Restrictive drug coverage policies can induce substantial drug exposure misclassification in pharmacoepidemiologic studies

Clinical Therapeutics
John-Michael GambleDean T Eurich

Abstract

Drugs reimbursed through a single-party payer such as health maintenance organizations or provincial governments are generally captured in administrative data if they have full-benefit status on that payer's formulary. However, drugs subject to restrictive drug coverage policies are often not fully captured if patients receive these drugs through mechanisms other than the single-payer formulary. The goal of this study was to estimate the association between restrictive drug coverage and drug exposure misclassification across the Canadian provinces of Manitoba and Saskatchewan, which provide universal coverage for formulary-approved drugs to all citizens regardless of age or socioeconomic status. Monthly dispensations were compared for 75 drugs between 2005 and 2008 from Canada's National Prescription Drug Utilization System database, which captures provincial drug formulary claims only, versus the IMS Brogan CompuScript Database, which captures all drug dispensations irrespective of formulary status. The association between restrictive drug coverage and drug exposure misclassification was measured using generalized estimating equations and multivariable adjustment. On average, 84% of monthly retail drug dispensations were captu...Continue Reading

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Citations

Sep 5, 2014·Drug Safety : an International Journal of Medical Toxicology and Drug Experience·Joshua J Gagne
Dec 10, 2015·Pharmacoepidemiology and Drug Safety·Kristian B FilionPierre Ernst
Mar 12, 2013·Pharmacoepidemiology and Drug Safety·John-Michael GambleDean T Eurich
Jan 22, 2015·Osteoporosis International : a Journal Established As Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA·A M BurdenS M Cadarette
Nov 20, 2013·Journal of Epidemiology and Community Health·Natalie Gavrielov-Yusim, Michael Friger
Nov 14, 2018·British Journal of Cancer·Vasily GiannakeasJoanne Kotsopoulos
Mar 16, 2019·BMC Medical Research Methodology·Guillermo Prada-RamallalAdolfo Figueiras
Dec 19, 2015·Journal of Managed Care & Specialty Pharmacy·Nathan James Pauly, Joshua David Brown

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