Canadian Health Policy Institute

Canadian Health Policy Institute

August 28, 2013 07:00 ET

Canadian Health Policy Institute Estimates Potential Cost of Therapeutic Substitution for PPI Drugs in Quebec Could Be $50 to $162 Million

TORONTO, CANADA--(Marketwired - Aug. 28, 2013) - Quebec's ministry of health recently announced changes to its reimbursement policy for proton pump inhibitor (PPI) drugs covered under the public prescription drug insurance plan, le régime public d'assurance médicaments (RGAM) du Québec. Effective October 1, 2013, the new policy sets the maximum price payable (MPP) for all PPI drugs at $.55 per unit. Costs up to the MPP are publicly insured. Patients who don't switch to PPI drugs that are priced under the MPP must pay the difference out of pocket. The policy change follows a study by the Institut national d'excellence en santé et en services sociaux (INESSS) that deemed all PPI drugs to be therapeutically equivalent though they are bio-chemically different products. INESSS projected that RGAM will save between $32 million and $41 million annually from the policy change.

In 2003, British Columbia's Pharmacare implemented a similar policy. A new study published in Canadian Health Policy, the online journal of the Canadian Health Policy Institute (CHPI), uses data from British Columbia's experience to estimate the potential impact on total health system costs from therapeutic substitution of PPI drugs that could occur in Quebec.

According to the study, assuming Quebec's experience in its first 3 years after implementation of the MPP (2014 to 2016) will be proportionally similar to BC's actual experience (2003 to 2005), the expected potential total net health system costs associated with therapeutic substitution of PPIs could reach an estimated $49.8 million. If the policy achieves 100% compliance among the group of patients affected by the financial incentive to switch PPI drugs, net costs could reach up to $162 million. Under both scenarios, the estimated costs are net of any price savings associated with the MPP for this group of patients.

The article, Potential costs from therapeutic substitution of proton pump inhibitor (PPI) drugs in Quebec, is available for free download from Canadian Health Policy, the online journal of the Canadian Health Policy Institute (CHPI) and can be accessed at the following web link:

About CHPI

Canadian Health Policy Institute (CHPI) is a non-profit think-tank funded by independent research grants and unrestricted operating grants from public sector, private sector and non-profit sector sources. CHPI is dedicated to conducting, publishing and communicating evidence-based socio-economic research on health system performance and health policy issues that are important to Canadians.

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