Seniors deserve voice in Pharmacare policy decisions
B.C.'s seniors are fundamentally in favour of the government's referenced-based drug pricing policy, are suspicious of large pharmaceutical companies that criticize it and want plain talk from their physicians about their pharmaceutical needs. They also have a major and beneficial role to play in formulating the government's Pharmacare policy. These are the primary findings of a three-and-a-half year study, the Seniors Drug Focus Project, conducted jointly by UVic, UBC and the Ministry of Health.
The federally-funded program investigated the province's drug benefits policy, Pharmacare's policy-making process and its effect on seniors. Ten months into the project, in the fall of 1995, B.C. adopted a reference drug program (setting a reimbursement limit on several categories of drugs) providing the study's investigators with the opportunity to observe and contribute to the full cycle of policymaking. Investigators conducted hundreds of interviews, focus groups, and surveys with Pharmacare policy-makers, seniors, clinicians, pharmacists and physicians. The resulting recommendations stress the need for consulting clients and consumers in advance of policy and decision making.
"Seniors made it very clear to us that they do not have the major concerns about the government's reference drug program that the pharmaceutical industry and other pressure groups promote. Indeed, only 8 per cent of the seniors were opposed to this program," says Dr. Howard Brunt (Nursing), one of the report's co-investigators. "Our research also indicates that the high premium seniors place on the preservation of Medicare and Pharmacare is generally underestimated by clinicians and policy-makers. In addition, we learned that seniors' experiences and opinions can differ markedly from the views expressed by groups claiming to speak on their behalf, such as physicians and the Canadian Association of Retired Persons."
While recognizing the difficulty in consulting consumers over proposed policy changes, due to the political sensitivity around potential policy leaks, the study's investigators still maintain that in-depth monitoring of consumer beliefs, values and attitudes will become more valuable as decision-makers are faced with more and more difficult decisions regarding funding allocation and policy choice.
The report reveals deep divisions of opinion among Pharmacare program stakeholders. While seniors reported they most trusted their physicians as a source of information on medication policy changes, both physicians and pharmacists revealed they didn't consider it part of their job to explain government policy to patients. Physicians also consider the reference drug program an intrusion on their long-established authority to prescribe medications they judge best for their patients.
The $500,000 study was funded by Health Canada National Health Research and Development Program (NHRDP) through a special competition co-sponsored by the Seniors Independence Research Program (SIRP) and the research arm of Canada's Drugs Strategy (CDS).
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