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Screening Questionnaire for Cost and Education [lack thereof] Related…

- - - - 10 Medication Pricing Policies: (1) external reference pricing (2) internal reference pricing (3) value-based pricing (4) regulation mark ups across the pharmaceutical supply and demand chain (5) promoting price transparency (6) tendering and negotiation (7) promoting the use of quality assured generic and bio-similar medication (8) pooled procurement (9) cost-plus pricing (10) tax exemptions or reductions [8 pg.1]
      - Medication Without Harm (WHO Global patient safety challenge) proposes solutions to address unsafe medication practices and medication errors causing injuries and avoidable harm in healthcare system [9 pg.1]
  - - - Under the Canada Health Act, equal access to prescription medications are given to all Canadians when they are admitted to the hospital [10]
      - Outside of the hospital setting, provincial and territorial governments are responsible for the administration of their own publicly-funded drug plans. The public drug plans determine what prescriptions drugs are listed and under what conditions for their eligible recipients. [10]
    - - Knowledge Gap: (1) international and domestic models suitable for Canada (2) cost accumulated by non adherence to prescriptions (3) formulary options (4) impact of improved access to medications (5) cost modelling to estimate expidenture [10]
      - Evidence:
        
        Universal Pharmacare can save the government billions in downstream healthcare costs by avoiding the greater costs that add up when manageable condition gets taxed onto hospital acuity. Our current system also weakens our negotiating position with pharmaceutical companies. [10]
        
        Canada spends about 34 million on prescription medication which is second to the biggest expenditure in healthcare, after hospitals. Yet, there are huge gaps in drug coverage.[10]
        
        A recent study demonstrated that if we removed out of pocket costs for medication, just for three diseases - diabetes, cardiovascular and respiratory illness, we could prevent up to 220, 000 ER visits and 90,000 fewer hospital admissions. [10]
      - Outcomes: (1) Canadians will have access to their prescription based solely on need, and not their financial means (2) Clinicians can provide best possible treatment without worrying about cost related adherence and modifying their treatment (3) Reducing ER visits and hospitalizations (4) Employers will no longer have to worry about providing sufficient drug coverage (5) replacing multiple private plans with a single, powerful purchaser with authority to negotiate lower medication rates [6]
      - Questions to national discourse: (1) How many Canadians face CRNA? (2) Who are at the most risk? (3) What consequences do CRNA lead to?
- - - - Social Workers can assist patients in securing drug coverage, financial assistance such as Alberta Works or AISH, and set up follow up with them in the community should they need homeware for medication administration
    - - Pharmacists can assist patient with (1) medication review to assess need, interactions and contraindications of medications (2) create an accurate medication reconciliation to assess what medications patients are taking regularly (3) educate patients thoroughly on each medication indication (4) assist patients in finding alternative generic medications for cost-savings
  - - - (1) Added documentation for physicians and nurses who are already piled with paperwork (2) Increased workload for social workers and pharmacist (3) Lack of patient transparency
    - - Government support through increased participation in Pharmacare research, increasing social programs for drug plan coverage and responding to the increased workload of healthcare providers in order to meet this proposed change
      - Pharmaceutical support: allowing for negotiations for lower prices for increased affordability
      - Stakeholders (ie organizations leaders): working with healthcare users to formulate guidelines to combat this health inequity
      - Healthcare Providers: facilitating honest discussions with patients, ensuring their understanding regarding safe use of generic medications and understanding patient's regimen, advocating for patients' informed decision making and becoming more cognizant of medication costs
- - - - Patient Characteristics: (1) Sociocultural influences (2) Perceived benefits of treatment (3) Mental status (4) Self-efficacy (5) Health literacy [12]
      - Medication regimen: (1) Adverse effects (2) Dosing complexity (3) Perceived need [12]
      - Clinician: (1) Knowledge of Rx costs (2) Therapeutic choice (3) Fostering trust (4) Discussion about Rx costs and adherence (5) Referrals to Rx cost assistance programs [12]
      - Health system: (1) Screening for Rx cost problems (2) Barriers to refilling (3) Barriers to applying for benefits (4) Prescriber incentives [12]