Dataset Information

Dataset on cost-analysis of medication deprescribing scenarios for older adult coverage under public drug benefit programs in Canada.

ABSTRACT: The dataset covers the equations and procedure used for the estimation of an older adult's total annual medication costs, across Canadian provinces and territories; detailed to report pharmacy margin, government share, and patient share. We presented a case of an older adult using 10 different medications commonly used, according to Canadian Institute for Health Information. Eight different deprescribing scenarios were created, based on recommendations from Beers Criteria and the Canadian Deprescribing Network, for the purpose of comparing the cost difference before and after each intervention on pharmacies, patients, and governments. Scenarios included: (1) Stopping an over the counter medication; (2) Discontinuation of a medication; (3) Slow taper of a potentially inappropriate medication; (4) Rapid taper of a potentially inappropriate medication; (5) Switching to safer medication; (6) Dose reduction; (7) Switching to a lower cost medication; (8) Changing from combination to a single medication. The data presented are related to the article entitled "Financial advantage or barrier when deprescribing for seniors: A case based analysis" [1].

SUBMITTER: Fadaleh SA

PROVIDER: S-EPMC7327419 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Dataset on cost-analysis of medication deprescribing scenarios for older adult coverage under public drug benefit programs in Canada.

Fadaleh Sarah Abu SA Shkrobot Jody J Makhinova Tatiana T Eurich Dean D Sadowski Cheryl A CA

Data in brief 20200608

The dataset covers the equations and procedure used for the estimation of an older adult's total annual medication costs, across Canadian provinces and territories; detailed to report pharmacy margin, government share, and patient share. We presented a case of an older adult using 10 different medications commonly used, according to Canadian Institute for Health Information. Eight different deprescribing scenarios were created, based on recommendations from Beers Criteria and the Canadian Depres ...[more]

PMID: 32637472

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Project description:ImportanceAlthough independent charity patient assistance programs improve patient access to costly prescription drugs, recent federal investigations have raised questions about their potential to increase pharmaceutical spending and to violate the federal Anti-Kickback Statute. Little is known about the design of the programs, patient eligibility, or drug coverage.ObjectiveTo examine the eligibility criteria of the independent charity patient assistance programs and the drugs covered by them.Design, setting, and participantsDescriptive cross-sectional study of the 6 largest independent charities offering patient assistance programs for patients including, but not limited to, Medicare beneficiaries in 2018. These charities offered 274 different disease-specific patient assistance programs. Drugs were identified for subgroup analysis that had any use reported on the Medicare Part D spending dashboard and any off-patent brand-name drugs that incurred more than $10 000 in Medicare spending per beneficiary in 2016.ExposuresSupport by independent charity patient assistance programs.Main outcomes and measuresThe primary outcomes were the characteristics of patient assistance programs, including assistance type, insurance coverage (vs uninsured), and income eligibility. The secondary outcomes were the cost of the drugs covered by the patient assistance programs and the coverage of expensive off-patent brand-name drugs vs substitutable generic drugs.ResultsAmong the 6 independent charity foundations included in the analysis, their total revenue in 2017 ranged from $24 million to $532 million, and expenditures on patient assistance programs ranged from $24 million to $353 million, representing on average, 86% of their revenue. Of the 274 patient assistance programs offered by these organizations, 168 (61%) provided only co-payment assistance, and the most common therapeutic area covered was cancer or cancer treatment-related symptoms (113 patient assistance programs; 41%). A total of 267 programs (97%) required insurance coverage as an eligibility criterion (ie, excluded uninsured patients). The most common income eligibility limit was 500% of the federal poverty level. The median annual cost of the drugs per beneficiary covered by the programs was $1157 (interquartile range, $247-$5609) compared with $367 (interquartile range, $100-$1500) for the noncovered drugs. Off-patent brand-name drugs (cost: >$10 000) were covered by a mean of 3.1 (SD, 2.0) patient assistance programs, whereas their generic equivalents were covered by a mean of 1.2 (SD, 1.0) patient assistance programs.Conclusions and relevanceIn 2018, among 274 patient assistance programs operated by the 6 independent charity foundations, the majority did not provide coverage for uninsured patients. Medications that were covered by the patient assistance programs were generally more expensive than those that were not covered.

Project description:BackgroundOvertreatment with cardiometabolic medication in older patients can lead to major adverse events. Timely deprescribing of these medications is therefore essential. Self-reported willingness to stop medication is usually high among older people, still overtreatment with cardiometabolic medication is common and deprescribing is rarely initiated. An important barrier for deprescribing reported by general practitioners is the patients' unwillingness to stop the medication. More insights are needed into the influence of patients' characteristics on their attitudes towards deprescribing and differences in these attitudes between cardiometabolic medication groups.MethodsA survey in older people using cardiometabolic medication using the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire was performed. Participants completed the general rPATD and an adapted version for four medication groups. Linear and ordinal logistic regression were used to assess the influence of age, sex, therapeutic area and number of medications used on the patients' general attitudes towards deprescribing. Univariate analysis was used to compare differences in deprescribing attitudes towards sulfonylureas, insulins, antihypertensive medication and statins.ResultsOverall, 314 out of 1143 invited participants completed the survey (median age 76 years, 54% female). Most participants (80%) were satisfied with their medication and willing to stop medications if their doctor said it was possible (88%). Age, sex and therapeutic area had no influence on the general attitudes towards deprescribing. Taking more than ten medicines was significantly associated with a higher perceived medication burden. Antihypertensive medication and insulin were considered more appropriate than statins, and insulin was considered more appropriate than sulfonylureas not favouring deprescribing.ConclusionsThe majority of older people using cardiometabolic medication are willing to stop one of their medicines if their doctor said it was possible. Health care providers should take into account that patients perceive some of their medication as more appropriate than other medication when discussing deprescribing.

Dataset Information

Dataset on cost-analysis of medication deprescribing scenarios for older adult coverage under public drug benefit programs in Canada.

Publications

Dataset on cost-analysis of medication deprescribing scenarios for older adult coverage under public drug benefit programs in Canada.

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