Journal Article

Inter-Provincial Variation in Government Drug Formularies

Grégoire, Jean-Pierre, McKenzie, Elaine, Skilton, Kevin, MacNeil, Pierre, Ferguson, Bryan, Menon, Devidas, Jacobs, Philip, Moisan, Jocelyne

2001

Overview

In Canada, coverage for ambulatory prescription drug expenditures is provided to some groups by provincial drug plans through a provincial formulary. Little is known about the drugs provincial formularies give access to. We report the variation in availability of new drug molecules (NDM) across provincial formularies. We identified 108 NDM approved in Canada between 1991 and 1998. From each drug plan bulletin or formulary, we abstracted names of NDM listed as per 15 January 1999. We compared the level of listing across provinces using kappa coefficients. In the Quebec, BC, Manitoba and Saskatchewan formularies, more than 70% of the NDM were listed. In four provinces, this proportion was lower than 50%. In general, the agreement between formularies was poor. There is a wide variation across provinces in terms of NDM listed in the formularies. This variation reflects inter-provincial differences in the way drugs are selected for coverage. Au Canada, les programmes provinciaux d'assurance-médicaments permettent aux citoyens admissibles d'obtenir sur ordonnance les médicaments dont le nom figure sur la liste provinciale. On en sait très peu sur le contenu de ces listes. Notre étude visait à répertorier les écarts entre les listes provinciales quant aux nouvelles molécules (NM). Entre 1991 et 1998, 108 NM ont été approuvées au Canada. Nous avons extrait le nom des NM figurant sur les listes provinciales le 15 janvier 1999, puis évalué la concordance entre les listes à l'aide de coefficients Kappa. Au Québec, en Colombie-Britannique, au Manitoba et en Saskatchewan, plus de 70 % des NM figuraient sur les listes. Dans quatre autres provinces, cette proportion n'atteignait pas 50 %. En général, la concordance entre les listes était faible. Les listes varient beaucoup d'une province à l'autre, ce qui traduit les différences interprovinciales dans la façon de sélectionner les médicaments remboursables.

• Publisher: Canadian Public Health Association,Springer Nature B.V,Springer International Publishing
• Subject: Antineoplastics / Biological and medical sciences / Canada / Cardiovascular agents / Cardiovascular system / Coefficients / Decision Making, Organizational / Drug Costs / Drug formularies / Drugs / Formularies as Topic - classification / General aspects / General pharmacology / Health care / Health Expenditures / Health Services Accessibility / Humans / Insurance, Pharmaceutical Services / Medical sciences / Medical treatment / Mesylates / Miscellaneous / National Health Programs - economics / Nervous system / Pharmacology. Drug treatments / Planification. Prevention (methods). Intervention. Evaluation / Polls & surveys / Prescription drugs / Prescriptions / Provinces / Public health. Hygiene / Public health. Hygiene-occupational medicine / Reimbursement / Reimbursement Mechanisms / Sodium