Saturday, June 12, 2010


I pick on the cholesterol reducer "Lipitor" only because it's widely advertised and hugely prescribed. There are thousands of other examples. But here in Ontario; Lipitor accounts for the single largest expense of the annual $3.5 billion Drug Benefit Program for residents over the age of 65.

On July first, the Ontario government is wiping-out a professional allowance (Read: Promotional) fee totalling $750 million per year paid by the drug manufacturers to pharmacists. The government claims the drug companies have been tacking-on the $ 3/4 billion fee to the cost of the drugs the pharmacists then sell back to the province.

One example cited is the oral Diabetes medication "Metformin" sold in Ontario for $0.10 to $0.15 a pill. In several American jurisdictions it's just given-away to diabetic patients as a loss leader on the sale of more testing supplies (monitors, strips etc) for the disease.

In the United-States, an in-depth investigation published by the respected Associated Press, caught my attention recently. It concludes that..."too much medical treatment is making many Americans sicker." Over treatment won't make people healthier, it may make them sicker. The Associated Press review of hundreds of pages of studies and interviews with dozens of specialists concludes that anywhere from one-fifth to one-third of medical tests and treatments are unnecessary.

It's a concept that our technology driven North American society, and our doctors find hard to believe: Avoidable care is costly in more ways than the bill - It may cause dangerous side effects. Physicians have the good intentions of doing what's best for their patients. But seems it's rare that a patient will say: Wait! I need more information. The A.P. analysis in the United-States concludes that our burgeoning epidemic of over treatment at every stage of life often means that someone could have fared as well or better with a lesser test or therapy, or maybe even none at all.

It frequently starts during birth where for platitudes expectant mothers choose Cesarean Section surgery; and it extends to futile intensive care efforts at the end of life. In between there are far too many CT (radiation) scans, MRI's, "stents" and bypasses for blocked arteries; and anti-biotics prescribed for viruses they can't help.

Though health care system delivery is different between Canada and in the United-States; the levelling fear for all North Americans is the ageing curve of the population explosion which followed the end of the Second World War. The early "baby boomers" have now entered their seventh decade of life. While there is no "fountain of youth", patient education is going to be extremely significant if we are to remain healthy before the money runs out.

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