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Examining the Impact of Pharma Industry on Canadian Healthcare, Study notes of Sociology of Health and Illness

The medical-industrial complex, a growing network of corporations providing medical care, products, and supplies for profit. The pharmaceutical industry is a significant player in canadian health care, with drugs being a major and increasing component of health spending. Demographic patterns, inappropriate prescribing, and the role of physicians and pharmacists in the over-prescription of drugs. It also touches upon the profitability and strategies of the pharmaceutical industry.

Typology: Study notes

2011/2012

Uploaded on 01/07/2012

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S/A 4071: Social/Cultural Aspects of Health and Illness:
Class 30: The Medical Industrial Complex 1:
* Medical-industrial complex= a large, growing network of private &
public corporations in the business of providing medical care, products,
supplies & products for profit (e.g. the pharmaceutical industry)
* The drug industry is a major player in Canadian health care, & drugs
are a major & growing component of health spending:
- 1995: an average of 8 prescriptions per Canadian
- 88% of Canadians have some coverage
- most expenditures on prescription drugs
- patent drugs make up less than 10% of drugs available but almost
46% of drug spending
* Demographic patterns:
- drugs frequently over-prescribed in Canada (e.g. antibiotics)
- between 5-23% of hospital admissions drug related
- inappropriate prescribing costs up to $1 billion annually
- the elderly & women particularly hard hit (the former due to bad
reactions to often unnecessary drugs, women to over-prescription
of sedatives & psychotropic drugs
- people over 65 comprise 12% of population but 40% of
prescription drug use (avg=13 prescriptions/year)
- danger increases of adverse drug interactions/ very costly
- multiple drug use associated with stress/ lack of social support
- all of this exacerbated by higher use of over the counter drugs
- drug use by elderly likely to continue growing due to aging
population, more doctors & more pharmacists
- females consistently heavier prescription drug users than men
- lower income groups spend more of income on prescription drugs
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S/A 4071: Social/Cultural Aspects of Health and Illness: Class 30: The Medical Industrial Complex 1:

  • Medical-industrial complex= a large, growing network of private & public corporations in the business of providing medical care, products, supplies & products for profit (e.g. the pharmaceutical industry)

  • The drug industry is a major player in Canadian health care, & drugs are a major & growing component of health spending:

  • 1995: an average of 8 prescriptions per Canadian
  • 88% of Canadians have some coverage
  • most expenditures on prescription drugs
  • patent drugs make up less than 10% of drugs available but almost 46% of drug spending
  • Demographic patterns:
  • drugs frequently over-prescribed in Canada (e.g. antibiotics)
  • between 5-23% of hospital admissions drug related
  • inappropriate prescribing costs up to $1 billion annually
  • the elderly & women particularly hard hit (the former due to bad reactions to often unnecessary drugs, women to over-prescription of sedatives & psychotropic drugs
  • people over 65 comprise 12% of population but 40% of prescription drug use (avg=13 prescriptions/year)
  • danger increases of adverse drug interactions/ very costly
  • multiple drug use associated with stress/ lack of social support
  • all of this exacerbated by higher use of over the counter drugs
  • drug use by elderly likely to continue growing due to aging population, more doctors & more pharmacists
  • females consistently heavier prescription drug users than men
  • lower income groups spend more of income on prescription drugs

(not only more expensive in their area, but as a group, more likely to be prescribed mood-altering drugs)

  • provincial drug programs for low-income people haven’t helped that much as drug prices have increased at same time
  • Physicians & prescribing:
  • high correlation between visits to doctor & # of prescriptions (between 21-86% of patients visiting)
  • between 6-10 prescriptions given for each hospital admission
  • doctors with higher rates of writing prescriptions tend to be male, G.P.’s, isolated practitioners in rural areas, solo practitioners, & come from certain medical schools
  • there exist large gaps in knowledge among doctors about the appropriate prescription of many drugs (most info comes from sales reps/commercial promotion in contrast to critical research)
  • the rate of inappropriate prescribing ranges from 17-43% (e.g. unnecessary prescriptions, wrong dosages, etc.)
  • inappropriate prescribing rooted in lack of knowledge & patterns of practice in relation to persistent commercial drug promotion
  • promotion & advertizing have a major impact on prescribing
  • the Compendium of Pharmaceuticals & Specialities (CPS) is also not comprehensive & has continued to promote drugs with problems. Many well-known risks & side effects ignored in over 60% of listed drugs
  • education, client vs. colleague dependence, time per patient, mode of payment, exposure to drug reps, & the position of the CMA all impact patterns of prescribing
  • Pharmacists:
  • have considerable discretionary influence in making recommendations to doctors & consumers
  • Government regulation inadequate:
  • over half of drugs in Canada haven’t passed modern safety/ effectiveness tests (worse in Third World)
  • drug companies seem to have a monopoly on information available to doctors
  • the responsibility for testing rests largely on the industry itself
  • the government has been cutting back on its own testing facilities
  • no matter how stringent regulations are, people will still use drugs inappropriately
  • Canada’s “branch plant economy”/ tests done abroad
  • close ties between government agencies & the manufacturers
  • The medical devices industry:
  • profitable & growing industry
  • many potential harmful effects
  • shortage of regulation/staff to police
  • no evidence required on harm/benefit except for those devices used within the body