Mark Collison, Heart & Stroke Foundation - Visions for Pharmacare
Pharmacare 2020Visions for Pharmacare Panel“Patient Perspective”Mark CollisonDirector, AdvocacyHeart and Stroke Foundation|BC & Yukon
Some Facts / Some Challenges Roughly half of Canadian adults take at least one prescription medication, while 15% take four or more Over 40% of Canadian seniors and 37% of people with chronic disease take four or more prescription medications In 2010 Canadian pharmacies dispensed roughly 77,000,000 prescriptions for medications to treat cardiovascular disease Roughly 3.5 million Canadians are either under insured (2.5 million) or not insured at all (1 million) 12% (4.1 million) Canadians reported paying more than $1,000 per year in out-of pocket costs 10% (3.4 million) Canadians either did not fill a prescription or skipped doses as a result of cost of medication
A Proposed Vision for National Pharmacare The Heart and Stroke Foundation believes that all Canadians should have access to prescription drug coverage that is timely, affordable, flexible and focused on achieving the most favourable health outcomes possible. Such a system of coverage must also strive to be sustainable over the long-term and work to provide Canadians with optimal value and benefits for the health care investments made. These two things need not be mutually exclusive and while difficult to balance, are in fact achievable.
Goal #1 - Coverage Attributes of Coverage Equitable coverage – no one should be without some form of coverage for prescription medications Catastrophic coverage – no one should face extraordinary costs for prescription medications Access Standards - reasonable and timely access to quality prescription medications Payer Network - combination of payers - private, public and patient – the order and weighting of payers will depend on an individual’s specific circumstance
Goal #2 - Choice Attributes of Choice Accommodating – tailored to the needs of the individual, not a “one size fits all” approach Autonomous - maintaining the independence and integrity of the patient-prescriber-pharmacist relationship Variety – must provide for a range of medication options in order to provide the most effective treatment Flexible – efficient system to allow patients to easily move or graduate to other drugs within and between classes
Goal # 3 - Capacity Attributes of Capacity Best Practice/Evidence – systems and processes that enable and support prescribers and pharmacists to make most efficient and effective decisions (appropriate prescribing) Self Efficacy/Empowerment – systems and processes that enable and support patients to understand their medication, treatment goals and regimens and self-manage (appropriate use) Quality Assurance – systems and processes that provide for a high level of vigilance in terms of drug quality and safety, optimal prescribing and outcomes, and incorporate the most current research and best practice (system competence)
Goal #4 - Quality Attributes of Quality Accountable – on the part of all parties – patients, prescribers, pharmacists, manufacturers, payers, policy-makers, politicians Reasonable – finding the right balance between open, closed & restricted access, cost-effectiveness and quality outcomes, brand and generic, research & innovation and economic & societal benefits Affordable – if we come to terms with the above two attributes will we be there? Or are we still just searching for the holy grail? Sustainable – finding the equilibrium that will produce and sustain a quality national Pharmacare system that will be resilient to the demands of current and future generations