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Forces' drug needs different, MD says
Members don't require all medications needed by politicians, bureaucrats
Gloria Galloway, Globe & Mail, 24 Jan 07
Article Link
OTTAWA -- The Canadian Forces say their members don't need access to the full range of medication offered through the drug plans provided to politicians and bureaucrats.
Physician Ken Scott, the colonel who is director of medical policy for the military's health services, said yesterday that members of the Forces have different physical characteristics than the average Canadian and don't suffer from the same types of disease.
"The Canadian Forces is not representative of the Canadian population at large," Col. Scott said.
For instance, "we exclude people with some medical conditions like Fabry's disease, a congenital disorder that the [Common Drug Review] may look at. "If we have nobody in the Canadian Forces with Fabry's disease, then why would we carry that on our formulary?"
A study released this week found that the drug plans administered for military personnel and aboriginals, as well as the government-run public plans in Ontario and British Columbia, provide reimbursement for fewer medications than the range covered under the Public Service Health Care Plan.
Elected officials and civil servants can recoup the cost of nearly all of the 73 drugs examined by Canada's Common Drug Review (CDR), the independent body that recommends what should be covered under the public drug plans. Soldiers, aboriginals and those who must rely on provincial plans are covered for a fraction of the total.
But Col. Scott said it just doesn't make sense for the military plan to cover drugs for diseases such as cystic fibrosis because no one with that ailment could become a member of the Forces.
In addition, he said, it's important to understand that there are many drugs developed to treat the same disease. So if there is a medication to lower cholesterol, and "if we already have four or five on our formulary and they all do the same thing, why would we add it?"
And in cases where an airman, seaman or sailor comes down with something unusual -- and a physician indicates that a medicine that has not been approved under the plan is required -- Col. Scott said exceptions can be made and the cost of the drugs will be covered.
Health Minister Tony Clement, whose department administers the drug plan for aboriginal Canadians, has offered the same commitment, as has Veterans Affairs .
Col. Scott cited as an example a drug called cloreg that is used in patients with systolic heart failure and was approved by the CDR in June of 2004.
"There are very few Canadian Forces members with significant heart failure running around," he said. "But, if you contact our drug-exception centre and the patient has evidence of congestive heart failure and other drugs such as digoxin and things have been unsuccessful, and there is a request for this drug, then they get it through the special-authorization criteria."
George Wyatt, founder of Wyatt Health Management which conducted the study for CARP, Canada's Association for the Fifty Plus, said the fact a drug plan will pay for unapproved drugs in exceptional cases doesn't mean it is equal to plans the cover the drugs.
"Every plan has special authorization processes. However, those processes in some cases can be onerous, and they require physicians to write individual letters, and sometimes the letter-writing skill is good and sometimes it's less than good," Dr. Wyatt said. "So the very same patients, if they had two doctors writing the letters, might get two different responses."
Forces' drug needs different, MD says
Members don't require all medications needed by politicians, bureaucrats
Gloria Galloway, Globe & Mail, 24 Jan 07
Article Link
OTTAWA -- The Canadian Forces say their members don't need access to the full range of medication offered through the drug plans provided to politicians and bureaucrats.
Physician Ken Scott, the colonel who is director of medical policy for the military's health services, said yesterday that members of the Forces have different physical characteristics than the average Canadian and don't suffer from the same types of disease.
"The Canadian Forces is not representative of the Canadian population at large," Col. Scott said.
For instance, "we exclude people with some medical conditions like Fabry's disease, a congenital disorder that the [Common Drug Review] may look at. "If we have nobody in the Canadian Forces with Fabry's disease, then why would we carry that on our formulary?"
A study released this week found that the drug plans administered for military personnel and aboriginals, as well as the government-run public plans in Ontario and British Columbia, provide reimbursement for fewer medications than the range covered under the Public Service Health Care Plan.
Elected officials and civil servants can recoup the cost of nearly all of the 73 drugs examined by Canada's Common Drug Review (CDR), the independent body that recommends what should be covered under the public drug plans. Soldiers, aboriginals and those who must rely on provincial plans are covered for a fraction of the total.
But Col. Scott said it just doesn't make sense for the military plan to cover drugs for diseases such as cystic fibrosis because no one with that ailment could become a member of the Forces.
In addition, he said, it's important to understand that there are many drugs developed to treat the same disease. So if there is a medication to lower cholesterol, and "if we already have four or five on our formulary and they all do the same thing, why would we add it?"
And in cases where an airman, seaman or sailor comes down with something unusual -- and a physician indicates that a medicine that has not been approved under the plan is required -- Col. Scott said exceptions can be made and the cost of the drugs will be covered.
Health Minister Tony Clement, whose department administers the drug plan for aboriginal Canadians, has offered the same commitment, as has Veterans Affairs .
Col. Scott cited as an example a drug called cloreg that is used in patients with systolic heart failure and was approved by the CDR in June of 2004.
"There are very few Canadian Forces members with significant heart failure running around," he said. "But, if you contact our drug-exception centre and the patient has evidence of congestive heart failure and other drugs such as digoxin and things have been unsuccessful, and there is a request for this drug, then they get it through the special-authorization criteria."
George Wyatt, founder of Wyatt Health Management which conducted the study for CARP, Canada's Association for the Fifty Plus, said the fact a drug plan will pay for unapproved drugs in exceptional cases doesn't mean it is equal to plans the cover the drugs.
"Every plan has special authorization processes. However, those processes in some cases can be onerous, and they require physicians to write individual letters, and sometimes the letter-writing skill is good and sometimes it's less than good," Dr. Wyatt said. "So the very same patients, if they had two doctors writing the letters, might get two different responses."
) Gov't drug plans are administered by Blue Cross or similar. It is a form of insurance, and like other forms of insurance they base fee's on the amount of coverage, not the actual drug usage. Less coverage = less cost, like any insurance policy.
