Lawrence S. Bloomberg Faculty of Nursing (Grundy, Quanbury, Hart, Tavangar) and Leslie Dan Faculty of Pharmacy (Chaudhry, Tadrous), University of Toronto; School of Health Policy and Management (Lexchin), York University; Department of Family and Community Medicine (Lexchin), University of Toronto, Toronto, Ont.; School of Public Policy and Administration (Gagnon), Carleton University, Ottawa, Ont.
CMAJ. 2023 Nov 26;195(46):E1565-E1576. doi: 10.1503/cmaj.230841.
Globally, pharmaceutical companies offer patient support programs in tandem with their products, which aim to enhance medication adherence and patient experience through education, training, support and financial assistance. We sought to identify the proportion and characteristics of such patient support programs in Canada and to describe the nature of supports provided.
We conducted a crosssectional study to identify and characterize all marketed prescription drugs available in Canada as of Aug. 23, 2022, using the Health Canada Drug Product and CompuScript databases. To describe the nature of supports provided, we conducted a content analysis of publicly available patient support program websites and Web-based documents. Using logistic regression, we identified characteristics of drugs associated with having a patient support program including brand-name or branded generic (generic medications with a proprietary name), orphan (medications for rare diseases) or biologic drug status; estimated total cost of prescriptions dispensed at retail pharmacies; and price per unit.
Of the 2556 prescription drugs marketed by 89 companies in the study period, 256 (10.0%) had a patient support program in Canada. Many of the 89 drug manufacturers ( = 55, 61.8%) offered at least 1 patient support program, frequently relying on third-party administrators for delivery. Brandname and branded generic medications, biologic agents and drugs with orphan status were more likely to have a patient support program than generic drugs. Compared with drugs priced $1.01-$10.00 per unit, drugs priced $10.01-$100.00 per unit were nearly 8 times more likely to have a patient support program (adjusted odds ratio 7.54, 95% confidence interval 4.07- 14.64). Most sampled patient support programs included reimbursement navigation ( = 231, 90.2%) and clinical case management ( = 223, 87.1%).
About 1 in 10 drugs marketed in Canada has a manufacturersponsored patient support program, but these are concentrated around brand-name, branded generic, biologic and high-cost drugs, often for rare diseases. To understand the impact of patient support programs on health outcomes and sustainable access to cost-effective medicines, greater transparency and independent evaluation of patient support programs is necessary.
在全球范围内，制药公司与他们的产品一起提供患者支持计划，旨在通过教育、培训、支持和经济援助来提高药物的依从性和患者的体验。我们旨在确定加拿大此类患者支持计划的比例和特征，并描述所提供支持的性质。
我们进行了一项横断面研究，使用加拿大卫生部药品产品和 CompuScript 数据库，确定并描述截至 2022 年 8 月 23 日在加拿大上市的所有处方药的特征。为了描述所提供支持的性质，我们对公开的患者支持计划网站和基于网络的文件进行了内容分析。我们使用逻辑回归确定了与患者支持计划相关的药物特征，包括品牌名或品牌通用名（具有专有名称的通用药物）、孤儿（用于罕见疾病的药物）或生物药物状态；估计在零售药店配药的总费用；以及每单位的价格。
在所研究期间，89 家公司销售的 2556 种处方药中，有 256 种（10.0%）在加拿大有患者支持计划。许多制药商（=55，61.8%）提供了至少 1 种患者支持计划，通常依靠第三方管理机构来提供。品牌名和品牌通用名药物、生物制剂和孤儿状态药物比通用药物更有可能有患者支持计划。与每单位价格为 1.01-10.00 美元的药物相比，每单位价格为 10.01-100.00 美元的药物更有可能有患者支持计划（调整后的优势比 7.54，95%置信区间 4.07-14.64）。大多数抽样的患者支持计划包括报销导航（=231，90.2%）和临床病例管理（=223，87.1%）。
在加拿大销售的药物中，约有 1/10 有制造商赞助的患者支持计划，但这些计划集中在品牌名、品牌通用名、生物制剂和高成本药物上，通常用于治疗罕见疾病。为了了解患者支持计划对健康结果和负担得起的药物可持续获取的影响，需要对患者支持计划进行更大的透明度和独立评估。
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