Pharmaceuticals have become, arguably, one of the fastest changing forms of health care. Advancements in pharmaceuticals are constantly bringing better treatments to illnesses previously untreatable. These advancements, however, come with a hefty price tag: In many countries they also represent the fastest growing source of health care expenditures. Innovative drugs often come to the market with high prices, and the prices of existing drugs can creep up if they are not reined in. These high prices can threaten patient access to the pharmaceuticals they need. Fortunately, there is a lot public policy can do, if it is designed to interact well with clinical, economic, and commercial factors, to safeguard this access.
This thesis contains three studies on the effects of public policy on the price-accessibility of pharmaceuticals. Its objectives are as follows: 1) To develop the definitions of a fair pricing of pharmaceuticals in terms of price-accessibility, 2) to present two case studies where public policy changes pharmaceutical prices and affects their utilization, and 3) discuss the significance of these case study policies on access to these drugs.
This thesis contributes to the existing body of literature by developing new theoretical models about what constitutes fair pricing of pharmaceuticals and about the relationships between the main parties responsible for making pharmaceuticals accessible to the people who need them. A new evaluation of the policy that delisted high-strength opioids from public formularies in Ontario is also presented with new regression models that allow the analysis of the effects of the policy across sociodemographic categories. Finally, this thesis also contains the first empirical analysis of OHIP plus, the policy that extended the public drug benefits to all individuals under 25 years of age; in this case, with the focus on oral chemotherapy drugs for cancer. / Dissertation / Doctor of Philosophy (PhD) / The rising prices of some pharmaceuticals have made them inaccessible to patients and their families, who must make big financial sacrifices to afford the drugs they need. This thesis contains three studies on the impact of ethical pricing and public policy on the accessibility of pharmaceuticals. Its objectives are to develop definitions of fair pricing in terms of access, to analyze two public policies that sought to change the utilization of pharmaceuticals by changing the price people pay for them, and to elaborate on what these policies mean for the accessibility of these drugs. This thesis’ contributions to the literature include novel theoretical models about pharmaceutical pricing and new evaluations of the effects, by sociodemographic category, of a policy designed to combat the ongoing opioids epidemic in Ontario, Canada, and the effects of OHIP plus on the emerging use of expensive oral-delivery cancer drugs in the same province.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/25838 |
| Date | January 2020 |
| Creators | Balderrama, Fanor |
| Contributors | Longo, Christopher, Health Policy |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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