadian prescription medications for Canadians.
This issue is complicated because it crosses so many policy areas – health, international trade, foreign affairs and industry.
But looking at the issue on the whole there are basically 3 areas of major concern to Canadians. They are:
- The Canadian prescription drug supply cannot withstand an all out onslaught of US patients wanting cheaper Canadian priced meds. Imagine if we, in Canada, at 33 million people went to Iowa, a State of 3 million people and said ‘ hand over your meds’? This is what we’re dealing with in the face of this new US legislation. In fact, an authoritative report out of the University of Texas at Austin recently published suggested that if this Legislation in the US was allowed to proceed, American patients could wipe out Canada’s drug supply in 38 days. Think about that for a moment – in one month our quota would be gone. That’s not a trade issue that’s outright lack of respect for our system,
- The proliferation of greed – counterfeit medications have increased as a direct result of this practice. In fact, in a recent crackdown in the United States, lawmakers seized a shipment of meds at the border at Detroit and uncovered 19 million dollars worth of counterfeit meds. That meant that several million Americans would not be receiving counterfeit meds and as a consequence lost millions of dollars in this scheme. The very real threat continues with much of the ‘booty’ going to nefarious organized crime elements in off shore locations.
- In much of our advocacy efforts, we have concurred with Giuliani Partners who in 2005 readily opined that if the practice of wholesale bulk importation was allowed to proliferate a new threat could emerge and that would be through terrorism via this re-importation scheme. Today it’s counterfeit drugs from crime gangs in off-shore locations – tomorrow it may be anthrax or cyanide from a terrorist element. Think about that for a moment.
We have brought our concerns to several State legislatures and Congress. We continue to fight this issue back home plying pressure on the federal government to move legislation of its own that will ban the practice of internet pharmacies selling to US patients and to ban outright any attempt to bulk importation. We have met recently with the federal Minister of Health, Tony Clement who has informed us that this issue is a high priority for him. In the meantime, we are taking our fight right to Washington with visits there in the coming weeks. Our goal is to protect the interests of Canadians patients and ensure that our supply and our system remains intact and Canadian.
U.S. Expert’s perspective on bulk export of Canadian Prescription Drugs
In response to the growing concerns over the cross-border prescription drug trade, an event was hosted at the National Press Club where Dr. Marv Shepherd, an expert on the importation of drugs from the University of Texas, spoke to a Canadian audience about the negative impact of drug exports to the US.
We have been voicing concerns for the past two years about the detrimental impact of the spread of cross-border trade in prescription drugs, and more specifically drug re-importation into the United States via Internet pharmacies.
“Our message to the government of Canada is to move quickly to ban all export of prescription drugs, said Marc Kealey. “This will in effect eliminate the potential risk to the Canadian supply of prescription drugs, and as importantly, eliminate the potential risk on patient safety due to the unregulated internet pharmacy trade.”
Prescription drugs are a highly political issue in the U.S. because of their high prices and cases of Americans going across the border to Canada for treatment or to buy drugs have been growing.
One of the biggest problems associated with importation is people never know exactly where the drugs are coming from. There is no guarantee that imported drugs are safe. Just because there is a Canadian flag on the website, doesn’t mean that the source of the drug is from Canada. Therein lies the problem for Americans – who may not be certain that the drugs they receive via Internet Pharmacy may be real.
A country with 33 million citizens should not be supplying the prescription needs of a country with 280 million,” said Kealey. “Raiding Canada’s medicine cabinet will not solve health care problems in the U.S.”
This has been the ongoing message that Marc Kealey has delivered to media and to stakeholders across the country and in several states in the United States, including Texas, Maine, Florida, Rhode Island, Michigan, Illinois, Nevada and Vermont.
Remarks from 5th Annual Health Policy Summit
Here is my speech entitled “Cross-border Prescriptions and the Impact on Canadian Health Care“, the entire document is reproduced below.
