University of Calgary
Drug coverage
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Effectiveness of drug key to coverage
Fiona Clement (left) is the lead author on the study; Dr. Braden Manns is the principal investigator.When comparing the reimbursement rate for drugs in three national public health-care systems, one of the key issues in deciding on coverage is the clinical effectiveness of the drug, according to a study led by researchers at the University of Calgary.The study comparing coverage in Canada, Australia and Britain was published this week in JAMA (Journal of the American Medical Association), the most widely circulated medical journal in the world. The uncertainty of a drug’s effectiveness, combined with the increasing number of expensive, targeted medications for chronic conditions, means reimbursement will continue to be a key challenge. “The cost of drugs has been increasing by more than 10 percent every year. At some point the cost becomes unsustainable; you hit a breaking point,” says Dr. Braden Manns, an associate professor in the departments of medicine and community health sciences at the Faculty of Medicine, a member of the Libin Cardiovascular Institute of Alberta, and the principal investigator of the study. In an attempt to control expenditures and to assess the value of new drugs, many countries, including Canada, have established agencies to determine which pharmaceutical treatments should be listed in public formularies. Fiona Clement, of the community health sciences department, is the lead author on the study. She points out that many considerations go into the decision to fund a drug. “All three systems face challenges when deciding what new drugs to recommend for funding, so we have a lot to learn from looking at other models,” she says. The research also finds that the current discussion of health-care reform in the United States might be enhanced by the study’s findings. It concludes that the clinical effectiveness of drugs, along with other relevant factors such as a drug’s cost-effectiveness, can be used by national agencies to support drug decision making. The study is supported with funding from the Canadian Agency for Drugs and Technologies in Health (CADTH), and investigators are funded by the Canadian Institutes of Health Research (CIHR) and the Canadian Health Services Research Foundation.
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October 8, 2009