“Breakthrough” drugs and growth in expenditure on prescription drugs in Canada

Morgan, Steven G.; Bassett, Kenneth; Wright, James M; Evans, Robert G.; Barer, Morris L.; Caetano, Patrícia; Black, Charlyn

doi:10.1136/bmj.38582.703866.ae

Cited by 89 publications

(50 citation statements)

References 1 publication

(1 reference statement)

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“…Medication costs increased considerably from 1991 to 2001 for both type 1 and type 2 diabetes. This trend could be the result of 1) increased use of medications overall, 2) increased use of more expensive disease treatment options for cardiovascular risk reduction, and 3) use of newer, more expensive antidiabetic agents in the later years of follow-up (18). Increasing prescription costs should not be viewed entirely as problematic, however, given that proven effective treatments in this population are reportedly underused (19,20).…”

Section: Resultsmentioning

confidence: 99%

Health Care Use and Costs in the Decade After Identification of Type 1 and Type 2 Diabetes

2006

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OBJECTIVE -To analyze trends in health care costs in the decade after identification of diabetes, contrasting type 1 and 2 diabetes.RESEARCH DESIGN AND METHODS -The Canadian National Diabetes Surveillance System criteria were applied to administrative databases to identify incident diabetes cases in 1992. Cases were categorized as type 1 or type 2 diabetes based on patterns of drug use. Per capita health care costs (in 2001 Canadian dollars) for five resource categories were estimated according to the type of diabetes, for the year before identification (1991) and 10 years after (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001) identification of the cases.RESULTS -We identified 156 type 1 and 3,469 type 2 incident cases of diabetes, from a population base of ϳ950,000. The mean (ϮSD) age of case subjects at index was 61.2 Ϯ 16.7 years, and 54% of subjects were male. Overall annual per capita health expenditures rose considerably in the year after identification of diabetes but then stabilized at a lower level for the next 9 years, ranging from $3,800 to $4,400. From 1992 to 2001, diabetic individuals used $137.1 million in health care resources, most of which (96%) was attributable to type 2 diabetes. The average 10-year cost per individual with diabetes was $37,820 ($33,684 per type 1 and $38,006 per type 2 diabetes case; adjusted P ϭ 0.45).CONCLUSIONS -Total health expenditures for diabetes are driven by the much larger prevalence of type 2 compared with type 1 diabetes. Policymakers need to acknowledge and allocate resources for diabetes prevention and management accordingly.

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Section: Resultsmentioning

confidence: 99%

Health Care Use and Costs in the Decade After Identification of Type 1 and Type 2 Diabetes

2006

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“…33 This means that many of the new brand name medications may not represent major therapeutic advances. Morgan and colleagues 36 recently studied overall drug expenditures in one Canadian province, British Columbia, and found that 80% of the increases in drug costs were due to use of new patented medications that were not considered to offer an important therapeutic advantage.…”

Section: Discussionmentioning

confidence: 99%

Long-term trends in use of and expenditures for cardiovascular medications in Canada

Jackevicius

Cox²,

Carreon³

et al. 2009

Canadian Medical Association Journal

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“…Also the allocation of resources for health insurances can be biased. A 2008 study demonstrated the existence of selective publication of so-called ''New Drug Applications'' in particular, which includes among other things very cost-intensive innovations in oncology [13,14]. The preference given to the presentation of positive effects distorts the calculations of cost-effectiveness, which can generally also be made on the basis of the published literature.…”

Section: Biased Resource Allocationmentioning

confidence: 99%

Normative arguments and new solutions for the unbiased registration and publication of clinical trials

Strech¹

2012

Journal of Clinical Epidemiology

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Empirical data and normative arguments outweigh their counterarguments and present a clear case in favor of an even more restrictive obligation to register trials. Institutional review boards and better-educated stakeholders might play a crucial role in facilitating unbiased registration and publication of clinical research. For evaluation purposes, the field needs better standards for study protocols.

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“Breakthrough” drugs and growth in expenditure on prescription drugs in Canada

Cited by 89 publications

References 1 publication

Health Care Use and Costs in the Decade After Identification of Type 1 and Type 2 Diabetes

Health Care Use and Costs in the Decade After Identification of Type 1 and Type 2 Diabetes

Long-term trends in use of and expenditures for cardiovascular medications in Canada

Normative arguments and new solutions for the unbiased registration and publication of clinical trials

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