Under Public Scrutiny: A preliminary exploration of the public’s view of the National Pharmace

What do Canadians know and understand about the National Pharmaceutical Strategy and the government’s plans? What role should they play in the development of the strategy, plans, and policies that will have an impact on their health and health outcomes? There is no denying “pharmaceutical policy is central to the sustainability of not only national pharmacare programs, but the long-term stability of health care systems as a whole”. In addition, the strategy and policies are also central to ensuring good health outcomes of Canadians, and that “no Canadian will suffer undue financial hardship in accessing needed drug therapies, and that affordable access to drugs is fundamental to equitable health outcomes for all our citizens”.

The purpose of a study undertaken with the Canadian public was to determine what different sectors knew and understood about the process and plans for the development of a National Pharmaceutical Strategy, and if they felt they should be involved in the process. The question is what are the perceptions and understandings of the Canadian public regarding the National Pharmaceutical Strategy, its strengths and weaknesses, and the involvement of the public in the process?

A mixed methods survey approach was used in the study described. A convenience sample was sought with a variety of the Canadian public (patients, consumers, health care providers, voluntary sector organization representatives, and others) who were accessed through different settings. A covering letter explaining the study and the questionnaire about different aspects of the strategy were emailed to voluntary and other health organizations to distribute broadly. Brief dialogue discussions occurred with several mixed groups of the public.

The number of respondents from surveys and dialogue sessions for this preliminary exploratory study was 423. About 70% of the respondents were living with chronic illnesses or conditions. About 12% were health professionals, and 16% said they represented the public sector including non-government organizations. Of these respondents, the majority had only heard about NPS within six months of this survey study, and it was through emails they had received from associations or patient organizations. Over 90% said that the government has not done a good job of informing Canadians about the proposed NPS and plans. In fact, 84% of respondents had not been involved in any discussions related to NPS, although 100% of respondents agreed that the public should or must be involved with the process and products related to this national strategy. The respondents also listed the strengths and weaknesses of the NPS. Its top strength is that “it is a start in the right direction”, while “limited consultations and input” is seen as its weakest quality. Another more comprehensive study is in progress.

Some of the recommendations include that the public, and particularly those individuals living with chronic diseases such as Arthritis, must be kept informed and involved in each of the nine areas of the NPS. The impact of decisions concerning access and costs for medications must be favorable for people with Arthritis and other chronic diseases, so that they have improved health outcomes and quality of life. The priorities of Canadians concerning what they see as the right approach for a national drug program must be reflected as much as those of the government. The lowest cost programs will not necessarily be long term cost savings for Canadians, and particularly for people with Arthritis or other chronic diseases. Nor will it be a savings for the health care system. We want and need a win-win approach!

Katharina Kovacs Burns, MSc, MHSA, PhD, Faculty of Nursing, University of Alberta is a member of the Best Medicines Coalition