Starting Dec. 1, NIHB will enforce a lowest-cost alternative policy for prescription drugs. As is the practice in most provincial drug plans, the NIHB program will pay for only the best-priced alternative drug as long as it contains the same active ingredient as the drug originally prescribed.
On Mar. 1, 1997, NIHB will introduce an updated drug-benefit list. After considering the evidence, availability of alternatives and particular needs of First Nation and Inuit clients, a Pharmacology and Therapeutics Committee comprising physicians, pharmacists and other experts recommended changes that will result in a small number of drugs being deinsured. Physicians may review the new drug-benefit list after Jan. 1, 1997, and assess any impact on their patients; call 800 259-5611. There will be an exception process for drugs that are not covered by the plan but are deemed necessary by a physician.
In July, after the recommendations were released, Ovide Mercredi, national chief of the Assembly of First Nations (AFN), informed the CMA that the AFN considers the cuts to be based solely on fiscal restraint, "as opposed to meeting the real health care needs of our citizens and communities." Mercredi noted that the health status of First Nations people is well below that of the general population.
Health Canada says the changes are consistent with other public and private drug plans and reflect current health care practices. The drug-benefit review was undertaken as part of a larger effort to improve the management of noninsured health benefits. The department says any savings will be directed to other First Nation and Inuit health programs.