| Authors | Morgan S, Bassett K, Mintzes B |
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| Source | Psychiatric Services: Journal of the American Psychiatric Association. 2004 November;55(11):1230-1232. |
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| Abstract | From the perspective of prescribing physicians, drug coverage decisions seldom deal adequately with idiosyncratic needs. Prescribers would prefer that all medicines be fully covered, regardless of cost, so that discretion can be exercised on a case-by-case basis for individual patients. From the perspective of drug benefit policy makers, who face rapidly increasing demands with limited resources, open formularies are no longer an option. Policies relating to drug coverage must set limits. The mechanism by which limits are set is critical to balancing access to necessary medications, program sustainability, and the autonomy of both prescribers and consumers. A best practice for drug coverage policy focuses on paying for proven health outcomes.
In this column we describe how decision makers in British Columbia, Canada, allocate the public drug subsidy in accordance with scientific evidence of comparative health benefit. The outcomes-based approach to drug coverage that is used in British Columbia can be characterized as the consistent restriction of the public subsidy until manufacturers provide published scientific evidence of a comparative mortality or morbidity benefit. This approach appears to control expenditures while avoiding the financial inequities and adverse health effects often associated with indiscriminate limits on drug
coverage. |
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| Code | CHSPR 04:25R |
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