A program that works

(Edmonton) Researchers in the University of Alberta’s School of Public Health have come out in support of Canada’s Common Drug Review, saying the streamlined drug-review process may result in quicker access through drug plans to prescription drugs for patients in some provinces.

The Common Drug Review evaluates comparative benefits and costs of drugs under consideration and provides a recommendation to publicly funded drugs plans about whether the drug reviewed should be listed as a potential benefit to eligible members. Decisions of the review include listing with and without conditions, in a similar manner to other drugs in the same class, or whether or not to list the drug at all.

Canada’s 19 publicly funded drug plans account for approximately 39 per cent of the $31 billion spent on drugs in 2010, according to a report produced by the Canadian Institute for Health Information.

The drug review was introduced in 2003 to standardize the process of reviewing each drug and to reduce any potential duplication during that process. Prior to its introduction, administrators from each plan reviewed evidence about the safety and cost effectiveness of new drugs introduced by pharmaceutical companies. This information was used to make decisions about whether to list and cover the cost of drugs.

In the study, researchers identified 198 drugs and comparable drug coverage five years before and five years following the introduction of the drug review; of those, 53 drugs were recommended for approval within the review.

“We compared the proportion of drugs listed, how long it took for the drugs to be listed and whether drug plan decisions agreed with the Common Drug Review recommendations,” said Dean Eurich, assistant professor in the School of Public Health and senior author of the article recently published in the Canadian Medical Association Journal.

Results of the study show that, in all participating provinces, the proportion of drugs listed decreased after introduction of the CDR. Participating drug plans listed between 47 per cent and 66 per cent of new drugs in the five years before the CDR and between 12 per cent and 40 per cent in the five years following.

“This may relate to the fact that, while the drugs reviewed were new, they were not necessarily innovative,” explained Eurich. For example, he says in some cases alternative drugs are available, while in other cases, the drug under review may be used for very specialized care and is deemed to be cost-prohibitive.

Eurich says that the shorter period between the review and approval of drugs may result from the more streamlined process and sharing of information across the participating plans. He adds that there may be positive economic implications related to the Common Drug Review as the administrative burden for evaluating and approving drugs is reduced.

Patients may also benefit from an increased element of protection that comes with quicker access to new drugs.

The researchers conclude that, “Any significant gains in the efficiency of publicly funded drug plans to make listing decisions are important factors in maintaining the health and safety of Canadian patients.”

This study was conducted by students John-Michael Gamble and Daniala Weir, under the supervision of Eurich and Jeff Johnson, professor in the School of Public Health.

It was funded, in part, by a team grant to the Alliance for Canadian Health Outcomes Research in Diabetes and was sponsored by the Canadian Institutes of Health Research-Institute of Nutrition, Metabolism and Diabetes.