Fighting Prescription Drug Abuse

Health Minister Rona Ambrose pledged $13 million over five years to perform 1000 pharmacy inspections across the country to put a stop to the sale of highly addictive but legal pain prescription drugs on the streets of Canada.

“Our Government has made it a priority to fight prescription drug abuse, and we are investing heavily in a range of initiatives to address this issue. Our team of inspectors will be working in cooperation with pharmacies across the country to track, report, and monitor the movement of prescription drugs which will ultimately help ensure they are being used for the right reasons by the right patients.”
The Honourable Rona Ambrose
Federal Minister of Health

It’s part of the Government’s National Anti-Drug Strategy, a $44 million over five years program that has been expanded to include prescription drug abuse.

The Honourable Rona Ambrose, Minister of Health, along with Dr. Gregory Taylor, Chief Public Health Officer of Canada, toured a local Edmonton Shoppers Drug Mart pharmacy and discussed the announcement of federal funding to increase the number of annual pharmacy inspections carried out by Health Canada.

The strategy is laid out below:

Building Partnerships and engaging directly with stakeholders is a key component of the Government’s comprehensive strategy to address prescription drug abuse, including:

• A national symposium with sectoral leaders to discuss prescription drug abuse, co-hosted by the Minister of Health and the Canadian Centre on Substance Abuse (January 2014).
• A roundtable co-hosted by the Minister of Health and Ontario First Nations leadership to discuss solutions to prescription drug abuse (June 2014).
• Two summits on addiction recovery focused on addressing the stigma associated with substance use disorders (December 2013, January 2015).
• A Prescribing Practices Forum at McMaster University on May 15, 2015, fostering engagement with health professionals from all fields on actions to improve prescribing practices in Canada.

Keeping communities healthy and safe by providing Canadians with tools they need to tackle prescription drug abuse in their communities, including:

• A public awareness campaign between October-December 2014, recently re-launched from May-July 2015, to equip parents with the information they need to talk with their teenagers about prescription drug abuse.
• Supporting the Canadian Association of Chiefs of Police for the last two years in organizing National Prescription Drug Drop-Off Day, providing Canadians with the opportunity to safely dispose of their unused prescription drugs.
• $13.5M in funding over 5 years to enhance access to prevention and treatment capacity for prescription drug abuse within First Nations communities across Canada.
• $13 million over five years by the Government of Canada, to increase the number of annual pharmacy inspections carried out by Health Canada to help reduce the diversion of prescription drugs.
• Health Canada’s Non-Insured Health Benefits (NIHB) Program for First Nations and Inuit delisted brand name OxyContin in February 2012. Furthermore, consistent with the advice of the NIHB Drugs and Therapeutics Advisory Committee (DTAC), generic long-acting oxycodone was not added to the NIHB formulary when it became available.

Supporting the health sector through targeted investments and actions to support innovative solutions and strategies to combat prescription drug abuse, including:

• Labelling changes for controlled-release opioid pain medicines to enhance their safe and appropriate use.
• An investment of $3.6 million to develop new guidelines and other training tools for physicians and other regulated healthcare professionals who prescribe and dispense drugs.
• $4.28 million for the Canadian Institute for Health Information to support a coordinated pan-Canadian approach for the monitoring and surveillance of prescription drugs, announced on May 15, 2015.
• $5 million over five years for the Canadian Institutes of Health Research to support research on new clinical and community-based interventions for preventing and treating prescription drug abuse.

The Announcement was made following a symposium on prescription drug abuse, where she met with provincial officials, doctors, pharmacists, First Nations representatives, law enforcement and addictions specialists. Discussions focused on identifying actions to address prescription drug abuse under the three action plans of the National Anti-Drug Strategy: prevention, treatment, and enforcement.

Last month the government announced $13.5 million to help combat prescription drug abuse on First Nations Reserves.

$13.5 Million to help prescription drug abuse

The Canadian Government announced $13.5 million in funds to combat prescription drug abuse on First Nations reserves. Health Minister Rona Ambrose said prescription drug abuse is a significant health and safety concern in North America.

Some of the money will go towards two regional hubs, one in Saskatchewan, the other in Manitoba, to coordinate a crisis intervention team.

The Regina Leader-Post has a fairly in depth article about the funding and issue of prescription drug abuse in general. Depending on how you look at it, $13.5 million is a lot of money. But not when you consider what is already spent:

This new funding is on top of what the federal government is already spending on mental health and addictions programming for First Nations. About $236 million annually goes to 44 treatment facilities.

In 2013, 2% of Canadians 15 or older self-reported abusing prescription drugs. That works out to 146,000 people. In my opinion, it’s probably higher as people are notoriously bad at self-reporting their own behaviour.

The federal funds will be devoted to centres tailoring services and intervention to their communities, training for staff, caseload management, and a crisis intervention team that will act as advisers for treatment facility caregivers. The government also wants to identify and share best practices across the country.

Universal drug plan in Canada

A study published in the Canadian Medical Association Journal (CMAJ) claims a universal prescription drug plan in Canada could reduce spending on prescription drugs by billions.

This has opened up a lot of discussion in the media (as illustrated in this CBC article with almost 700 comments from readers), in coffee shops, and I’m sure among politicians in Ottawa.

The study explains that all countries with universal health care also have universal prescription drug coverage – except for Canada. The arguments against universal pharmacare usually hinge on the increased costs of running the program. This study seems to refute those points, but there is often a difference between study results and real world results.

You can read both the CBC article and the study for yourself, but you can also stay right here and read this abstract from the study, which does a great job of summarizing and explaining the findings:

Background: With the exception of Canada, all countries with universal health insurance systems provide universal coverage of prescription drugs. Progress toward universal public drug coverage in Canada has been slow, in part because of concerns about the potential costs. We sought to estimate the cost of implementing universal public coverage of prescription drugs in Canada.

Methods: We used published data on prescribing patterns and costs by drug type, as well as source of funding (i.e., private drug plans, public drug plans and out-of-pocket expenses), in each province to estimate the cost of universal public coverage of prescription drugs from the perspectives of government, private payers and society as a whole. We estimated the cost of universal public drug coverage based on its anticipated effects on the volume of prescriptions filled, products selected and prices paid. We selected these parameters based on current policies and practices seen either in a Canadian province or in an international comparator.

Results: Universal public drug coverage would reduce total spending on prescription drugs in Canada by $7.3 billion (worst-case scenario $4.2 billion, best-case scenario $9.4 billion). The private sector would save $8.2 billion (worst-case scenario $6.6 billion, best-case scenario $9.6 billion), whereas costs to government would increase by about $1.0 billion (worst-case scenario $5.4 billion net increase, best-case scenario $2.9 billion net savings). Most of the projected increase in government costs would arise from a small number of drug classes.

Interpretation: The long-term barrier to the implementation of universal pharmacare owing to its perceived costs appears to be unjustified. Universal public drug coverage would likely yield substantial savings to the private sector with comparatively little increase in costs to government.

Dr. Brian Goldman doesn’t think it will happen, not because he doesn’t think it is a good idea, more because of the current political climate. I’m interested in what you think…

Smoking is bad for your health

An obvious statement in the headline, from a great post on www.dauphinclinichpharmacy.com. Written by my colleague Trevor Shewfelt, the blog outlines some innovative new tips and tricks the Dauphin Clinic Pharmacy has to help you quit smoking this year.

Last year the Dauphin Clinic Pharmacy participated in a fantastic Smoking Cessation project involving pharmacies from all over the province. We learned so much from the pilot project we’re better than ever at helping people quit smoking (and I like to think we were pretty good before!).

I don’t want to steal all of Trevor’s thunder and give you all the information he so nicely laid out, so I’m going to direct you over to the original post. Give it a read to find out how the Dauphin Clinic Pharmacy can help you quit smoking.

Merck & Co to buy Idenix to boost hepatitis C drugs portfolio

I recent Reuters article reported that Merck & Co Inc said it would buy Idenix Pharmaceuticals Inc IDIX.O for $3.85 billion and plans to combine the two companies’ most promising drugs to produce a faster, more effective cure for hepatitis C.

Merck said it would pay $24.50 per share, more than three times Idenix’s Friday closing price of $7.23.

The payoff for Merck could come from a triple therapy that may cure patients with all genotypes, or strains, of the hepatitis C virus in as little as four to six weeks, its research chief, Roger Perlmutter, said in an interview.

“An ideal therapy means something that works in every hepatitis C-infected patient, irrespective of which genotype,” Perlmutter said. “Our goal is to cure everyone quickly using an oral regimen.”

Read more on the article here.