Reflections on a month in the life of the Ontario Drug Benefit Plan
By: W. McIsaac ... [et al.].
Contributors: McIsaac, W.; Naylor, C. D.; Anderson, G. M.; O'Brien, B. J.; Institute for Clinical Evaluative Sciences in Ontario.
Series: ICES working paper series -- no. 4
Publisher: Institute for Clinical Evaluative Sciences in Ontario
Published: 1993
Place of publication: Ontario
Language: eng
Number of pages: 21
Subjects: Insurance, Pharmaceutical Services; Prescriptions, Drug; Drug Utilization; Financing, Government; Forecasting; Health Expenditures; Health Policy; Insurance, Pharmaceutical Services -- trends; Humans; Ontario
Description: Government-administered prescription drug plans are under increasing financial pressure.  Drugs are acknowledged to be a central component of modern medical therapy, but growing concerns about their effective and efficient use has focused attention on current prescription practices. We examined selected data from the Ontario Drug Benefit Plan (ODB) for January 1992, to introduce a discussion of policy options for improving drug utilization. Ten individual products accounted for 19% of all ODB expenditures for the month.  There was a strong preference for ranitidine as the H2-antagonist of choice compared to a less costly, but similarly effective alternative--cimetidine ($4.1 million vs. $250,000). Although benzodiazepines have been associated with various adverse effects in the elderly, eleven such products were included in the formulary and over 200,000 prescription claims (6.5% of all ODB claims that month) were filled for this primarily elderly population. Lovastatin, a cholesterol-lowering agent, was the third most costly individual preparation that month ($1.6 million) despite limited evidence for efficacy in preventing coronary heart disease and a continuing controversy about drug therapy for hypercholesterolemia as a primary preventive manoeuvre among the elderly. A simplified framework of options for effecting change in prescribing practices is presented, highlighting the need for data to better understand and monitor prescribing trends, potential approaches to change physician behaviour, concerns about the role of industry-sponsored drug information activities, and the importance of evaluating new policies and programs.
Notes: March 1993.

Includes bibliographical references. (33 ref.)