Open Collections

Itiola, Ademola Joshua

University of British Columbia

Introduction: People living with diabetes and not using insulin may not derive clinically significant benefit from routine self-monitoring of their glucose level. In response to this evidence, the Government of British Columbia (BC) in January 2015 introduced a policy that restricted the quantity of blood glucose test strips (BGTS) reimbursable under BC PharmaCare plans as a means of reducing unnecessary healthcare spending. To date, the impact of this policy has not been evaluated in BC. Therefore, we conducted this study to examine the impact of the policy on utilization, costs, and health outcomes. Methods: To evaluate the impact of British Columbia’s BGTS reimbursement restriction policy, we identified a cohort of adults (≥ 18 years old) with diabetes between 2013 and 2019 using BC’s administrative data. We described trends of utilization and costs among individuals with at least one PharmaCare-eligible BGTS claim. We also estimated cost savings using interrupted time series analysis and determined level of policy adherence. Using interrupted time series analysis, we investigated longitudinal changes in average 1) physician visits, 2) all-cause hospitalizations, 3) emergency department visits for hypoglycemia and hyperglycemia and, 4) healthcare spending. Results: Over the 7-year study period, a total of 279.7 million BGTS were eligible for PharmaCare coverage, on which the government spent $124.3 million. Overall, we observed an immediate decline in the average utilization and PharmaCare expenditure on BGTS following policy implementation, with non-insulin users mostly responsible for this reduction. In addition to good policy adherence, we estimated that PharmaCare saved $15.5 million between 2015 and 2019 (95% confidence interval: $4.4 million, $26.6 million) due to this change. We also found that the policy was not associated with an increase in overall health services utilization, or an increase in overall healthcare spending over the longer term. Conclusion: Our evaluation suggests that the BGTS reimbursement restriction policy in BC resulted in significant cost savings without any attendant increase in health services utilization or worsening of health outcomes in the long term. This demonstrates that disinvestment can free up resources that could be channeled towards more beneficial interventions.  

Text

2024-01-31

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/80477

Population and Public Health

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/