McLaughlin Tom, Jong Geert 't, Gilpin Andrea, Hepburn Charlotte Moore
Canadian Paediatric Society, Ottawa, Ontario.
Goodman Family Pediatric Formulations Centre, CHU Sainte-Justine, Montreal, Quebec.
Paediatr Child Health. 2020 Mar;25(2):113-124. doi: 10.1093/pch/pxz176. Epub 2020 Mar 13.
Canada's drug insurance system is one of the most expensive in the world, yet millions of Canadians still struggle to access necessary medications. As a result, provincial, territorial, and federal governments are considering public pharmacare policy proposals to ensure that all Canadians can access the medications they need. Pharmacare policies offer an opportunity to prioritize children and youth, whose unique drug needs have long been neglected. Prescription drug use is common in this population, with approximately half of Canadian children and youth requiring at least one prescription in any given year. Drug use remains concentrated, however, among those with complex, chronic, and serious diseases. Children and youth rely heavily on compounded and off-label prescription drugs, which impacts safety, efficacy, palatability, and cost. Reimbursement decision-making bodies do not appropriately value the unique benefits of paediatric drugs, including child-friendly formulations, improved quality of life for children and families, and cost-savings outside the healthcare system. Regardless of the pharmacare model ultimately implemented, ensuring universal, comprehensive, and portable prescription drug coverage for all children and youth is essential. To accomplish this, paediatric drug experts should develop a national, evidence-informed formulary of paediatric drugs. Health Canada should also improve processes to make commercial paediatric drugs and child-friendly formulations more available and accessible. The federal government must also support paediatric drug research and development to this end.
加拿大的药品保险体系是全球最昂贵的体系之一，然而仍有数百万加拿大人难以获得所需药物。因此，各省、地区和联邦政府正在考虑公共药物护理政策提案，以确保所有加拿大人都能获得所需药物。药物护理政策提供了一个将儿童和青少年作为优先考虑对象的机会，他们独特的药物需求长期以来一直被忽视。在这一人群中，处方药的使用很普遍，在任何一年中，约有一半的加拿大儿童和青少年至少需要开具一张处方。然而，药物使用仍集中在患有复杂、慢性和严重疾病的人群中。儿童和青少年严重依赖复方和非标签处方药，这对安全性、有效性、适口性和成本都有影响。报销决策机构没有充分重视儿科药物的独特益处，包括适合儿童的剂型、改善儿童及其家庭的生活质量以及在医疗保健系统之外节省成本。无论最终实施何种药物护理模式，确保为所有儿童和青少年提供普遍、全面和可携带的处方药保险至关重要。要做到这一点，儿科药物专家应制定一份基于证据的全国儿科药物处方集。加拿大卫生部还应改进相关流程，使商业儿科药物和适合儿童的剂型更容易获得。为此，联邦政府也必须支持儿科药物的研发。
