Association for Public Policy Analysis & Management

Panel: Addressing the Challenge of Inappropriate- and over-Medication: An Exploration of Policy Levers from Multiple Perspectives

(Health Access and Coverage)

Canada and the United States are among the top spenders on prescription drugs in the OECD, due to both higher prices and higher consumption of medicines.  One of the pressing health challenges faced in these and other high-income jurisdictions is of polypharmacy and in particular the overuse of potentially inappropriate medications and their corresponding health and economic impacts.  Health system leaders have implemented a range of policies and system changes to address this policy challenge. At the national level in Canada, the Deprescribing Network and Choosing Wisely Canada represent two major initiatives that provide evidence and tools for clinicians to improve prescribing practices, and to raise awareness of the risks of potentially inappropriate medications. At the provincial level, where responsibility for administration of health care resides, there is variation in the extent to which governments have achieved major change to enable improved prescribing. Some efforts have been taken to move toward more of a team-based, medical home model, supported with information systems that allow for communication across providers to facilitate e-prescribing and medication reviews, and to develop essential medicines lists to improve prescribing practices.  There is also variation in how governments have responded to the opioid crisis and the prescribing and monitor of opioid prescriptions in particular. This panel will bring together researchers on comparative health systems, deprescribing, prescription drug coverage and essential medicine lists, as well as the drivers and responses to the opioid crisis to improve prescribing, reduce system costs and improve health outcomes.