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- Survey
Survey 2000 was sent out last year to our readers (physicians, pharmacists, and other health care professionals). The graph below summarizes the responses from ~ 20% of readers (n=93).
- Objective data
Below is a summary of in-house data we have submitted to Pharmacare in our annual reports. Please note:
a)NS = North Shore Health Region (the region in Vancouver that we work in)
b)Richmond is the region we compare ourselves to. It is most similar to the NorthShore in terms of wealth and percent of seniors in the population. In addition, there is only one community hospital in each region.
c)Pharmacare is our provincial drug plan (much like the Ontario Drug Benefit)
d)The dates shown in the “prescribing changes” and “economic impact” columns reflect the months that the data encompass
e)Prescribing changes: most of the data represent a change in prescribing of the target drug as a % of all drugs in the same category
f)In situations where usage decreased, a negative symbol (-) is used
g)Analytical methods changed annually
h)All our newsletters have been archived and are available free online at (use password: pudc)
NEWSLETTER& distribution date / PRESCRIBING CHANGES / ECONOMIC IMPACT
Comparing the NSAIDs: few differences other than cost
Nov 1993 / % change of utilization naproxen/NSAIDs:
- 7.6% (NS) – naproxen recommended if using NSAID
- 2.9% (Richmond)
$42, 352 (NS)
(Dec 93 – Nov 95)
Oral nitrates…Nitrong SR versus Isordil
Mar 1994 / % change of utilization ISDN/?cardiac drugs:
- -2.2% (NS) – ISDN recommended if using nitrate
- -0.4% (Richmond)
$1, 254 (NS)
(Apr 94 – Oct 95)
Rediscovering cimetidine
Mar/Apr 1994 / % change of utilization cimetidine/antisecretory drugs:
- -1.2% (NS) – cimetidine recommended if using H2 blocker
- -2.1% (Richmond)
$ 115, 144 (NS)
(Apr 94 – Sept 95)
Urinary tract infections: comparing treatment options
Jul 1994 / cumulative savings:
$18, 546 (NS)
Respiratory tract infections: are the new antibiotics more effective?
Aug 1994
Antibiotics for the treatment of acute otitis media
Nov 1994 (revised) / (Apr 94-Dec 95)
Low dose thiazide diuretics in the treatment of hypertension
Jan 1995 / % change of utilization HCTZ/antihypertensives:
- 3.8% (NS) – HCTZ use recommended
- 3.6% (Richmond)
$ 66, 095 (NS)
(Apr 94 – Dec 95)
Beta blockers for the treatment of hypertension
Feb 1995 / % change of utilization atenolol/antihypertensives:
- 2.4% (NS) – atenolol recommended if using -blocker
- 1.7% (Richmond)
ACE inhibitors in hypertension: more similarities than differences
Mar 1995 / % change of utilization ramipril/antihypertensives:
- 4.5% (NS) – ramipril recommended if using ACE inhibitor
- 4.1% (Richmond)
Calcium channel blockers in the treatment of hypertension
Apr 1995 / % change of utilization felodipine/antihypertensives:
- 2.1% (NS) – felodipine recommended if using CCB
- 2.5% (Richmond)
Alpha-1 blockers and other antihypertensive drugs
June 1995 / (Apr 94 – Dec 95)
Taking another look at NSAIDs
Aug 1995
Tricyclic antidepressants: they are not all the same!
Nov 1995 / % change of utilization TCA /antidepressants:
- -4.2% (NS)
- -4.4% (Richmond)
$471.54 (NS)
$589.96 (Richmond)
Selective serotonin reuptake inhibitors
Nov 1995 / % change of utilization fluoxetine/antidepressants:
- -3.3% (NS) – fluoxetine use discouraged in elderly
- -2.7% (Richmond)
Three new antidepressants…three different mechanisms
Dec 1995 / % change of utilization venlafaxine/antidepressants:
- 1.3% (NS) – recommended reserving atypical agents
- 3.9% (Richmond)
Inhaled corticosteroids and inhaled beta-2 agonist
Jan 1996 / Analysis not performed
- asthma and COPD had the reverse recommendations for inhaled corticosteroids
- salmeterol is not a Pharmacare benefit
Topical corticosteroids: a little dab will do ya!
May 1996 / %utilization hydrocortisone/topical corticosteroids:
- no change (NS) –HC recommended if using topical corticosteroids
- -2.1% (Richmond)
Hormone replacement therapy: practical considerations
Oct 1996 / Analysis not performed
- patients <65 y.o., thus not in Pharmacare database
- oral estrogen favoured over patch, however patch was soon delisted from Pharmacare
- micronized progesterone not a Pharmacare benefit
Sleeping pills: the good, the bad, and the expensive!
Feb 1997 / New zopiclone prescriptions:
- 31% (CI: 7-49%) relative reduction in NS compared to Richmondzopiclone use discouraged
Oral hypoglycemics for NIDDM: the old and the new
May 1997 / % change in utilization metformin or tolbutamide /oral hypoglycemics:
- No change (NS) – metformin recommended in obese patients and tolbutamide recommended in renal impairment
- No change (Richmond)
HMG CoA reductase inhibitors: “statin” the facts
Oct 1997 / % change in number of “statin” prescriptions:
- 37.4% (NS) – use of statin discouraged for patients not at risk
- 39.8% (Richmond)
$278, 307 (NS)
$332, 562 (Richmond)
(Nov 96 – Oct 98)
New drugs for asthma…a “kast” of 2!
Mar 1998 / Analysis not performed
- neither drugs are Pharmacare benefits
Drugs for Parkinson’s disease
Jun 1998 / Analysis not performed
- no academic detailing performed
Hormone replacement therapy: practical considerations
Aug 1998 (update) / Analysis not performed
- patients <65 y.o., thus not in Pharmacare database
Oral contraceptives: too many choices!
Oct 1998 / Analysis not performed
- patients <65 y.o., thus not in Pharmacare database
Antibiotics for community acquired pneumonia (CAP)
Feb 1999 / % change utilization cipro/CAP antibiotics:
- -2.6% (NS) – routine use of cipro discouraged
- 3.7% (Richmond)
$18, 773 (NS)
(Feb 98 – Dec 99)
Migraine therapy: stopping brain pain
May 1999 / % change in number of “triptan” prescriptions:
- 31.1% (NS) – “triptan” use discouraged
- 53.8% (Richmond)
$60, 226 (NS)
(Nov 98 – Dec 99)
Migraine therapy: preventing brain pain
Jun 1999 / Analysis not performed
- recommended drugs have multiple indications