“Breakthrough” drugs and growth in expenditure on prescription drugs in Canada
BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.38582.703866.AE (Published 06 October 2005) Cite this as: BMJ 2005;331:815
- Steven G Morgan, assistant professor (morgan@chspr.ubc.ca)1,
- Kenneth L Bassett, associate professor2,
- James M Wright, professor3,
- Robert G Evans, professor1,
- Morris L Barer, professor1,
- Patricia A Caetano, Post-doctoral fellow1,
- Charlyn D Black, director1
- 1 Centre for Health Services and Policy Research, University of British Columbia, 429-2194 Health Sciences Mall, Vancouver, BC, Canada V6T 1Z3,
- 2Department of Family Practice, Centre for Health Services and Policy Research, University of British Columbia
- 3Department of Pharmacology and Therapeutics, Centre for Health Services and Policy Research, University of British Columbia
- Correspondence to: S G Morgan
- Accepted 22 July 2005
Introduction
Driven by increased use of prescription drugs and by shifts from old to new products, spending on drugs in Canada doubled between 1996 and 2003.1 Which drugs drove this expenditure growth? The Canadian Patented Medicine Prices Review Board appraises the therapeutic novelty of every patented medicine in Canada to distinguish “breakthrough” drugs from other medicines. Since 1990, the board has published these appraisals in annual reports.2 We applied the board's classifications for breakthrough drugs to total expenditures on and use of prescription drugs in the province of British Columbia (population 4.2 million).
Methods and results
Between 1990 and 2003, the board appraised 1147 newly patented drugs (identified by active ingredient(s), formulation, and strength), including derivatives of existing medicines, such as esomeprazole. Of these new drugs, 68 (5.9%) met the regulatory criterion of being a breakthrough drug (“the first drug to treat effectively a particular illness or which provides a substantial improvement over existing drug products”).2 These included, for example, filgrastim, donepezil hydrochloride, and infliximab. We expanded …