Shoppers Drug Mart Prescription Centre in Toronto on Feb. 07, 2011.Deborah Baic/The Globe and Mail
A new study has found that 10 per cent of prescription drugs on the market in Canada are linked to patient support programs sponsored by drug companies, raising questions about whether this allows the pharmaceutical industry to have too much influence over patient care.
The study, published Monday in the Canadian Medical Association Journal, found that expensive drugs were much more likely to have a patient support program attached to them compared to lower-cost drugs. Patient support programs are designed to help individuals pay certain costs associated with drugs, navigate the health care system or manage their care, and can include access to a nurse who can assist with medication administration.
Dr. Quinn Grundy, a registered nurse and assistant professor at the Lawrence Bloomberg Faculty of Nursing, University of Toronto, and lead author, said one concern is that support programs funded by drug companies may not align with the best interests of patients, and that it’s often difficult to assess the programs because information on their operations or outcomes is not publicly available.
“We don’t know anything about the patient experience with these programs,” Dr. Grundy said.
She added that there is evidence to show patient support programs have been used to encourage use of a company’s drug, which is problematic and has led to pushback and legal restrictions in other countries to crack down on the practice.
The study notes that it’s problematic for support programs to be built around a particular drug, rather than around a disease or health concern. For instance, Dr. Grundy wondered what happens if a patient has an adverse reaction to a drug that is supported by a patient support program and must switch to another drug without a similar support system.
“How do we ensure people continue to have access to the care they need?” she asked.
At the same time, the lack of universal coverage for drugs in Canada and the increasing prevalence of expensive medications means that many patients are desperate for help in paying for drugs, which can make these programs very attractive, Dr. Grundy said.
“All these financial supports show the challenges Canadians have accessing drugs,” she said.
The study authors found that of the more than 2,500 drugs currently on the market, 256 have patient support programs. They noted that this number is likely an underestimate of the true extent of such programs, as they may have missed some during their research.
The study calls for greater transparency of patient support programs in order to understand their scope and impact. In France, for instance, patient support programs are regulated and company representatives are not allowed to be involved.
An interview request sent to Innovative Medicines Canada, which represents the pharmaceutical industry, did not receive a response.
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