FROM THE TEAM
Thoughts from South of the Border
My wife has recently started a Radiology Fellowship in San Diego. So, besides an opportunity to spend time in one of the most ideal climates in North America, I have also had the opportunity to become better acquainted with some of the American philosophies on prescription drug use and management.
The first thing I really noticed was the pervasiveness of direct-to-consumer advertising. I was well aware of its constant presence on US television stations, but I didn't appreciate the degree it occurred through other venues. On our first weekend, we spend Saturday morning at nearby La Jolla beach, where we were quickly accosted by a 20-something year old woman pitching the newest birth control pill, Seasonique™. There was an entire troop of these representatives out on the beach targeting women aged 13 to 35, handing out pamphlets and coupons for samples if it was prescribed by their physicians. Needless to say, I found it somewhat disconcerting to see prescription medications being hocked along side beach towels and boogie boards on the boardwalk.
Another notable experience was a conversation I had with the leasing manager of the apartment complex my wife and I moved into. The complex is the property of a large company which owns and manages a number of resorts, apartments, offices and recreational facilities in California. When I explained what I did and the company I worked with in Canada, he proceeded to tell me that their company had recently undergone some "upgrades" to their healthcare benefits program. One of the notable changes was the shift from a 3-tier to a 5-tier drug plan. Their new plan expanded their access to some newer drugs in the 5th tier (with a high co-pay), but also lowered the co-pay for generic drugs in the 1st tier. Beyond this, he mentioned a large expansion in wellness programs and other preventative strategies that were available to him.
Thinking about these two separate experiences, I was struck by the polarized nature of the system in the United States. On the one hand, you have the extreme commercialization of drug use and on the other, you have the very rational drug use polices of their corporate plan sponsors. If you then consider the Canadian system, you basically see moderation in both these areas. We have laws against direct-to-consumer advertising which limits commercialization of healthcare to some extent. However, we also have corporate benefits philosophies and structures that in general do not implement strategies for rational drug use. For example, only a relatively modest percentage of Canadian plan sponsors even have generic substitution policies in place, let alone fully managed formularies. I believe it is worthwhile to look towards the United States, both for things we should and should not do to rationalize drug use in Canada.
To pass along any comments on Cubic Health Monthly, or to see back issues of our publication, please visit our website at http://www.cubichealth.ca.
Sincerely,
Kyle MacNair
Vice President, Clinical
| LATEST NEWS |
Generic Drug Prices Questioned Again
A study just released by the Fraser Institute finds that the prices for generic drugs in Canada in 2006 were on average more than double (115%) those in the United States. At the same time, prices for brand name pharmaceutical products in Canada were 51% lower than their American counterparts during the same period. These differences are up from the 78% and 43% discrepancies in generic and brand name drug prices, respectively, found from a similar review in 2005.
Click here to read more...
|
| DRUG & DISEASE NEWS |
Prexige® Withdrawn in Australia
On August 10th, 2007, the Australian Therapeutic Goods Administration (TGA) put out an Urgent Medicine Recall for all dosages of Prexige® (lumaricoxib). This medication belongs to the same "COX-II" anti-inflammatory class of drugs as Vioxx®, which received considerable attention from the media with its withdrawal from the market in September 2004. Although Prexige® has only been on the market in Canada for 9 months, it has been marketed in Australia for just over three years. In this time period, the TGA has received 8 case reports of serious liver adverse events, two of which resulted in the death of the patient and two others that resulted in liver transplantation. Because of the severity of these reported reactions, the regulatory authority chose to cancel the registration of this drug and recommended that patients immediately discontinue its use.
Click here to read more...
|
Avandia® Safety Questioned
Yet another new therapy is under serious scrutiny by drug regulators around the world for potentially increasing cardiovascular events. The safety of Avandia® (rosiglitazone), used in the management of type 2 diabetes, was brought into question with the publication of a meta-analysis in the June edition of the New England Journal of Medicine.1 A meta-analysis is not itself a study, but a combination of data from several smaller trials into a larger analysis. It is a good way for researchers to look for rare side effects that may not show up in individual studies that have limited patient enrollment or a short duration.
Click here to read more...
|
NOC Watch:
Novo-Olanzapine (olanzapine)
Seasonale® (levonorgestrel and ethinyl estradiol)
Click here to read more...
|
| FOR THE PLAN SPONSOR |
The Impact Of The Few
Many plan sponsors continue to experience year-over-year increases in their drug plan that are of concern, yet find themselves feeling that their hands are tied, unable to consider changes to their overall plan design. A question we often field is what, if anything, can be done?
Click here to read more...
|
|
