National Prescription Drug Utilization Information System (NPDUIS)
Background
In September 2001, Federal/Provincial/Territorial Ministers of Health announced the establishment of the National Prescription Drug Utilization Information System (NPDUIS) based on a Business Case prepared by the PMPRB and the Canadian Institute for Health Information (CIHI). The purpose of the NPDUIS is to provide critical analyses of price, utilization and cost trends so that Canada´s health system has more comprehensive, accurate information on how prescription drugs are being used and on sources of cost increases.
The responsibilities of the PMPRB in this undertaking have been established by the Minister of Health pursuant to Section 90 of the Patent Act. In the Minister´s letter of October 2002, the Minister has requested that the PMPRB “inquire into trends in pharmaceutical prices, expenditures and cost drivers, and such other analytical studies, as described in the Business Case, and endorsed by the Steering Committee.” The provisions of this letter are established through a Memorandum of Understanding between Health Canada and the PMPRB covering the period from April 1, 2002 until March 31, 2005.
The NPDUIS initiative involves two major elements:
CIHI is responsible for the first of these elements, while as per the request of the Minister of Health, the PMPRB is principally responsible for the second.
A steering committee comprising representatives of public drug plans and Health Canada advises CIHI and the PMPRB on the development of the NPDUIS databases and analysis. The steering committee met three times in 2003, to discuss technical issues on database development and direction for analytical studies.
As a result of the steering committee meetings, the PMPRB confirmed the importance to the public plans of the items on its NPDUIS research agenda. During the June 2003 meeting, public drug plan officials agreed to expedite the PMPRB´s work by sharing their aggregated drug expenditures data. As of November 2003, nine public drug plans had shared data with the PMPRB.
Projects
The projects that have been approved for 2004-2005 are listed below along with a brief description. The first two projects follow from earlier analytical cost-driver work conducted by the PMPRB in relation to the structure and performance of provincial pharmaceutical reimbursement programs.
Non-Insured Health Benefits Cost Drivers Study
This study – completed in Spring 2004 – examines spending on drugs within the Non-Insured Health Benefits Program of the First Nations and Inuit Health Branch of Health Canada over the period from 1999-2000 to 2001-2002. The study provides decision-makers with information on drug expenditure that will help in dealing with the challenge of providing programs and services in an environment of fixed resourcing levels.
Pharmaceutical Trends Overview Report
Work commenced in spring 2004 on the Pharmaceuticals Trends Overview Report which will examine trends in provincial drug expenditures; expenditures by therapeutic class; disaggregated expenditure growth into its component factors; costs per beneficiary; and costs of drugs per defined daily dose.
Budget Impact Analysis Methodology
This project will develop methodological guidelines for calculating the net financial impact of a provincial drug plan listing a new drug as a benefit. The PMPRB is partnering on this project with the Canadian Coordinating Office for Health Technology Assessment (CCOHTA) due to the overlap of this project with CCOHTA´s Common Drug Review initiative. Input from interested parties will be sought.
Program Expenditure Forecasting Methodology
In the last decade growth in public drug program plan expenditure has been rapid and volatile. This combination makes budgeting for drug plan expenditures a challenge. The goal of this project is to develop best practices in forecasting drug program expenditure.
Input and methodological advice for this project will be sought from interested stakeholders and outside experts.
Therapeutic Cost Index
The PMPRB will develop an index that calculates the average increase in costs per defined daily dose (DDD) that reflects that patients do switch from one drug to another. These results will be calculated in aggregate for all drugs and by leading therapeutic classes using the data supplied to the PMPRB by the participating public drug plans.
Methodological advice for this project will be sought from outside experts.
For current information on the PMPRB´s and CIHI´s involvement in NPDUIS please visit their respective Web sites – at www.pmprb-cepmb.gc.ca and www.cihi.ca/drugs
