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© Copyright 2000 Rogers Media. The following article first appeared in the May 2001 edition of
BENEFITS CANADA magazine.
Industry
By Andrea Davis
Depression a leading cause of doctor visits
Depressive disorders are one of the leading causes for visits to physicians, according to data from IMS
Health. Over the past six years, visits for depression have gone up 36%, says the Mississauga, Ont.- based
healthcare research firm in its annual review of prescribing and diagnoses trends.
In 2000, Canadians made 7.8 million visits to physicians for depressive disorders, an increase of almost
10% over 1999 when visits totalled 7.1 million. The majority of those visiting physicians (47%) for this
reason were aged 40 to 59, with the next largest group made up of 20 to 39 year olds. In 1995, depression
was the fourth leading reason for visiting a physician. It now ranks second behind hypertension.
Bill Wilkerson, president and co-founder of the Business and Economic Roundtable on Addiction and Mental
Health, calls the report a wake-up call for employers. "It's another sharp and vivid piece of evidence that
merits a look at by the business world," he says.
"I'm not surprised by the increase in visits for depression," says Dr. Stanley Kutcher, professor and head
of the department of psychiatry at Dalhousie University in Halifax. "The disorder is now better understood
by physicians and the population in general. People tend to consult more as it does not carry the same
stigma as it did 10 or 15 years ago."
Dr. Kutcher warns, however, that many people still do not talk to their doctors about depression. "There is
still a great need for education on the causes and treatments of depressive disorders," he says.
Since 1996, there has been a 63% increase in the number of prescriptions filled by patients for drugs used
to treat depressive disorders, according to IMS Health. From 1999 to 2000, prescriptions for
anti-depressants rose 15% to 15.8 million. Psychotherapeutics, which include anti-depressants, accounted
for 32 million retail prescriptions in 2000, making it the second most dispensed class in Canada behind
cardiovasculars.
Paxil was the most commonly prescribed anti-depressant in Canada in 2000, with approximately three million
prescriptions filled in retail pharmacies. Paxil ranks eighth among Canada's most prescribed medications.
Other findings include:
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Last year, Canadians filled almost 291 million retail prescriptions at a total retail price of $11
billion. This is equivalent to nine prescriptions per person at an average price of $35.48 per
prescription. In 1996, the average prescription price was $29.64 and the average number of
prescriptions filled per person was eight.
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The most commonly dispensed drug in Canada in 2000 was Synthroid, which is used to treat
hypothyroidism.
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Lipitor (for cholesterol), Flovent (for asthma) and Altace (for high blood pressure) showed the most
significant growth among the top 20 dispensed drugs, growing 47%, 51% and 165%, respectively.
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The most successful product launch last year, in terms of purchases by hospitals and pharmacies, was
the diabetes medication Avandia. From its launch in March 2000 until December 2000, average monthly
purchases of the drug by hospitals and pharmacies reached $1.6 million.
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Losec, a drug used for peptic ulcers, remained Canada's top-selling drug in 2000. Canada's top 20
selling drugs account for 27% of total spending by pharmacies and hospitals.
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There were 31 brand name products launched in 2000, up from 27 the year before. From 1994 to 1999,
brand name manufacturers introduced on average 40 new medications per year.
Governance guidelines approved by CAPSA
The Canadian Association of Pension Supervisory Authorities (CAPSA) approved governance guidelines for
pension plans at its semi-annual meeting in Toronto last month. The proposed guidelines were not ready for
public consultation at press time.
Topics outlined in the guidelines include rules and responsibilities for pension committees, codes of
conduct regarding conflicts of interest and performance measurement of governance bodies.
"Good governance is a cornerstone of the private pension system," says Sherallyn Miller, chair of CAPSA and
superintendent of pensions for B.C. "[We] look forward to finalizing these guidelines after receiving input
during the consultations."
The guidelines include an implementation tool which pension plans can use to determine which principles of
good governance have already been instituted and to define what action should be taken to further improve
their governance practices.
One pension consultant, however, expressed concern over CAPSA's accountability and authority in developing
regulatory initiatives. "The [pension governance guideline] tool itself is not at issue [because] we
haven't seen it yet," says Greg Hurst, manager, pension division, with Heath Lambert Benefits Consulting in
Vancouver. "Efforts to encourage better pension governance are highly laudable and should be encouraged
from all participants in the pension industry."
He maintains, though, that the "promulgation by CAPSA of a guideline in the form of a tool--the voluntary
use of which [provincial] regulators might coercively encourage within the scope of their legitimate
regulatory mandate--seems like regulation by the back door."
CAPSA has also approved principles for the electronic exchange of information between pension plan
administrators and plan members. Public consultations on these guidelines will also be held sometime this
spring. CAPSA's proposed Guidelines for the Exchange of Information by Electronic Means recommend standards
for electronic communication between pension plan administrators and plan members.
Draft legislation on FSCO/OSC merger available
Ontario Finance Minister Jim Flaherty announced last month that the government will hold a second round of
consultations on the proposed merger of the Ontario Securities Commission and the Financial Services
Commission of Ontario.
Draft legislation for the merger can be downloaded at www.gov. on.ca/fin/english/pubseng.htm. The deadline
for submissions on the draft legislation is June 29, 2001. The consultations will be led by John O'Toole,
parliamentary assistant to the minister.
Last fall, the government released its first proposal outlining how the new merged body would operate. It
met with lukewarm response from the pension industry.
"The information we gather through this [second] consultation will assist us in drafting a balanced and
representative piece of legislation," says Flaherty.
Changes at Sun Life
Cathy Honor, vice-president, group retirement services with Sun Life Financial in Toronto is moving on,
having taken a position as senior vice-president with RBC Insurance. Her replacement is Kevin Dougherty,
who is currently vice-president, group insurance.
New publication launched
A new guide for plan sponsors on the role pharmacists can play in managing drug benefits plans is availabe
from Pharmacy Post, a trade magazine for Canadian pharmacists. Solutions in Drug Plan Management uses case
studies, as well as articles on drug utilization and cost containment, to highlight how pharmacists can
help plan sponsors manage their drug benefits. The publication makes the case for cost containment
measures, such as trial prescriptions, disease management and call backs, and promotes the role of
pharmacists as allies in reducing absenteeism.
The guide is sponsored by Shoppers Drug Mart, Buffett Taylor, BCE Emergis and Pharmacia. For more
information, contact Pharmacy Post editor Karen Welds at (416) 596-3465 or at kwelds@rmpublishing.com.
The supplement's sponsors are hosting a breakfast seminar in Toronto on June 7 at Sutton Place hotel. To
register, call Keri Michaud at (416) 596-3469 or e-mail kmichaud@rmpublishing.com.
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