The timing of drug funding announcements relative to elections: a case study involving dementia medications

Following initial regulatory approval of prescription drugs, many factors may influence insurers and health systems when they decide whether to add these drugs to their formularies. The role of political pressures on drug funding announcements has received relatively little attention, and elections...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2013-02, Vol.8 (2), p.e56921-e56921
Main Authors: Gill, Sudeep S, Gupta, Neeraj, Bell, Chaim M, Rochon, Paula A, Austin, Peter C, Laupacis, Andreas
Format: Article
Language:English
Subjects:
Alzheimer's disease
Alzheimers disease
Canada
Canada Health Act
Cancer therapies
Case reports
Case studies
Cholinesterase
Cholinesterase inhibitors
Cholinesterase Inhibitors - economics
Chronology
Cost control
Decision Making
Decisions
Dementia
Dementia - economics
Dementia disorders
Drug formularies
Drug policy
Drugs
Election results
Elections
Funding
Government agencies
Health care policy
Hospitals
Humans
Inhibitors
Legislatures
Medicine
Neurodegenerative diseases
Patient Protection & Affordable Care Act 2010-US
Patient safety
Pharmaceuticals
Politics
Prescription drugs
Prescription Drugs - economics
Pressure
Product life cycle
Provincial elections
Public health
Regulatory approval
Reviews
Statistical analysis
Time Factors
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Following initial regulatory approval of prescription drugs, many factors may influence insurers and health systems when they decide whether to add these drugs to their formularies. The role of political pressures on drug funding announcements has received relatively little attention, and elections represent an especially powerful form of political pressure. We examined the temporal relationship between decisions to add one class of drugs to publicly funded formularies in Canada's ten provinces and elections in these jurisdictions. Dates of provincial formulary listings for cholinesterase inhibitors, which are drugs used to treat Alzheimer's disease and related dementias, were compared to the dates of provincial elections. Medical journal articles, media reports, and proceedings from provincial legislatures were reviewed to assemble information on the chronology of events. We tested whether there was a statistically significant increase in the probability of drug funding announcements within the 60-day intervals preceding provincial elections. Decisions to fund the cholinesterase inhibitors were made over a nine-year span from 1999 to 2007 in the ten provinces. In four of ten provinces, the drugs were added to formularies in a time period closely preceding a provincial election (P = 0.032); funding announcements in these provinces were made between 2 and 47 days prior to elections. Statements made in provincial legislatures highlight the key role of political pressures in these funding announcements. Impending elections appeared to affect the timing of drug funding announcements in this case study. Despite an established structure for evidence-based decision-making, drug funding remains a complex process open to influence from many sources. Awareness of such influences is critical to maintain effective drug policy and public health decision-making.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0056921