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      • Electronic Theses and Dissertations
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      • HARVEST
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      Impact of the Saskatchewan seniors’ drug plan (SDP) to medication utilization and adherence among Saskatchewan residents

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      YAO-THESIS.pdf (1.517Mb)
      Date
      2015-07-06
      Author
      YAO, Shenzhen
      Type
      Thesis
      Degree Level
      Masters
      Metadata
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      Abstract
      Background: In 2007, Saskatchewan’s Ministry of Health launched the Seniors’ Drug Plan (SDP), whereby provincial beneficiaries at or above the age of 65 receive medications at a maximum self-payment of $15. The purpose of this study was to document the impact of the SDP using provincial health-administrative databases. Methods: Aggregate medication utilization and costs were described using the prescription drug database starting two years before the implementation of the SDP and continuing for two years after. Interrupted time series analysis using segmented regression models were developed to test the impact of the SDP. Also, the probability of achieving optimal medication adherence was examined among cohorts receiving medications after SDP implementation versus similar patients receiving medications before the SDP and also a group of patients <65 years who were not eligible for the SDP at all. The impact of the SDP on the outcome of optimal adherence was estimated using logistic regression models with generalized estimating equations (GEE). Results: Monthly government spending on medications increased by 47.5% following implementation of the SDP, while total medication dispensations only increased by 5.8%. The SDP was associated with more dispensations per month among prevalent users (+5.4%, 95% CI: 1.3% to 9.5%) but not incident users who did not receive the study medication in the previous 365 days (+1.3%, 95% CI: -8.0% to 10.7%). Similarly, the SDP did not appear to impact the use of blood-glucose-lowering agents, (-0.5%, 95% CI: -6.2% to 5.2%). A small but significant increase in the odds of optimal medication adherence was observed after the SDP compared with before (OR=1.08, 95% CI 1.04 to 1.11). However, the impact was only observed in prevalent users (OR=1.08, 95% CI 1.04 to 1.12), but not incident users (OR=1.05, 95% CI 0.98 to 1.13). Also, the impact of the SDP on medication adherence was not consistent for all medication classes examined. Discussion: In summary, the SDP resulted in substantially higher government investment into drug costs without a major effect on medication utilization and adherence. However, cost reduction for seniors must have provided substantial relief independent of the impact on adherence and utilization.
      Degree
      Master of Science (M.Sc.)
      Department
      Pharmacy and Nutrition
      Program
      Pharmacy
      Supervisor
      Blackburn, David F.
      Committee
      Lix, Lisa; Shevchuk, Yvonne; Teare, Gary
      Copyright Date
      May 2015
      URI
      http://hdl.handle.net/10388/ETD-2015-05-2075
      Subject
      adherence
      copayment
      medication utilization
      out-of-pocket payment
      drug benefit
      drug policy
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      • Electronic Theses and Dissertations
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