A study conducted by Saskatchewan researchers – including collaborators from the Health Quality Council (HQC) – has resulted in a change in the provincial reimbursement policy for a particular cholesterol-lowering drug known as ezetimibe or Ezetrol®.
Despite clear evidence that ezetimibe should be designated as a secondary drug for lowering cholesterol, researchers showed that ezetimibe was commonly being used as a first-line therapy in Saskatchewan. Furthermore, its overall use and cost were increasing every year. As a direct result of these study findings, the policy for reimbursing ezetimibe was changed. As of July 1, 2013, it is now listed under the Drug Plan’s Exception Drug Status Program, meaning it will only be covered for patients meeting specific criteria.
This research was conducted by the Saskatchewan Drug Utilization and Outcomes Research Team – also referred to as SDUORT. SDUORT is led by David Blackburn, from the University of Saskatchewan (U of S) College of Pharmacy and Nutrition. Co-investigators on the team are Gary Teare, the executive director of measurement and analysis services at HQC; Yvonne Shevchuk, from the College of Pharmacy and Nutrition at the U of S; and Lisa Lix, from the University of Manitoba Department of Community Health Sciences.
The lead author of the ezetimibe study was Wasem Alsabbagh, a SDUORT research associate at the time. Other co-investigators on the study were Joseph Dagenais (Department of National Defence), Lin Yan (University of Manitoba) and Xinya Lu (HQC).
The results of the researchers’ ezetimibe analysis were published in the February 2014 edition of the Canadian Journal of Cardiology, in a paper entitled “Use and Misuse of Ezetimibe: Analysis of Use and Cost in Saskatchewan, a Canadian Jurisdiction With Broad Access.”
Teare said HQC research analysts provide invaluable support to the SDUORT researchers, drawing on their breadth of experience working with Saskatchewan administrative health databases.
“The HQC analysts’ expertise with the data and their analysis complements the subject area knowledge of the academic researchers at the university,” he said.
Shevchuk, who is an HQC board member, said supporting projects such as the ezetimibe study is an important part of HQC’s work as outlined in The Health Quality Council Act.
“According to the Act, one of the objects of the council is ‘to research and evaluate prescription drug prescribing practices, prescription drug utilization and existing processes for reviewing and approving prescription drugs,’ ” she said.
“The ezetimibe study is a good example of that type of work.”
Blackburn said SDUORT is building capacity in the province to conduct important pharmaco-epidemiological research that directly impacts Saskatchewan people.
“The pharmaceutical market is continually evolving, so it is important to ensure prescribing practices continue to conform to the best available evidence,” he said.
“Our research addresses important questions of interest to the administrators of the Saskatchewan Drug Plan, helping to inform evidence-based policy decisions and prescribing practices. SDUORT reports to the Ministry of Health and also publishes in scientific journals. Publishing our work is important because other provinces or regions are often facing similar issues and may be able to learn from our discoveries.”
Anne Champagne, senior pharmaceutical policy analyst with the Ministry of Health, said one of the objectives of the Saskatchewan Drug Plan is to encourage the rational and appropriate use of prescription drugs.
“The work of SDUORT helps us to ensure that Saskatchewan residents receive treatments in accordance with best-practice recommendations,” she said.
To read the paper online, go to http://www.onlinecjc.ca/article/S0828-282X(13)01713-3/abstract.