Thursday, May 21, 2009

No more free Samples

If you were about to purchase a new vehicle, you may want to test drive a number of cars to see which you liked best , felt the safest , liked the gas mileage, had the smoothest ride,  wanted a hybrid, etc.  Then you decide and with the assistance of your financial institute you make your purchase.   Just imagine, instead of being able to test drive a number  of vehicles, you are automatically directed  to test drive only the newer expensive models. If you want to try a less expensive model , you have to go down the street and you have to pay to try these models.  To make matters worse, these models have foreign names that you find confusing .  In fact the dealer may not even know the names!  

Nowadays, your choice of drug may cost as much as a new car over the course of several years.  Or in some case in just one year. 

Well, there is an article on Plos Medicine with the above title , you can click here for the link.  It makes the case for eliminating pharmaceutical samples or even vouchers from physicians offices.  I feel this is too big a change and one which may never occur.  One area not explored by this story is to actually increase the sampling to physicians.  If you read the article this sounds like a wild idea, but, consider that the article talks about samples that are the higher priced new drugs with relatively little number of studies .  So, what if there were samples of drugs with huge volumes of data behind them and that they were lower cost.  Now the physician would have to choose... Do I (A) write this drug that is being marketed by the industry  or  (B) continue to write this product that I have learned so much about.  I know its safety profile and efficacy and can leave the newer agent as my second choice or even third choice.  If evidence is provided to show the new drug does amazing new advances then the Physician may consider it.   
Here in Atlantic Canada  we have tried this very thing in our projects and have had great success with physicians and local pharmacists  but have been met with significant push back from some areas you never would have guessed.  We used a voucher system through the pharmacy to obtain the lower cost meds.  Physicians like the approach and so do patients.  A much larger trial is needed now.  

Friday, May 15, 2009


More charges laid in alleged Ontario drug reselling scheme... Canadian Press 

Tuesday, May 5, 2009


I had a very interesting and productive trip recently to Saskatchewan and had the opportunity to hear the deputy Minister of Health , Dan Florizone speak about their "Patient First Review " program.  He focussed on the difficulties of running the health system and the specifics to wait times within the system.  He made a humorous analogy to opening three restaurants (the only three in town) and waiting in line to get a table.  It really was an effective way to demonstrate the complexities and issues with wait times.  He cited lack of communication and respect as a major barrier and an abundance of administrative duties as some key areas. They recognize that it is the Patient that actually experiences the full process from beginning to end and they are trying to learn from this.  Fixing one area which may cause disruption in another is not the answer.  They are still struggling to make changes but certainly they appear to be seeking answers.