Guilcher Sara, Munce Sarah, Conklin James, Packer Tanya, Verrier Molly, Marras Connie, Bereket Tarik, Versnel Joan, Riopelle Richard, Jaglal Susan
Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, Ontario M5S 3M2, Canada; Center for Urban Health Solutions, St. Michael's Hospital, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada.
Toronto Rehabilitation Institute-University Health Network, 550 University Avenue, Toronto, Ontario M5G 2A2, Canada.
Health Policy. 2017 Apr;121(4):389-396. doi: 10.1016/j.healthpol.2017.01.010. Epub 2017 Feb 4.
This paper describes the current situation in Canada concerning the availability and use of prescription drugs for neurological conditions. We conducted semi-structured qualitative interviews with health care providers, administrators, community organization representatives, opinion leaders and policy makers. The analysis revealed three primary themes related to the availability of and access to prescription drugs to treat neurological conditions. First, we learned that across Canada there is significant vulnerability and a need for advocacy on behalf of people living with these conditions. Second, we learned that the heightened level of vulnerability and need for advocacy stems in part from the significant differences in the drug coverage available in the different provinces and territories. As a result, there are significant inequities across Canada. Third, we determined that the existing situation is also due to the current approach to health governance (i.e., accountability, transparency). Our study provides evidence for the urgent need for a formal discourse on national pharmacare in Canada, with representatives of neurological conditions having a voice at the table.
本文描述了加拿大治疗神经系统疾病的处方药的可及性和使用现状。我们对医疗保健提供者、管理人员、社区组织代表、意见领袖和政策制定者进行了半结构化的定性访谈。分析揭示了与治疗神经系统疾病的处方药的可及性和获取相关的三个主要主题。首先,我们了解到在加拿大全国,患有这些疾病的人群面临着巨大的脆弱性,需要有人为他们发声。其次,我们了解到这种高度的脆弱性和对倡导的需求部分源于不同省份和地区药品覆盖范围的显著差异。因此,加拿大存在严重的不公平现象。第三,我们确定当前的情况也是由于当前的卫生治理方式(即问责制、透明度)所致。我们的研究为加拿大迫切需要就国家药物保险进行正式讨论提供了证据,让患有神经系统疾病的代表能够参与其中。