December 19, 2008

BC Lowest (for now) in Prescription Costs

"If cost-drivers in British Columbia were the same as the national average on an age-standardized basis, total spending on prescription drugs in that province would be $701 million higher than was the case in 2007. Most of this difference ($455 million) was a result of British Columbia residents purchasing fewer prescription drugs on an age-standardized basis. The selection of lower-cost treatment options within therapeutic categories also explained a sizable amount ($208 million) of the low spending in British Columbia."
Canadian Rx Atlas, 2nd Edition (Dec 2008)

At the same time that Researchers at The University of British Columbia's Centre for Health Services and Policy Research (CHSPR) are breaking ground with their analysis of prescription drug use in Canada, the Campbell government appears determined to move BC up from the lowest spending province to one of the highest by eliminating the Therapeutics Initiative. That's the UBC based project, started in 1994, to essentially provide a balance to the propaganda ("detailing") that the pharmaceutical industry uses to influence the prescribing habits of physicians. In April 2008 the Campbell government announced support for a recommendation to: "establish a new Drug Review Resource Committee (DRRC) to carry out the drug submission review role currently performed by the Therapeutics Initiative."

CHSPR can't be accused of playing politics, releasing its findings a week before Christmas when most reporters have finished their yearend review pieces. It will be surprising if their study, which could save the province billions of dollars, gets two column inches at this time of the year.

Steve Morgan, associate director in UBC's CHSPR, doesn't criticize the Campbell government directly, but anyone reading his research group's report must wonder why BC would consider in any way weakening its system that puts patients ahead of pharmaceutical profits.

Apart from the normal incentives to control costs while maximizing returns, in these challenged economic times one would think that the BC government would embrace Morgan's findings and ask his research group for advice. The Canadian Rx Atlas reported that in terms of provincial governments' share of spending in 2007: "British Columbia had the lowest levels of average spending per person aged 45-64 ($79), per person aged 65 and older ($304), and per capita for all ages ($65)." The Campbell government is jeopardizing that cost advantage as it moves to reorganize, weaken or dismantle the Therapeutics Initiative.

The most likely way government could weaken cost control provided by the Therapeutics Initiative while keeping its position at the bottom of provincial costs would be to shift more costs onto those who need drugs. The Campbell government never has understood the difference between cost saving and cost shifting.