Archive for the ‘Drug treatment’ Category


The cost of drug treatment in Ontario(8)

Oct 11, 2012 Author: Walter Mcneil | Filed under: Drug treatment

I am still optimistic that there are many avenues, including prescribing guidelines, that can be pursued in a concerted way that will lead to improved drug therapy and better health outcomes. For example, guidelines should be combined with physician education programs that may include information delivered by pharmaceutical detailers, published materials, clinical guidelines, etc, as part of a multidimensional program.

There is evidence to show that behavioural interventions aimed directly at doctors and other relevant health professionals can influence prescribing through various means, most notably by educational outreach visits modelled on the familiar activities of drug company representatives.

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The cost of drug treatment in Ontario(7)

Oct 10, 2012 Author: Walter Mcneil | Filed under: Drug treatment

The cost of drug treatment in Ontario(5)

The OPOT funding is also employed to encourage studies related to the dissemination of guidelines, the development of implementation strategies such as education, the promotion of ongoing assessment of drug use in Ontario and the evaluation of the impact of guidelines.

Additionally, the Ministry of Health and Canada’s Research Based Pharmaceutical Companies (Rx&D) recently established a committee to review the process under which forecasts of future drug use are made in written agreements with manufacturers. The committee is expected to identify causes and actions to deal with inappropriate utilization. The first meeting of the DUAC was held in late September 1999. The committee, chaired by Dr George Carruthers, Chair of the Department of Medicine and Chief of Clinical Medicine, University of Western Ontario, London, Ontario, is made up of 10 other members representing physicians, pharmacists, consumers, industry and the Ministry of Health. buy diabetes drugs

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The cost of drug treatment in Ontario(6)

Oct 9, 2012 Author: Walter Mcneil | Filed under: Drug treatment

3. Do not ignore factors influencing prescribing practices, such as the unique needs of the patient

4. Do not make self-interested decisions

On the other hand, there are some things that should definitely be done.

1. Make the setting of prescribing guidelines a collaborative effort

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The cost of drug treatment in Ontario(5)

Oct 8, 2012 Author: Walter Mcneil | Filed under: Drug treatment

The cost of drug treatment in Ontario(5)

Part of New Zealand’s Preferred Medicines Concept aims to give general practitioners information on cheap drugs and to provide administrative support to help them develop their own ‘preferred medicines lists’ in a ‘critical and rational’ manner. Again, use of these lists is voluntary, and guidelines for therapeutic choice are provided without any explicit incentive to reward compliance.

Of course, there are many other levers that the government may use to manage prescribing expenditures. Of particular note is reference-based pricing, which involves the establishment of a reimbursement price for a therapeutic category of drugs. Patients are required to pay the difference between the cost of the prescribed product and the reference price. Another method is copayment, which requires that patients pay a proportion of the cost of a prescribed product or a fixed charge per prescription. In some models, copayment and reference-based pricing appear to affect the use of other health services. Elsewhere, governments employ budgetary restrictions to limit drug spending by forcing physicians to pay for the drugs prescribed over their set budget.

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The cost of drug treatment in Ontario(4)

Oct 7, 2012 Author: Walter Mcneil | Filed under: Drug treatment

Surveys suggest that 75% of French doctors prescribe in line with the new treatment guidelines. Introduction of the guidelines was associated with a 15% reduction in antibiotic prescribing for the first six months of 1994, although this may be accounted for by fewer large influenza epidemics and other potential confounding factors. Prescriptions for nonsteroidal anti-inflammatory drugs and antiulcer drugs have also been reduced, apparently as a result of guidelines.

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The cost of drug treatment in Ontario(3)

Oct 6, 2012 Author: Walter Mcneil | Filed under: Drug treatment

The cost of drug treatment in Ontario(3)

The Ministry has also undertaken to work with all interested parties to address drug costs. For example, we now enter into written agreements with brand name manufacturers on individual products to be listed in the formulary. To review this process and to offer guidance with respect to predictability of use and price, the Drug Utilization Advisory Committee (DUAC) has been established. Last year, the Ontario Program for Optimal Therapeutics (OPOT) was established and funded to commission prescribing guidelines and related evaluative studies.

No one party, least of all government, should take sole responsibility on the cost issue. Government, pharmaceutical companies, pharmacists, doctors, patients, insurers and employers all have a role to play in a collaborative effort that puts aside self-interested decision making.

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The cost of drug treatment in Ontario(2)

Oct 5, 2012 Author: Walter Mcneil | Filed under: Drug treatment

Nonetheless, the program cannot pay for every drug. For prescription drugs, the line is drawn in stages so that some drugs are routinely available, some drugs are approved only for limited uses and other drugs are not available unless a clinically credible case for special circumstances is made.

The program must deliver maximum benefit for public expenditure. This means that the best possible value must be obtained for drug products, and the best possible dispensing fees should be negotiated, while keeping within a budget.

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The cost of drug treatment in Ontario(1)

Oct 4, 2012 Author: Walter Mcneil | Filed under: Drug treatment

The cost of drug treatment in Ontario(1)

You might have the impression from the title of this article that there is a monetary value, a specific number, that the Ministry of Health and Long term care attaches to drugtreatmentin Ontario. While budgets are set every year for specific drug programs, including the Ontario Drug Benefit program, the Trillium Drug Program and the SpecialDrugsProgram, the resulting expenditure represents a balanced equation. The reality is that the entire health care system must be managed with finite resources. This means that the Ministry is responsible for examining the relationships among all of the programs that it manages, and realizing that changes to one mean changes to others. Therefore, priorities and limits must be set for drug programs while trying to achieve the goal of offering the best possible service for patients.

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