Survey shows new drug plan hurts

Patients are being compromised by B.C.’s square-peg-in-a-round-hole drug payment plan, an independent CARP survey of doctors and pharmacists has determined.

Vancouver’s MarkTrend Research questioned 254 physicians and 250 pharmacists for CARP. “The survey results confirm the problems our B.C. members have been telling us about since this policy began a year and a half ago,” said CARP’s President, Lillian Morgenthau. “These are real people with real health problems that are being made worse by this restrictive drug policy,” she told a packed forum held in Surrey, B.C., hosted by CARP’s White Rock Chapter on May 13th. Panelists included Dr. William McArthur of the Fraser Institute, Derek Desrosiers, Director of Pharmacy Services, British Columbia Pharmacy Association, and Wilf Hurd, Liberal MLA of White Rock.

The system of reference-based drug pricing requires doctors to prescribe the cheapest drug from a group of medications that treat the same condition. (This should not be confused with the substitution of generic drugs.) But three-quarters of the physicians surveyed reported patients whose symptoms — particularly high blood pressure — worsened after switching to a dierent drug under the plan. Problems also included side effects from the medication and non-compliance (not taking the medication as directed).

Patient visits increased following implementation of the plan, 78 per cent of the doctors noted; one in five reported patients who needed emergency room treatment or hospitalization. This increased use of healthcare resources mirrors the situation in other countries using similar restrictive drug policies. Although doctors can now request Special Authorization (SA) to obtain permission to prescribe a non-reference drug, the physicians worry that the system is time-consuming and inefficient, causing delays in getting the appropriate medication to patients. The intervention of an added layer of bureaucracy hampers their ability to prescribe what they see as appropriate treatment.

Medications currently covered by reference-based pricing include drugs for treating high blood pressure, congestive heart failure, angina, ulcers and arthritis. The survey showed the doctors, by a two to one margin, opposed adding drugs for asthma and for lowering cholesterol to the scheme.

The vast majority of doctors (81 per cent) and pharmacists (91 per cent) want alternatives to reference-based drug pricing, such as integrated care models or education programs for patients and physicians. CARP President Morgenthau agreed. “For seniors, the bottom line is our health. That means making sure doctors and their patients have the maximum choice when making prescribing decisions.”

“Access to the right drugs is so critical that we can’t let governments take us down this road to American-style medicine,” she said.