Noncompliance costs billions: researcher
CMAJ 1997;156:1371
Patients' failure to take medicines properly costs the Canadian health care system between $7 billion and $9 billion every year, an associate at the University of Toronto's Centre for Health Promotion said recently. Dr. Robert Coambs told the Pharmaceutical Manufacturers Association of Canada (PMAC) semi-annual education day that a national pharmacare program -- which is expected to be a major plank in the Liberal platform in the upcoming federal election campaign -- should have components to enhance compliance and improve computer monitoring of prescriptions. "All Canadians could benefit from information on how to use medicines to their best effect," he said.
Inappropriate prescribing is another concern related to the utilization of prescription medicines. Coambs, who called for more fact-based information for physicians and patients, said an effective pharmacare program should not limit access to more expensive medications or prevent MDs from selecting the best medicine for each patient. "Noncompliance often occurs because the medicine is awkward to use, does not fit the lifestyle of the patient or causes intolerable side effects," he said, adding that a cost saving at the front end may result in "enormous wastage" if it leads to extra doctor visits and hospitalization because of complications resulting from noncompliance.
Former health minister Monique Bégin, now dean of health sciences at the University of Ottawa, also spoke at the PMAC conference. Although she supports the concept of a universal drug program, she said ideology must not drive its development. "A national pharmcare program must be based on evidence-based decisions," she said. "Purely financial concerns must be balanced against sound clinical practices" to maintain the care that Canadians already receive, expect and need.
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