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  1. Article ; Online: Strategies to reduce out-of-pocket medication costs for Canadians with peripheral arterial disease.

    McClure, Graham R / McIntyre, William F / Belesiotis, Peter / Kaplovitch, Eric / Chan, Noel / Bhagirath, Vinai / Chahill, Gurneet / Hayes, Abigail / Sohi, Gursharan / Bordman, Wendy / Whitlock, Richard P / Anand, Sonia S / Belley-Côté, Emilie P

    Canadian journal of surgery. Journal canadien de chirurgie

    2024  Volume 67, Issue 1, Page(s) E1–E6

    Abstract: Background: Given that peripheral arterial disease (PAD) disproportionately affects people of lower socioeconomic status, out-of-pocket expenses for preventive medications are a major barrier to their use. We carried out a cost comparison of drug ... ...

    Abstract Background: Given that peripheral arterial disease (PAD) disproportionately affects people of lower socioeconomic status, out-of-pocket expenses for preventive medications are a major barrier to their use. We carried out a cost comparison of drug therapies for PAD to identify prescribing strategies that minimize out-of-pocket expenses for these medications.
    Methods: Between March and June 2019, we contacted outpatient pharmacies in Hamilton, Ontario, Canada, to assess pricing of pharmacologic therapies at dosages included in the 2016 American College of Cardiology/American Heart Association guideline for management of lower extremity PAD. We also gathered pricing information for supplementary charges, including delivery, pill splitting and blister packaging. We calculated prescription prices with and without dispensing fees for 30-day brand-name and generic prescriptions, and 90-day generic prescriptions.
    Results: Twenty-four pharmacies, including hospital-based, independent and chain, were included in our sample. In the most extreme scenario, total 90-day medication costs could differ by up to $1377.26. Costs were affected by choice of agent within a drug class, generic versus brand-name drug, quantity dispensed, dispensing fee and delivery cost, if any.
    Conclusion: By opting for prescriptions for 90 days or as long as possible, selecting the lowest-cost generic drugs available in each drug class, and identifying dispensing locations with lower fees, prescribers can minimize out-of-pocket patient medication expenses. This may help improve adherence to guideline-recommended therapies for the secondary prevention of vascular events in patients with PAD.
    MeSH term(s) Humans ; Costs and Cost Analysis ; Drugs, Generic/economics ; Ontario ; Peripheral Arterial Disease/drug therapy ; United States ; Health Expenditures ; Drug Costs
    Chemical Substances Drugs, Generic
    Language English
    Publishing date 2024-01-03
    Publishing country Canada
    Document type Journal Article
    ZDB-ID 410651-9
    ISSN 1488-2310 ; 0008-428X
    ISSN (online) 1488-2310
    ISSN 0008-428X
    DOI 10.1503/cjs.003722
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: A prospective observational study of pediatric opioid prescribing at postoperative discharge: how much is actually used?

    Caldeira-Kulbakas, Monica / Stratton, Catherine / Roy, Renu / Bordman, Wendy / Mc Donnell, Conor

    Canadian journal of anaesthesia = Journal canadien d'anesthesie

    2020  Volume 67, Issue 7, Page(s) 866–876

    Abstract: Purpose: Research describing opioid misuse in children after surgery currently describes single specialties, short follow-up, and heterogeneous data not conducive to comparative discussion. Our primary objective was to quantify opioids prescribed to ... ...

    Title translation Étude observationnelle prospective de la prescription d’opioïdes chez des patients pédiatriques recevant un congé postopératoire : quelle quantité est véritablement utilisée?
    Abstract Purpose: Research describing opioid misuse in children after surgery currently describes single specialties, short follow-up, and heterogeneous data not conducive to comparative discussion. Our primary objective was to quantify opioids prescribed to pediatric surgical patients on discharge from hospital. Secondary objectives were quantifying opioids remaining unused at four-week follow-up, and family attitudes to safe storage and disposal.
    Methods: We conducted a prospective observational study under counterfactual consent with telephone follow-up at four weeks of children who had undergone a surgical procedure and filled an opioid prescription at The Hospital for Sick Children, Toronto, ON, Canada. Exclusion criteria included opioid use within the previous six months, history of chronic pain, or discharge to a rehabilitation facility. Pre- and post-discharge prescribing, dispensing, and consumption data were collected prospectively in addition to parental reports of home opioid use. Opioid-dosing was converted to oral morphine milligram equivalents (MME).
    Results: There were 8,672 MMEs prescribed to 110 patients. Twenty-one patients were lost to follow-up, accounting for 1,416 MME. Of the remaining 7,256 MME, 67% went unused. At follow-up, 78% of unused opioid remained in the home. Most opioids were stored in an easily accessible location in the home.
    Conclusion: These findings confirm overprescribing of opioids to pediatric surgical patients. Families tend not to return opioids that exceed post-discharge analgesic requirements at home and many of the reported disposal methods are unsafe. We recommend future studies focus on optimizing opioid prescriptions to meet, but not excessively surpass, home pain management requirements, and to encourage safe opioid disposal/return methods.
    Trial registration: www.clinicaltrials.gov (NCT03562013); registered 7 June, 2018.
    MeSH term(s) Aftercare ; Analgesics, Opioid ; Canada ; Child ; Humans ; Pain, Postoperative/drug therapy ; Patient Discharge ; Practice Patterns, Physicians' ; Prospective Studies
    Chemical Substances Analgesics, Opioid
    Language English
    Publishing date 2020-03-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 91002-8
    ISSN 1496-8975 ; 0832-610X
    ISSN (online) 1496-8975
    ISSN 0832-610X
    DOI 10.1007/s12630-020-01616-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Strategies to Reduce Out-of-Pocket Medication Costs for Canadians Living with Heart Failure.

    McIntyre, William F / Belesiotis, Peter / McClure, Graham R / Demers, Catherine / Chahill, Gurneet / Hayes, Abigail / Sohi, Gursharan / Bordman, Wendy / Whitlock, Richard P / Belley-Côté, Emilie P

    Cardiovascular drugs and therapy

    2020  Volume 35, Issue 5, Page(s) 1009–1023

    Abstract: Introduction: Daily medication is the cornerstone of evidence-based therapy to reduce mortality and morbidity in patients with heart failure (HF). Up to 20% of Canadian patients pay for medications out of pocket. We sought to identify strategies that ... ...

    Abstract Introduction: Daily medication is the cornerstone of evidence-based therapy to reduce mortality and morbidity in patients with heart failure (HF). Up to 20% of Canadian patients pay for medications out of pocket. We sought to identify strategies that patients and prescribers can employ to reduce these costs.
    Methods: We collected data from outpatient pharmacies in Hamilton, Ontario. We determined prices for different medications in each of the drug classes recommended for HF with reduced ejection fraction in the Canadian Cardiovascular Society's guidelines. We examined differences in dispensing and delivery fees and inquired about other cost-saving strategies.
    Results: We collected data from 24 different pharmacies, including a selection of hospital-based, independent, and larger chain pharmacies. In the most extreme scenario (i.e., 90-day prescription instead of a 30-day prescription and the least expensive generic drug instead of the most expensive brand name drug), total medication costs can differ by up to $495.56 per month. Costs were affected by choice of agent within a drug class, generic versus brand-name drug, quantity dispensed, dispensing fee, and delivery cost.
    Conclusions: Prescription content, dispensing practice, and pharmacy choice can remarkably impact out-of-pocket costs for HF medications. Prescribers can reduce costs by writing 90-day prescriptions and choosing the lowest-cost generic drugs in each therapeutic class. Patients should consider the services received for their pharmacy dispensing fees, use free delivery services where needed, and request inexpensive generic drugs. Pharmacists can facilitate cost minimization without compromising therapeutic efficacy.
    MeSH term(s) Canada ; Cardiovascular Agents/economics ; Cardiovascular Agents/therapeutic use ; Drugs, Generic/economics ; Drugs, Generic/therapeutic use ; Heart Failure/drug therapy ; Humans ; Prescription Fees/statistics & numerical data
    Chemical Substances Cardiovascular Agents ; Drugs, Generic
    Keywords covid19
    Language English
    Publishing date 2020-08-17
    Publishing country United States
    Document type Journal Article
    ZDB-ID 639068-7
    ISSN 1573-7241 ; 0920-3206
    ISSN (online) 1573-7241
    ISSN 0920-3206
    DOI 10.1007/s10557-020-07046-1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: Strategies to Reduce Out-of-Pocket Medication Costs for Canadians Living with Heart Failure

    McIntyre, William F / Belesiotis, Peter / McClure, Graham R / Demers, Catherine / Chahill, Gurneet / Hayes, Abigail / Sohi, Gursharan / Bordman, Wendy / Whitlock, Richard P / Belley-Côté, Emilie P

    Cardiovasc. drugs ther

    Abstract: INTRODUCTION: Daily medication is the cornerstone of evidence-based therapy to reduce mortality and morbidity in patients with heart failure (HF). Up to 20% of Canadian patients pay for medications out of pocket. We sought to identify strategies that ... ...

    Abstract INTRODUCTION: Daily medication is the cornerstone of evidence-based therapy to reduce mortality and morbidity in patients with heart failure (HF). Up to 20% of Canadian patients pay for medications out of pocket. We sought to identify strategies that patients and prescribers can employ to reduce these costs. METHODS: We collected data from outpatient pharmacies in Hamilton, Ontario. We determined prices for different medications in each of the drug classes recommended for HF with reduced ejection fraction in the Canadian Cardiovascular Society's guidelines. We examined differences in dispensing and delivery fees and inquired about other cost-saving strategies. RESULTS: We collected data from 24 different pharmacies, including a selection of hospital-based, independent, and larger chain pharmacies. In the most extreme scenario (i.e., 90-day prescription instead of a 30-day prescription and the least expensive generic drug instead of the most expensive brand name drug), total medication costs can differ by up to $495.56 per month. Costs were affected by choice of agent within a drug class, generic versus brand-name drug, quantity dispensed, dispensing fee, and delivery cost. CONCLUSIONS: Prescription content, dispensing practice, and pharmacy choice can remarkably impact out-of-pocket costs for HF medications. Prescribers can reduce costs by writing 90-day prescriptions and choosing the lowest-cost generic drugs in each therapeutic class. Patients should consider the services received for their pharmacy dispensing fees, use free delivery services where needed, and request inexpensive generic drugs. Pharmacists can facilitate cost minimization without compromising therapeutic efficacy.
    Keywords covid19
    Publisher WHO
    Document type Article
    Note WHO #Covidence: #32803405
    Database COVID19

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