Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Coverage of inexpensive drugs may increase length and quality of life after heart attack

01.12.2009
Many who must pay out-of-pocket for life-saving drug regimen are not filling their prescriptions, researchers say

Providing free medications to people after heart attack could add years to patients' lives at a relatively low cost for provincial governments, according to a new study by researchers at St. Michael's Hospital in Toronto.

"Many patients are not benefiting from effective prescribed medications because they simply don't fill their prescriptions," says Dr. Irfan Dhalla, the study's lead author and a physician at St. Michael's Hospital. "There is growing evidence that having to pay for medications out of pocket is a major reason."

Public coverage of pharmaceuticals in Canada is neither universal nor uniform because the Canada Health Act covers only physician and hospital services. According to data published in 2005, 11 per cent of Canadians had only catastrophic public coverage, and 4 per cent had no coverage at all.

The goal of the study was to demonstrate to policymakers what would happen if governments fully covered the costs of five heart attack medications—a beta blocker, low-dose aspirin, an ACE inhibitor, a statin, and a relatively new drug called clopidogrel—which are routinely prescribed for patients who have survived a heart attack.

The use of these effective and relatively inexpensive drugs has led to a dramatic decline in deaths from cardiovascular disease in recent years. Between 1980 and 2000, mortality from cardiovascular disease in Canada decreased by approximately 50%.

The researchers compared the benefits and the costs of two options:

The "status quo" option reflects the current situation across Canada where people who don't have private drug insurance or who aren't eligible for government-funded drug programs are expected to pay the full cost of their prescriptions after a heart attack.

The "full coverage" option would see governments pay the full cost of five recommended medications.

Implementing the full-coverage strategy for the five medications would result in average survival of 7.02 quality-adjusted life-years (QALYs) after heart attack at an average cost of $20,423 per patient, the study found.

The status quo strategy resulted in an average survival of 6.13 QALYs at an average cost of $17,173 per patient.

(In health care research, the term "QALY" is used to describe survival time based not just on quantity of years but also on quality of life. A year in perfect health is considered equal to 1.0 QALY. The value of a year in ill health would be lower—for example, a year spent in hospital might have a value equal to 0.5 QALY.)

"Full coverage would save lives at very low cost and would be cost-effective compared to the status quo," says Dr. Dhalla. "Our model suggests that providing free medications to people after heart attack would result in one more year of life for each additional $3,663 spent by government. We used very conservative assumptions, and it is quite possible that a full coverage strategy would even be cost-saving for governments over the long-term."

The researchers say any added cost would be significantly below current thresholds used to decide whether new drugs and medical devices should be eligible for public funding.

Although the study looked at heart attack because that is where the evidence is strongest, there are many diseases where cheap, effective medications are available.

"Policy makers may wish to consider providing medications free of charge to all patients with chronic illnesses where specific drug treatments are known to be both highly cost-effective and associated with poor adherence—for example, preventing kidney and cardiovascular disease in patients with diabetes," Dr. Dhalla says. "Providing medications free of charge where they are likely to have the most value is one way policy makers can allocate limited public resources more efficiently."

About St. Michael's Hospital

St. Michael's Hospital provides compassionate care to all who walk through its doors. The Hospital also provides outstanding medical education to future health care professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital's recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing Knowledge Institute, research at St. Michael's Hospital is recognized and put into practice around the world. Founded in 1892, the Hospital is fully affiliated with the University of Toronto.

Julie Saccone | EurekAlert!
Further information:
http://www.toronto.ca

More articles from Health and Medicine:

nachricht Antibiotic effective against drug-resistant bacteria in pediatric skin infections
17.02.2017 | University of California - San Diego

nachricht Tiny magnetic implant offers new drug delivery method
14.02.2017 | University of British Columbia

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

Im Focus: Three Magnetic States for Each Hole

Nanometer-scale magnetic perforated grids could create new possibilities for computing. Together with international colleagues, scientists from the Helmholtz Zentrum Dresden-Rossendorf (HZDR) have shown how a cobalt grid can be reliably programmed at room temperature. In addition they discovered that for every hole ("antidot") three magnetic states can be configured. The results have been published in the journal "Scientific Reports".

Physicist Dr. Rantej Bali from the HZDR, together with scientists from Singapore and Australia, designed a special grid structure in a thin layer of cobalt in...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

Biocompatible 3-D tracking system has potential to improve robot-assisted surgery

17.02.2017 | Medical Engineering

Real-time MRI analysis powered by supercomputers

17.02.2017 | Medical Engineering

Antibiotic effective against drug-resistant bacteria in pediatric skin infections

17.02.2017 | Health and Medicine

VideoLinks
B2B-VideoLinks
More VideoLinks >>>