Dollars and sense of access and choice of medications

On September 14, 2006 on CBC.ca News a news item entitled “Doctors urged to prescribe older drugs to curb overspending” caught CAPA’s attention. Dr. Jim Wright, a clinical pharmacologist, and Dr. Alan Cassels, a drug policy researcher at the University of Victoria are both urging doctors in B.C. to prescribe older cheaper drugs. Dr. Jim Wright states, “typically new drugs cost twice the amount of older drugs without offering any substantial benefit to the patient.” This may be right sometimes but it is not right all of the time. Some of the newer drugs that have recently entered the market for arthritis sufferers, such as biologics, are superior to the older drugs. Yes the initial cost is high but these drugs can slow or stop the progression of the disease and in the end, avoids other healthcare costs such as hospitalization, surgery, rehabilitation, and long-term care.

CAPA believes arthritis patients must have access to treatments that provide the greatest relief from pain, inflammation, and stiffness and that slow or prevent the progression of their illness. Timely access to appropriate treatments is paramount to disease management. Many patients do not need the newest and most expensive medications. Their disease is managed well with older therapies. Others have had little or no success with these drugs. Regardless of the medication prescribed, the most appropriate treatment is a decision reached by the patient and the physician based on the health status of the patient and after weighing the alternatives including potential benefits and possible adverse side effects. Medications and other treatments that have been shown to be helpful in treating arthritis must be available to Canadians living with arthritis, along with all available information on potential benefits and possible adverse side effects so that informed decisions can be made.

A physician’s duty is to provide patients with proper relief and/or a cure. The Hippocratic Oath, a tenet of every physician makes this clear. Canadian doctors should not see their prescribing actions restricted by financial considerations and Canadian patients should not be restricted from obtaining the best possible care. Recommendations that focus on costs first are ill conceived, ignore the impact on primary health care delivery and place the well being of the patient in last place.