Better Pharmacare Coalition survey reveals British Columbians physically, financially and emotionally affected by expansion to BC Governments Reference Drug Program
Date: April 18, 2017
Better Pharmacare Coalition (BPC) eager to work with government to get it right for patients
A recent BPC survey found 81% of responding British Columbians from all health regions, were physically impacted by having to change their medication under PharmaCare’s Reference Drug Program’s (RDP) new rules.
On June 1, 2016 the BC Government created three new reference drug categories – Angiotensin Receptor Blocker (reduces high blood pressure), Proton Pump Inhibitor (treats GERD/heartburn), and Statin (lowers cholesterol) – and began transitioning patients to other medications, which could immediately put their health at risk. On December 1, 2016, the new policy came into full effect and patients have reported many negative results.
The 81% who had physical impact reported new or different side effects, including stomach upset, heartburn, muscle pain, dizziness, headaches, tiredness, and trouble with breathing. Two thirds (66%) of respondents revealed that their physical symptoms became worse since the switch in medication, and 48% indicated that their medical condition was less predictable/less stable since the switch in medication.
Over three-quarters (76%) of survey respondents indicated that the switch in medication affected them emotionally. Of these, 77% became anxious or worried as a result of the new/switched medication; 29% became sad or depressed; and 23% were less willing to socialize with other people. 60% of respondents experienced ‘other’ emotional impacts due to the switch in medication such as increased stress, anger and frustration about the change, and uncertainty and doubt about the RDP policy.
54% of survey respondents revealed that they used out-of-pocket cash to purchase the medication that they needed to stay well; 42% of respondents had to cut back on other expenses in order to purchase the new medication; 10% were not able to purchase the medication; and 6% had to reduce their medication (i.e. take less of the medication than what was prescribed).
Patient comments included:
And there were additional healthcare system costs.
- “I don’t know how I am going to pay for all of this.”
- “I can’t take the new medication - too many side effects, and can’t afford the old medication, so I am not taking any medication.”
- “This (cost) puts a huge burden on my other bills.”
- “I have to make a decision between medications and groceries.”
- “My food bank visits have increased.”
- 59% of survey respondents indicated that they underwent additional or unexpected visits to their doctor
- 57% of survey respondents indicated that they underwent additional or unexpected visits to the pharmacist
- 15% of survey respondents taking the new/switched medication undertook a trip to the hospital 18% of survey respondents taking the new/switched medication visited other health care providers as a result of their change in medication including specialists such as cardiologists, gastroenterologists, respirologists, neurologists, psychiatrists, endocrinologists, and rheumatologists and/or they underwent additional diagnostic tests and appointments which included: medical laboratory tests, stress test, colonoscopy, x-rays, CT scan, and ultrasound.
In the most distressing finding 17% of survey respondents indicated that the switch in medication adversely affected their relationship with their doctor. Comments included:
- “There is more stress between the doctor and me.
- “I feel uneasy complaining to my doctor.”
- “I don’t see my doctor as often; I just stopped going.”
- “I think my doctor can do something about it, but he won’t get involved.
These results were not unforeseen. In December 2015, when BPC polled British Columbians on proposed Reference Drug Program expansion* we found a resounding 82% of British Columbians are concerned that administrators of the BC PharmaCare program will be implementing a policy that tells physicians which medications they can prescribe for patients, even if it goes against physicians’ opinions of the best care for their patients.
79% of those polled then, including 88% of those in the lowest income bracket, feared paying out-of-pocket for medications would create a financial hardship for them and their family.
70%, including 85% of those in the lowest income bracket agreed with the statement.
“I might have to stop taking a medication for financial reasons if is if not fully covered by PharmaCare.” –
79%, including 81% of those aged 55+ agreed with the statement. “Changing my medication because of a government decision, when I am stable on my current medication, will be bad for my health.” –
Additional medical costs have also been identified as a concern in the past. “A 2009 study using PharmaCare’s own data1
showed that changing medication against doctor’s orders was intended to preserve $42 million in the drug budget but it actually cost the BC government $43 million more, a difference of $85 million for BC,” said Gail Attara, BPC member and CEO of the Gastrointestinal Society, who’s sister charity, The Canadian Society of Intestinal Research, analyzed the data and published it in a peer-reviewed journal. “Interestingly, this short-sighted policy of switching medication for non-medical reasons actually increased the PharmaCare spending by more than $9 million,” added Attara.
An economic study,2
conducted after RDP was introduced in BC in 1997, revealed that the policy pushed costs to other parts of the health care system, generated negative health outcomes for the elderly and low income patients. “The BPC has been clear from its beginning and through consultations with the BC government’s Pharmaceutical Task Force, that Reference Drug Program expansion will reduce quality health care at the individual level.” said Rennie Hoffman, executive Director of the BPC. “The government needs to understand what doctors already know, in that patients are unique and they cannot be treated with a cookie cutter approach. Government should make every effort to meaningfully consult with our coalition’s members when contemplating any change that will touch even one patient life. We are ready, willing, and able to work by their sides to get it right for BC patients.”
About Better Pharmacare Coalition
The Better Pharmacare Coalition was formed in 1997 in response to BC PharmaCare policy development not being reflective of current medical literature, best clinical practices and the needs of patients in BC. The coalition works together to call for appropriate access to evidence-based medicines that are proved effective and needed by patients in BC. The member organizations include: The Arthritis Society, BC and Yukon Division; atypical Hemolytic Uremic Syndrome Canada; British Columbia Coalition of Osteoporosis Physicians; BC Lung Association; BC Schizophrenia Society; Canadian Arthritis Patient Alliance; Canadian Society of Intestinal Research; Canadian Diabetes Association; Canadian Osteoporosis Patient Network; Canadian Skin Patient Alliance; Crohn’s and Colitis Foundation of Canada; Gastrointestinal Society; Kidney Foundation of Canada; Mood Disorders Association of British Columbia; MS Society of Canada, BC Division; Pacific Hepatitis C Network of BC; Parkinson Society British Columbia; Save your Skin Foundation; and Prostate Cancer Foundation BC; More information is available online at www.betterpharmacare.org.
* BPC conducted an online survey in December 2015 to determine British Columbians’ opinions on BC PharmaCare and in particular their opinions on the expansion of the Reference Drug Program. Results are based on an online study among 858 adult British Columbians. The data has been statistically weighted according to Canadian census figures for age, gender and region. The margin of error (which measures sample variability) is ±3.4 percentage points.
For further information please contact:
Rennie Hoffman, Executive Director
Better Pharmacare Coalition,
1 Skinner BJ, Gray JR, Attara GP.
Increased health costs from mandated Therapeutic Substitution of proton pump inhibitors in British Columbia. Alimentary Pharmacology and Therapeutics. 2009;29(8):882–891.
2 Aslam Anis.
Why is calling an ACE an ACE so controversial? Evaluating reference-based pricing in British Columbia. Canadian Medical Association Journal. 2002; 166(6):763-764.