scholarly journals Income-Based Drug Coverage in British Columbia: The Impact on Access to Medicines

2006 ◽  
Vol 2 (2) ◽  
Author(s):  
Patricia Caetano ◽  
Colette Raymond ◽  
Steve Morgan ◽  
Lixiang Yan
Keyword(s):  
British Columbia ◽  
Access To Medicines ◽  
Drug Coverage ◽  
The Impact

scholarly journals The impact of public coverage of newer hepatitis C medications on utilization, adherence, and costs in British Columbia

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0247843
Author(s):  
Harriet Ho ◽  
Naveed Z. Janjua ◽  
Kimberlyn M. McGrail ◽  
Mark Harrison ◽  
Michael R. Law ◽  
...  
Keyword(s):  
British Columbia ◽  
Hepatitis C ◽  
Private Insurance ◽  
Insurance Coverage ◽  
Drug Coverage ◽  
Administrative Claims ◽  
Public And Private ◽  
Treatment Uptake ◽  
Private Expenditure ◽  
The Impact

Background Sofosbuvir and ledipasvir-sofosbuvir are both newer direct-acting antiviral agents for the treatment of hepatitis C. The high list prices for both drugs have led to concern about the budget impact for public drug coverage programs. Therefore, we studied the impact of public prescription drug coverage for both drugs on utilization, adherence, and public and private expenditure in British Columbia, Canada. Methods We used provincial administrative claims data from January 2014 to June 2017 for all individuals historically tested for either hepatitis C and/or human immunodeficiency virus. Using interrupted time series analysis, we examined the impact of public insurance coverage on treatment uptake, adherence (proportion of days covered), and public and private expenditures. Results Over our study period, 4,462 treatment initiations were eligible for analysis (1,131 sofosbuvir and 3,331 ledipasvir-sofosbuvir, which include 19 patients initiated on both treatments). We found the start of public coverage for sofosbuvir and ledipasvir-sofosbuvir increased treatment uptake by 154%. Adherence rates were consistently high and did not change with public coverage. Finally, public expenditure increased after the policy change, and crowded out some private expenditure. Conclusion Public coverage for high-cost drugs for hepatitis C dramatically increased use of these drugs, but did not reduce adherence. From a health policy perspective, public payers should be prepared for increased treatment uptake following the availability of public coverage. However, they should not be concerned that populations without private insurance coverage will be less adherent and not finish their treatment course.

scholarly journals Incidence of diabetes mellitus among people living with and without HIV in British Columbia, Canada between 2001 and 2013: a longitudinal population-based cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e048744
Author(s):  
Andreea Bratu ◽  
Taylor McLinden ◽  
Katherine Kooij ◽  
Monica Ye ◽  
Jenny Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
British Columbia ◽  
Cohort Study ◽  
Population Based ◽  
Incidence Rates ◽  
Trend Test ◽  
People Living With Hiv ◽  
Age Related ◽  
Hiv Serostatus ◽  
The Impact

IntroductionPeople living with HIV (PLHIV) are increasingly at risk of age-related comorbidities such as diabetes mellitus (DM). While DM is associated with elevated mortality and morbidity, understanding of DM among PLHIV is limited. We assessed the incidence of DM among people living with and without HIV in British Columbia (BC), Canada, during 2001–2013.MethodsWe used longitudinal data from a population-based cohort study linking clinical data and administrative health data. We included PLHIV who were antiretroviral therapy (ART) naïve at baseline, and 1:5 age-sex-matched persons without HIV. All participants had ≥5 years of historic data pre-baseline and ≥1 year(s) of follow-up. DM was identified using the BC Ministry of Health’s definitions applied to hospitalisation, physician billing and drug dispensation datasets. Incident DM was identified using a 5-year run-in period. In addition to unadjusted incidence rates (IRs), we estimated adjusted incidence rate ratios (IRR) using Poisson regression and assessed annual trends in DM IRs per 1000 person years (PYs) between 2001 and 2013.ResultsA total of 129 PLHIV and 636 individuals without HIV developed DM over 17 529 PYs and 88,672 PYs, respectively. The unadjusted IRs of DM per 1000 PYs were 7.4 (95% CI 6.2 to 8.8) among PLHIV and 7.2 (95% CI 6.6 to 7.8) for individuals without HIV. After adjustment for confounding, HIV serostatus was not associated with DM incidence (adjusted IRR: 1.03, 95% CI 0.83 to 1.27). DM incidence did not increase over time among PLHIV (Kendall trend test: p=0.9369), but it increased among persons without HIV between 2001 and 2013 (p=0.0136).ConclusionsAfter adjustment, HIV serostatus was not associated with incidence of DM, between 2001 and 2013. Future studies should investigate the impact of ART on mitigating the potential risk of DM among PLHIV.

scholarly journals Forest Road Status Assessment Using Airborne Laser Scanning

2019 ◽  
Vol 66 (4) ◽  
pp. 501-508 ◽  
Author(s):  
Katalin Waga ◽  
Piotr Tompalski ◽  
Nicholas C Coops ◽  
Joanne C White ◽  
Michael A Wulder ◽  
...  
Keyword(s):  
British Columbia ◽  
Laser Scanning ◽  
Airborne Laser Scanning ◽  
Height Distribution ◽  
Forest Roads ◽  
The Road ◽  
Airborne Laser ◽  
Independent Field ◽  
The Status ◽  
The Impact

Abstract Forest roads allow access for silvicultural operations, harvesting, recreational activities, wildlife management, and fire suppression. In British Columbia, Canada, roads that are no longer required must be deactivated (temporarily, semipermanently, or permanently) in order to minimize the impact on the overall forested ecosystem. However, the remoteness and size of the road network present challenges for monitoring. Our aim was to examine the utility of airborne laser scanning data to assess the status and quality of forest roads across 52,000 hectares of coastal forest in British Columbia. Within the forest estate, roads can be active or deactivated, or have an unknown status. We classified road segments based on the vegetation growth on the road surface, and edges, by classifying the height distribution of airborne laser scanning returns within each road segment into four groups: no vegetation, minor vegetation, dense understory vegetation, and dense overstory vegetation. Validation indicated that 73 percent of roads were classified correctly when compared to independent field observations. The majority were classified as active roads with no vegetation or deactivated with dense vegetation. The approach presented herein can aid forest managers in verifying the status of the roads in their management area, especially in remote areas where field assessments are costly and time-consuming.

Using polycyclic aromatic hydrocarbons to determine post-wildfire contamination and sediment sources in a large watershed in central British Columbia, Canada

2021 ◽  
Author(s):  
Kristen Kieta ◽  
Philip Owens ◽  
Ellen Petticrew
Keyword(s):  
British Columbia ◽  
Magnetic Susceptibility ◽  
Polycyclic Aromatic Hydrocarbons ◽  
Aromatic Hydrocarbons ◽  
Large Scale ◽  
Sediment Samples ◽  
Burned Areas ◽  
Total Pahs ◽  
Polycyclic Aromatic ◽  
The Impact

<p>The Nechako River Basin (NRB) in central British Columbia is a large (52,000 km<sup>2</sup>), regulated basin that supports populations of sockeye and chinook salmon and the endangered Nechako white sturgeon. These important species are experiencing population declines and one potential cause of this decline is excess sediment, which can clog their spawning habitat and reduce juvenile success. This excess sediment is likely the product of a combination of factors, the most visible being the significant land cover changes that have occurred in the basin, which includes pressure from forestry and agriculture, the Mountain Pine Beetle epidemic, and large-scale wildfires in 2018. Focusing specifically on the impact of the 2018 wildfires on sediment transport from upland burned areas to adjacent waterways, this research aimed to determine the spatial and temporal contamination of tributaries and the mainstem of the Nechako River with polycyclic aromatic hydrocarbons (PAHs), which are produced during the combustion of organic matter and have been identified as toxic to aquatic organisms and to humans. Additionally, this study intended to determine if burned areas were a more significant contributor of sediment than unburned areas and better understand the utility of PAHs as a potential tracer. Source soil samples were collected in 2018 and 2020 from burned and unburned sites, and suspended sediment samples were collected throughout the ice-free period from 2018-2020 in three tributaries and three mainstem sites. All samples were analysed for PAHs, magnetic susceptibility, colour, and particle size. Results from the fall 2018 source samples show a significant difference in PAH concentrations between unburned and burned soils, and while concentrations of PAHs in source soils in 2020 were lower than in 2018, they were still elevated compared to unburned soils. Sediment samples showed that concentrations of total PAHs are higher in the mainstem sites than in the tributaries, with the greatest concentrations consistently found at the most downstream site on the mainstem of the Nechako River. Concentrations across sites were highest in samples taken during the spring snowmelt period in 2019, have decreased throughout the rest of the sampling period (2019-2020), and are well below sediment quality guidelines for total PAHs. In addition to determining the spatial and temporal extent of PAH contamination, this study also aims to use PAHs along with colour and measurements of magnetic susceptibility to trace sediments associated with the 2018 wildfires. The high cost of PAH analysis limits the number of samples that can be analysed and thus, these additional tracers will allow for the use of models such as MixSIAR that improve with a more robust number of samples. As large-scale megafires continue to burn across the globe, understanding their potential to contribute PAHs to local waterbodies and potentially be used as a tracer is as prescient as ever.</p>

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