Lessons for a national pharmaceuticals strategy in Canada from Australia and New Zealand.
BACKGROUND
The provincial formulary review processes in Canada lead to the slow and inequitable availability of new products. In 2004, the exploration of a national pharmaceuticals strategy (NPS) was announced. The pricing policies of New Zealand and Australia have been suggested as possible models for the NPS.


OBJECTIVE
To compare health care indexes and health care use information from Canada, Australia and New Zealand.


METHODS
The 2006 Organisation for Economic Co-operation and Development health data were used to compare health and health care indexes from Canada, Australia and New Zealand between 1994 and 2002 to 2004. The principal focus of the evaluation was cardiovascular and respiratory disorders.


RESULTS
Although the mortality rate from acute myocardial infarction decreased in each country from 1994, it levelled off in New Zealand in 1997, 1998 and 1999. Between 1994 and 2003, the average length of hospital stay for any cause and for cardiovascular disorders was stable in Australia and Canada, but increased in New Zealand, while the rate of hospital discharges for cardiovascular diseases decreased in Canada and Australia, but strongly increased in New Zealand. Over the same period, sales of cardiovascular drugs decreased in New Zealand, while sharply increasing in Canada and Australia.


CONCLUSIONS
Although only circumstantial, our results suggest an association between decreasing cardiovascular drug sales and markers of declining cardiovascular health in New Zealand. Careful consideration must be given to the potential consequences of any model for an NPS in Canada, as well as to opportunities provided for discussion and input from health care professionals and patients.
LeLorier
Jacques
J
Centre de recherche CHUM - Hôtel-Dieu de Montréal, Pharmacoepidemiology and Pharmacoeconomics Research Unit, Montreal, Quebec. massicoa@umontreal.ca
Rawson
Nugek S B
NS
D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D002317:Cardiovascular Agents / Q000191:economics / Q000600:supply & distribution / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000401:mortality; D016527:Drug Costs / Q000706:statistics & numerical data; D019981:Health Care Sector / Q000592:standards*; D006291:Health Policy; D006801:Humans; D008017:Life Expectancy / Q000639:trends; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends
D002317:Cardiovascular Agents