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dc.contributor.advisorBlackburn, David F.en_US
dc.creatorYAO, Shenzhenen_US
dc.date.accessioned2015-07-07T12:00:17Z
dc.date.available2015-07-07T12:00:17Z
dc.date.created2015-05en_US
dc.date.issued2015-07-06en_US
dc.date.submittedMay 2015en_US
dc.identifier.urihttp://hdl.handle.net/10388/ETD-2015-05-2075en_US
dc.description.abstractBackground: 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.en_US
dc.language.isoengen_US
dc.subjectadherenceen_US
dc.subjectcopaymenten_US
dc.subjectmedication utilizationen_US
dc.subjectout-of-pocket paymenten_US
dc.subjectdrug benefiten_US
dc.subjectdrug policyen_US
dc.titleImpact of the Saskatchewan seniors’ drug plan (SDP) to medication utilization and adherence among Saskatchewan residentsen_US
thesis.degree.departmentPharmacy and Nutritionen_US
thesis.degree.disciplinePharmacyen_US
thesis.degree.grantorUniversity of Saskatchewanen_US
thesis.degree.levelMastersen_US
thesis.degree.nameMaster of Science (M.Sc.)en_US
dc.type.materialtexten_US
dc.type.genreThesisen_US
dc.contributor.committeeMemberLix, Lisaen_US
dc.contributor.committeeMemberShevchuk, Yvonneen_US
dc.contributor.committeeMemberTeare, Garyen_US


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