Prescription drug funding would increase quality, length of life

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Providing free drug coverage for inexpensive medications routinely prescribed to heart attack patients could improve patient quality and length of life, a study by researchers at St. Michael's Hospital in Toronto found.

Five routinely prescribed heart attack medications were analyzed in the single-center study—beta blockers, low-dose aspirin, ACE inhibitors, statins and clopidogrel.

According to researchers, cardiovascular mortality rates in Canada between 1980 and 2000 dropped by almost 50 percent. This decline, researchers believe, is linked to the effectiveness and economical costs associated with the aforementioned drugs.

"Many patients are not benefiting from effective prescribed medications because they simply don't fill their prescriptions," said Irfan Dhalla, MD, lead author of the study and physician at St. Michael's Hospital. "There is growing evidence that having to pay for medications out of pocket is a major reason."

According to researchers, the Canada Health Act only covers physician and hospital services. This has resulted in a large fraction of Canadians paying out of pocket for drug treatment. In 2005, according to statistics, 11 percent of Canadians had only “catastrophic” drug coverage, 4 percent had no coverage at all.

Dhalla and colleagues measured the costs and quality-adjusted life years (QALYs) of two alternatives: “status quo,” which evaluated Canadians without private drug coverage, not eligible for government-funded programs that pay out-of-pocket costs for drugs; and “full coverage” where the government pays the full-cost of the medications prescribed.

Results found that a full-coverage strategy for the five medications would cost on average $20,423 per patient and have an average survival of 7.02 QALYs, while the status quo strategy would have a lower average cost of $17,173 per patient, but also have a lower QALY value (6.13).

"Our model suggests that providing free medications to people after heart attack would result in one more year of life for each additional $3,663 spent by government. We used very conservative assumptions, and it is quite possible that a full coverage strategy would even be cost saving for governments over the long term," said Dhalla.

Although the study focused on heart attack medications because thats where evidence was strongest, researchers alleged that cost-effective and effective medications are widely available for other diseases and should also be considered for public funding.

Dhalla said, "Providing medications free of charge where they are likely to have the most value is one way policy makers can allocate limited public resources more efficiently."