The impact of cost-sharing within Canadian provincial drug benefit programs: A review

Journal of Pharmaceutical Finance, Economics and Policy

Volumn 13, Issue 1, 2004, Pages 35-53

  Harten, Cheryl ^a   Ballantyne, Peri ^a  

^a UNIVERSITY OF TORONTO   (Canada)

Author keywords

Cost sharing; Medicines; Pharmacare; Prescription drugs

Indexed keywords

ANTIHYPERTENSIVE AGENT; BENZODIAZEPINE;

CANADA; COST; COST BENEFIT ANALYSIS; DRUG COST; DRUG PROGRAM; DRUG UTILIZATION; ECONOMIC ASPECT; HEALTH CARE POLICY; HEALTH PROGRAM; PRESCRIPTION; PRIORITY JOURNAL; REVIEW;

EID: 5444254860     PISSN: 15385698     EISSN: None     Source Type: Journal    
DOI: 10.1300/J371v13n01_04     Document Type: Review

References (50)

1. Romanow Roy J. Building on Values. The Future of Health Care in Canada. Final Report. Commission on the Future of Health Care in Canada Cat. No. CP32-85/ 2002E-IN. November 2002.
2. Shah, Chandrakant, Public Health and Preventive Medicine in Canada 4th Edition. University of Toronto Press, 1998.
3. Jacobs P, Bachynsky J. Public polices related to drug formularies in Canada: economic issues. Institute of Health Economics Working Paper 00-2, 2000.
4. Canadian Health Services Research Foundation. Pharmacare in Canada. Commission on the Future of Health Care in Canada, May 2002. http://www. healthcarecommission.ca/default.asp?DN=cn=1007,cn=1004,cn=9,cn=2,ou=Stories,ou= Suite247,o=HCC (Aug. 9, 2002).
5. Anis A, Guh D, Wang X. A dog's breakfast: Prescription drug coverage varies widely across Canada. Med Care 2001; 39(4): 315-326.
6. Canadian Pharmacists Association. Provincial Drug Benefit Programs: A summary of prescription drug benefit plans sponsored provincially in Canada. Ottawa: Canadian Pharmacists Association; 2001a.
7. Gregoire J, MacNeil P, Skilton K, Moisan J, Menon D, Jacobs P, et al. Inter-provincial variation in government drug formularies. Can J Public Health 2001; 92(4): 307-12.
8. Angus D, Karpetz H. Pharmaceutical policies in Canada. Issues and challenges. Pharmacoeconomics 1998; 14 Suppl 1: 81-96.
9. Hurley J, Johnson N. The effects of co-payments within drug reimbursement programs. Can Public Policy 1991; 17(4): 473-89.
10. Canadian Institute for Health Information. Health care in Canada 2002. 2002. http://secure.cihi.ca/cihiweb/hcic/hcic.html#chapter (Aug. 14, 2002).
11. Canadian Pharmacists Association. Submission to the Romanow Commission on the Future of Health Care in Canada. Ottawa, October 2001b.
12. Vail S. Canadians' values and attitudes on Canada's health care system: a synthesis of survey results. Conference Board of Canada October 6, 2000. www. conferenceboard.ca/health/reports.htm
13. Canadian Pharmacists Association. 1999. Canadian Pharmacy Coalition on Pharmacare. Building Pharmacare: Expanding the Health Care Contract with Canadians. http://www.pharmacists.ca/content/about_cpha/who_we_are/ partnerships_coalitions/ pdf/PharmacareDiscussionPaper.pdf (Aug. 9, 2002).
14. National Forum on Health. Directions for a Pharmaceutical Policy in Canada. Synthesis reports and issues papers-Final Report-Volume II; 1997. wwwnfh.hc-sc.ca/publicat/finvol2/pharm/idxphar.htm (Aug 9, 2002).
15. Rx&D Canada's Research Based Pharmaceutical Companies. http://www. canadapharma.org/Patient_Pathways/Drug_Plans/provincial_e.html (Aug. 9, 2002).
16. Roemer M, Hopkins C, Lockwood C, Gartside F. Copayments for ambulatory care: penny-wise and pound-foolish. Med Care 1975; 13(6): 457-66.
17. Biais L, Boucher JM, Couture J, Rahme E, Lelorier J. Impact of a cost-sharing drug insurance plan on drug utilization among older people. J Am Geriatr Soc 2001; 49(4): 410-14.
18. Tamblyn R, Laprise R, Hanley J, Abrahamowicz M, Scott S, Mayo N. et al. Adverse events associated with prescription drug cost-sharing among poor and elderly persons. JAMA 2001; 285(4): 421-29.
19. Reeder CE, Lingle E, Schulz R, Mauch R Jr, Nightengale B, Pedersen C, et al. Economic impact of cost-containment strategies in third party programs in the US (Part 1). PharmacoEconomics 1993; 4(2): 92-103.
20. Nelson A Jr, Reeder CE, Dickson M. The effect of a Medicaid drug copayment program on the utilization and cost of prescription services. Med Care 1984; 22(8): 724-35.
21. Harris B, Stergachis A, Ried LD. The effect of drug co-payments on utilization and cost of pharmaceuticals in a Health Maintenance Organization. Med Care 1990; 28(10): 907-917.
22. Smith D. The effects of copayments and generic substitution on the use and costs of prescription drugs. Inquiry 1993; 30: 189-98.
23. Johnson R, Goodman M, Hornbrook M, Eldredge M. The effect of increased prescription drug cost sharing on medical care utilization and expenses of elderly health maintenance organization members. Med Care 1997a; 35(11): 1119-31.
24. Martin B, McMillan J. The impact of implementing a more restrictive prescription limit on Medicaid recipients. Med Care 1996;34(7): 686-701.
25. Johnson R, Goodman R, Hornbrook M, Eldredge M. The impact of increasing patient prescription drug cost sharing on therapeutic classes of drugs received and on the health status of elderly HMO members. Health Serv Res 1997b; 32(1): 103-122.
26. Noyce P, Huttin C, Atella V, Brenner G, Haaijer-Ruskamp, Hedvall M. The cost of prescription medicines to patients. Health Policy 2000; 52 (2): 129-145.
27. Lundberg L, Johannesson M, Isacson D, Borquist L. Effects of user charges on the use of prescription medicines in different socio-economic groups. Health Policy 1998; 44(2): 123-34.
28. Management Sciences For Health in collaboration with the World Health Organization Action Program for Essential Drugs. Managing Drug Supply: The Selection, Procurement, Distribution and Use of Pharmaceuticals. Kumarian Press, 1997.
29. University of Calgary. Glossary of insurance and financial planning terms. http://www.ucalgary.ca/MG/inrm/glossary/gloss-p.htm (Aug. 9, 2002).
30. Poirier S, Lelorier J, Page V, Lacour A. The effect of a $2 co-payment on prescription refill rates of Quebec elderly and its relationship to socio-economic status. Can Pharm J 1998; 130(10): 30-34.
31. Hux J, Fielding D. The Ontario Drug Benefit program copayment: its impact on access for Ontario seniors and charges to the program. Institute for Clinical Evaluative Sciences in Ontario Working Paper, 1997.
32. Kozyrskyj A, Mustard C, Cheang M, Simons E. Income-based drug benefit policy: impact on receipt of inhaled corticosteroid prescriptions by Manitoba children with asthma. CMAJ 2001; 165(7): 897-902.
33. Fassbender K, Pickard S. A policy impact analysis of pharmaceutical cost containment strategies in Alberta. Institute of Health Economics Working Paper 00-12, 2000.
34. Anderson G, Kerluke K, Pulcins I, Hertzman C, Barer M. Trends and determinants of prescription drug expenditures in the elderly: Data from the British Columbia Pharmacare Program. Inquiry 1993; 30:199-207.
35. Fortess E, Soumerai S, McLaughlin T, Ross-Degnan D. Utilization of essential medications by vulnerable older people after a drug benefit cap: Importance of mental disorders, chronic pain, and practice setting. J Am Geriatr Soc 2001; 49(6): 793-7.
36. Soumerai S, Ross-Degnan D, Avorn J, McLaughlin T, Choodnovskiy I. Effects of Medicaid drug-payment limits on admission to hospitals and nursing homes. N Engl J Med 1991; 325(15): 1072-7.
37. Soumerai S, McLaughlin T, Ross-Degnan D, Casteris C, Bollini P. Effects of limiting Medicaid drug-reimbursement benefits on the use of psychotropic agents and acute mental health services by patients with schizophrenia. N Engl J Med 1994; 331: 650-655.
38. Soumerai S, Avorn J, Ross-Degnan D, Gortmaker S. Payment restrictions for prescription drugs under Medicaid. N Engl J Med 1987; 317(9):550-556.
39. Stuart B, Zacker C. Who bears the burden of Medicaid drug co-payment policies? Health Aff 1999; 18(2): 201-212.
40. Stuart B, Grana J. Ability to pay and the decision to medicate. Med Care 1998; 36(2): 202-11.
41. Evans RG, Barer ML, Stoddart GL. User fees for health care: Why a bad idea keeps coming back (or, what's health got to do with it?). Can J Aging 1995; 14(2): 360-87.
42. Fuller S, Stephens L. Cost-shift: How British Columbians are paying for their tax cut. Canadian Centre for Policy Alternatives 2002. http://www.bcpolicyalternatives. org/costshift/report.php (Aug. 12, 2002).
43. O'Brien B. The effect of patient charges on the utilisation of prescription medicines. J Health Econ 1989; 8:109.
44. Tamblyn, Robin and Perreault, Robert. Encouraging the wise use of prescription medication by older adults. In Determinants of Health: Adults and Senior. National Forum on Health, 1998. Editions Multimondes. 1998.
45. Lichtenberg F. Are the benefits of newer drugs worth their cost? Evidence from the 1996 MEPS. Health Aff 2001; 20(5): 241-251.
46. Miller R, Frech H. Is there a link between pharmaceutical consumption and improved health in OECD countries? Pharmacoeconomics 2000; 18 (Suppl 1): 33-45.
47. Rawls John. A Theory of Justice. United States of America: Belknap Press of Harvard University Press, 1971.
48. Centre for Health Economics and Policy Analysis. Beyond 'equitable access': new perspectives on equity in health care systems. Report of the Centre for Health Economics and Policy Analysis' 5th Annual Policy Conference, 1992.
49. Ontario College of Pharmacists. Changes to the Ontario Drug Benefit program. Pharmacy Connection 1996; 3(3): 22-3.
50. National Council of Welfare. Poverty profile 1997. Minister of Public Works and Government Services Canada, 1999.