Health Services Utilization With Reference Drug Pricing of Histamine2 Receptor Antagonists in British Columbia Elderly

BACKGROUND: In October 1995, British Columbia introduced a reference pricing policy for five therapeutic classes of drugs, including histamine(2) receptor antagonists (H(2)RAs), for beneficiaries of its prescription drug program, Pharmacare. OBJECTIVES: To evaluate utilization trends in consumption of health services in a cohort of Pharmacare beneficiaries to determine if a worsening of health outcomes could be detected after implementation of the reference pricing policy. RESEARCH DESIGN: Two cohorts, "control" (21 months before the reference pricing policy) and "exposed" (at risk for policy effects), were followed for 21 months. Using a longitudinal generalized linear model (Poisson), and controlling for age, sex, and prescriptions in unique drug classes, trend lines in each of these time series were compared for 3 periods: 9 months before policy implementation (or corresponding index date in the control cohort), 6 months after policy implementation, and a subsequent 6-month period. SUBJECTS: Two cohorts, each of size 10,000, were constructed by randomly sampling the population of Pharmacare beneficiaries exposed to H(2)RAs and other antisecretory drugs for 1993 through 1996. MEASURES: Prescriptions, physician office visits and associated transactions (ie, laboratory tests), emergency room visits, hospitalizations, hospital length of stay, and vital statistics. RESULTS: Differences between periods and between cohorts for health services utilization were not significant or decreased after imposition of the reference pricing policy. CONCLUSION: For these measures, there has been no worsening of health outcomes associated with implementing the reference pricing policy

Business · Cohort · Environmental health · Interrupted time series · Medical prescription · Poisson regression · Population · Prescription drug · Psychological intervention · Internal Medicine · Mast cells and histamine · Medication Adherence and Compliance · Medicine · Nursing · Pharmaceutical Economics and Policy

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