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An outcomes-based approach to decisions about drug coverage policies in British Columbia.

https://arctichealth.org/en/permalink/ahliterature177508
Source
Psychiatr Serv. 2004 Nov;55(11):1230-2
Publication Type
Article
Date
Nov-2004

Antidepressants and adverse effects in young patients: uncovering the evidence.

https://arctichealth.org/en/permalink/ahliterature181467
Source
CMAJ. 2004 Feb 17;170(4):487-9
Publication Type
Article
Date
Feb-17-2004
Author
Andrew Herxheimer
Barbara Mintzes
Author Affiliation
Cochrane Collaboration, London, England. Andrew_Herxheimer@compuserve.com
Source
CMAJ. 2004 Feb 17;170(4):487-9
Date
Feb-17-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adverse Drug Reaction Reporting Systems
Antidepressive Agents - adverse effects
Canada
Child
Clinical Trials as Topic
Depressive Disorder - drug therapy
Drug Approval
Great Britain
Humans
Serotonin Uptake Inhibitors - adverse effects
Substance Withdrawal Syndrome - etiology
Suicide
Notes
Cites: CMAJ. 2004 Feb 17;170(4):489-9114970097
Cites: J Neurol Neurosurg Psychiatry. 1960 Feb;23:56-6214399272
Cites: JAMA. 2001 Jan 24-31;285(4):437-4311242428
Cites: Am J Psychiatry. 2002 Mar;159(3):469-7311870014
Cites: CMAJ. 2003 Nov 25;169(11):1167-7014638652
Cites: J Am Acad Child Adolesc Psychiatry. 1991 Mar;30(2):179-862016219
Cites: CMAJ. 1998 Sep 8;159(5):481-39757171
Comment In: CMAJ. 2004 Jun 8;170(12):1771; author reply 1171-215184311
Comment On: CMAJ. 2004 Feb 17;170(4):489-9114970097
PubMed ID
14970096 View in PubMed
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Direct to consumer advertising of prescription drugs.

https://arctichealth.org/en/permalink/ahliterature155360
Source
BMJ. 2008;337:a985
Publication Type
Article
Date
2008
Author
Barbara Mintzes
Source
BMJ. 2008;337:a985
Date
2008
Language
English
Publication Type
Article
Keywords
Advertising as Topic
Canada
Drug Prescriptions
Humans
Pharmaceutical Preparations
Notes
Comment On: BMJ. 2008;337:a105518765444
PubMed ID
18765449 View in PubMed
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Direct-to-consumer prescription drug advertising in Canada: permission by default?

https://arctichealth.org/en/permalink/ahliterature183814
Source
CMAJ. 2003 Sep 2;169(5):425-7
Publication Type
Article
Date
Sep-2-2003
Author
David M Gardner
Barbara Mintzes
Aleck Ostry
Author Affiliation
Department of Psychiatry and the College of Pharmacy, Dalhousie University, Halifax, NS. david.gardner@dal.ca
Source
CMAJ. 2003 Sep 2;169(5):425-7
Date
Sep-2-2003
Language
English
Publication Type
Article
Keywords
Advertising as Topic - legislation & jurisprudence - methods
Canada
Consumer Participation
Drug Industry - economics
Drug Prescriptions
Humans
Notes
Cites: J Fam Pract. 2000 Dec;49(12):1092-811132058
Cites: Lancet. 2001 Jun 9;357(9271):1870-511410214
Cites: CMAJ. 2001 Aug 21;165(4):46211531059
Cites: Lancet. 2001 Oct 6;358(9288):1141-611597668
Cites: Prescrire Int. 2001 Apr;10(52):52-411718161
Cites: J Clin Pharmacol. 1991 Jan;31(1):17-242045524
Cites: N Engl J Med. 2002 Feb 14;346(7):526-811844858
Cites: Annu Rev Public Health. 2002;23:73-9111910055
Cites: JAMA. 2002 May 1;287(17):2215-2011980521
Cites: Health Aff (Millwood). 2003 Jan-Jun;Suppl Web Exclusives:W3-82-9514527237
Cites: Health Aff (Millwood). 2003 Jan-Jun;Suppl Web Exclusives:W3-112-514527241
Cites: BMJ. 2002 Feb 2;324(7332):278-911823361
PubMed ID
12952804 View in PubMed
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Do higher drug costs lead to better health?

https://arctichealth.org/en/permalink/ahliterature173554
Source
Can J Clin Pharmacol. 2005;12(1):e22-7
Publication Type
Article
Date
2005
Author
Barbara Mintzes
Joel Lexchin
Source
Can J Clin Pharmacol. 2005;12(1):e22-7
Date
2005
Language
English
Publication Type
Article
Keywords
Canada
Drug Approval - legislation & jurisprudence
Drug Costs - trends
Drug Prescriptions - economics
Drug Utilization - economics
Health Expenditures - trends
Humans
Product Surveillance, Postmarketing
Quality of Health Care - trends
Abstract
Prescription drugs are the fastest growing healthcare cost in Canada. Increased spending is mainly due to use of newer, more expensive medicines and a higher overall volume of prescription drug use. In the large majority of cases, empirical studies fail to support claims of a net benefit to health. Newer high-priced drugs are neither consistently safer nor more effective than older alternatives. Over 2000 new drugs and indications introduced in France from 1981-2000 were compared to existing treatments: 81% offered little to no added value and 3% were less safe or effective. In Canada, only 5% of drugs introduced from 1996-2000 offered substantial improvement to therapy. Claims linking use of newer drugs to reduced hospitalization and mortality fail to distinguish between underlying differences in disease severity and treatment outcomes. For "newer" to truly mean "better", fundamental changes are needed to the regulations governing market approval and post-approval surveillance. Such changes are possible, but would require strong political will.
Notes
Comment On: Can J Clin Pharmacol. 2005 Winter;12(1):e10-2116055940
PubMed ID
16055941 View in PubMed
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Drugs in the news: an analysis of Canadian newspaper coverage of new prescription drugs.

https://arctichealth.org/en/permalink/ahliterature185620
Source
CMAJ. 2003 Apr 29;168(9):1133-7
Publication Type
Article
Date
Apr-29-2003
Author
Alan Cassels
Merrilee A Hughes
Carol Cole
Barbara Mintzes
Joel Lexchin
James P McCormack
Author Affiliation
School of Health Information Science, University of Victoria, Victoria, BC. jmccorma@interchange.ubc.ca
Source
CMAJ. 2003 Apr 29;168(9):1133-7
Date
Apr-29-2003
Language
English
Publication Type
Article
Keywords
Acetamides - adverse effects
Advertising as Topic
Anti-Inflammatory Agents, Non-Steroidal - adverse effects
Anticholesteremic Agents - adverse effects
Antiviral Agents - adverse effects
Bibliometrics
Canada
Cholinesterase Inhibitors - adverse effects
Consumer Product Safety
Disclosure
Drug Industry
Drug Prescriptions
Drug-Related Side Effects and Adverse Reactions
Estrogen Antagonists - adverse effects
Heptanoic Acids - adverse effects
Humans
Indans - adverse effects
Newspapers
Oseltamivir
Patient Education as Topic
Piperidines - adverse effects
Pyrazoles
Pyrroles - adverse effects
Raloxifene - adverse effects
Sulfonamides - adverse effects
Abstract
Patients routinely cite the media, after physicians and pharmacists, as a key source of information on new drugs, but there has been little research on the quality of drug information presented. We assessed newspaper descriptions of drug benefits and harms, the nature of the effects described and the presence or absence of other important information that can add context and balance to a report about a new drug.
We looked at newspaper coverage in the year 2000 of 5 prescription drugs launched in Canada between 1996 and 2001 that received a high degree of media attention: atorvastatin, celecoxib, donepezil, oseltamivir and raloxifene. We searched 24 of Canada's largest daily newspapers for articles reporting at least one benefit or harm of any of these 5 drugs. We recorded the benefits and harms reported and analyzed how such information was presented; we also determined whether clinical or surrogate outcomes were mentioned; if and how drug effects were quantified; whether contraindications, other treatment options and costs were mentioned; and whether any information on affiliations of quoted interviewees and potential conflicts of interest was presented.
Our search yielded 193 articles reporting at least one benefit or harm for 1 of the 5 drugs. All of the articles mentioned at least one benefit, but 68% (132/193) made no mention of possible side effects or harms. Only 24% (120/510) of mentions of drug benefits and harms presented quantitative information. In 26% (31/120) of cases in which drug benefits and harms were quantified, the magnitude was presented only in relative terms, which can be misleading. Overall, 62% (119/193) of the articles gave no quantification of the benefits or harms. Thirty-seven (19%) of the 193 articles reported only surrogate benefits. Other information needed for informed drug-related decisions was often lacking: only 7 (4%) of the articles mentioned contraindications, 61 (32%) mentioned drug costs, 89 (46%) mentioned drug alternatives, and 30 (16%) mentioned nondrug treatment options (such as exercise or diet). Sixty-two percent (120/193) of the articles quoted at least one interviewee. After exclusion of industry and government spokespeople, for only 3% (5/164) of interviewees was there any mention of potential financial conflicts of interest. Twenty-six percent (15/57) of the articles discussing a study included information on study funding.
Our results raise concerns about the completeness and quality of media reporting about new medications.
Notes
Cites: N Engl J Med. 2000 Jun 1;342(22):1645-5010833211
Cites: Can Fam Physician. 2002 Jan;48:104-1011852597
Cites: N Engl J Med. 1991 Oct 17;325(16):1180-31891034
Cites: Lancet. 1998 Sep 19;352(9132):943-89752816
Cites: Ann Intern Med. 1992 Dec 1;117(11):916-211443954
Cites: Lancet. 1994 May 14;343(8907):1209-117909875
Cites: BMJ. 1994 Sep 24;309(6957):761-47950558
Cites: JAMA. 1992 Aug 26;268(8):999-10031501326
PubMed ID
12719316 View in PubMed
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How does direct-to-consumer advertising (DTCA) affect prescribing? A survey in primary care environments with and without legal DTCA.

https://arctichealth.org/en/permalink/ahliterature183815
Source
CMAJ. 2003 Sep 2;169(5):405-12
Publication Type
Article
Date
Sep-2-2003
Author
Barbara Mintzes
Morris L Barer
Richard L Kravitz
Ken Bassett
Joel Lexchin
Arminée Kazanjian
Robert G Evans
Richard Pan
Stephen A Marion
Author Affiliation
Centre for Health Services and Policy Research, and the Department of Pharmacology and Therapeutics, University of British Columbia, Vancouver, BC. bmintzes@chspr.ubc.ca
Source
CMAJ. 2003 Sep 2;169(5):405-12
Date
Sep-2-2003
Language
English
Publication Type
Article
Keywords
Adult
Advertising as Topic - methods
British Columbia
California
Consumer Participation
Drug Industry - trends
Drug Prescriptions
Female
Humans
Linear Models
Male
Middle Aged
Physician's Practice Patterns - statistics & numerical data
Physician-Patient Relations
Questionnaires
Abstract
Direct-to-consumer advertising (DTCA) of prescription drugs has increased rapidly in the United States during the last decade, yet little is known about its effects on prescribing decisions in primary care. We compared prescribing decisions in a US setting with legal DTCA and a Canadian setting where DTCA of prescription drugs is illegal, but some cross-border exposure occurs.
We recruited primary care physicians working in Sacramento, California, and Vancouver, British Columbia, and their group practice partners to participate in the study. On pre- selected days, patients aged 18 years or more completed a questionnaire before seeing their physician. We asked these patients' physicians to complete a brief questionnaire immediately following the selected patient visit. By pairing individual patient and physician responses, we determined how many patients had been exposed to some form of DTCA, the frequency of patients' requests for prescriptions for advertised medicines and the frequency of prescriptions that were stimulated by the patients' requests. We measured physicians' confidence in treatment choice for each new prescription by asking them whether they would prescribe this drug to a patient with the same condition.
Seventy-eight physicians (Sacramento n = 38, Vancouver n = 40) and 1431 adult patients (Sacramento n = 683, Vancouver n = 748), or 61% of patients who consulted participating physicians on pre-set days, participated in the survey. Exposure to DTCA was higher in Sacramento, although 87.4% of Vancouver patients had seen prescription drug advertisements. Of the Sacramento patients, 7.2% requested advertised drugs as opposed to 3.3% in Vancouver (odds ratio [OR] 2.2, 95% confidence interval [CI] 1.2-4.1). Patients with higher self- reported exposure to advertising, conditions that were potentially treatable by advertised drugs, and/or greater reliance on advertising requested more advertised medicines. Physicians fulfilled most requests for DTCA drugs (for 72% of patients in Vancouver and 78% in Sacramento); this difference was not statistically significant. Patients who requested DTCA drugs were much more likely to receive 1 or more new prescriptions (for requested drugs or alternatives) than those who did not request DTCA drugs (OR 16.9, 95% CI 7.5-38.2). Physicians judged 50.0% of new prescriptions for requested DTCA drugs to be only "possible" or "unlikely" choices for other similar patients, as compared with 12.4% of new prescriptions not requested by patients (p
Notes
Cites: West J Med. 2000 Oct;173(4):221-211017964
Cites: J Fam Pract. 2000 Dec;49(12):1092-811132058
Cites: CMAJ. 2001 May 15;164(10):1449-5111387918
Cites: CMAJ. 2001 Aug 21;165(4):46211531059
Cites: BMJ. 2002 Feb 2;324(7332):278-911823361
Cites: JAMA. 1999 Jan 27;281(4):380-29929095
Cites: JAMA. 2003 Feb 19;289(7):827-812588246
Cites: Adv Data. 2002 Jun 5;(328):1-3212661586
Cites: Health Aff (Millwood). 2003 Jan-Jun;Suppl Web Exclusives:W3-82-9514527237
Cites: Health Aff (Millwood). 2003 Jan-Jun;Suppl Web Exclusives:W3-112-514527241
Cites: J Health Serv Res Policy. 2003 Oct;8(4):237-4414596759
Cites: N Engl J Med. 2002 Feb 14;346(7):498-50511844852
Comment In: CMAJ. 2004 Mar 2;170(5):768-70; author reply 770-114993155
Comment In: CMAJ. 2004 Mar 2;170(5):768 ,770; author reply 770-114993157
PubMed ID
12952801 View in PubMed
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Influence of direct to consumer pharmaceutical advertising and patients' requests on prescribing decisions: two site cross sectional survey.

https://arctichealth.org/en/permalink/ahliterature191695
Source
BMJ. 2002 Feb 2;324(7332):278-9
Publication Type
Article
Date
Feb-2-2002
Author
Barbara Mintzes
Morris L Barer
Richard L Kravitz
Arminée Kazanjian
Ken Bassett
Joel Lexchin
Robert G Evans
Richard Pan
Stephen A Marion
Author Affiliation
Centre for Health Services and Policy Research, University of British Columbia, Vancouver BC, Canada V6T 1Z3. bmintzes@chspr.ubc.ca
Source
BMJ. 2002 Feb 2;324(7332):278-9
Date
Feb-2-2002
Language
English
Publication Type
Article
Keywords
Adult
Advertising as Topic
Canada
Cross-Sectional Studies
Health Care Surveys
Humans
Patient Acceptance of Health Care
Pharmaceutical Preparations
Physician's Practice Patterns
United States
Notes
Cites: CMAJ. 2001 Aug 21;165(4):46211531059
Comment In: BMJ. 2002 Apr 27;324(7344):103911976254
Erratum In: BMJ 2002 May 11;324(7346):1131
PubMed ID
11823361 View in PubMed
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Introduction of direct-to-consumer advertising of prescription drugs in Canada: an opinion survey on regulatory policy.

https://arctichealth.org/en/permalink/ahliterature166293
Source
Res Social Adm Pharm. 2005 Jun;1(2):310-30
Publication Type
Article
Date
Jun-2005
Author
Barbara Mintzes
Morris Barer
Joel Lexchin
Ken L Bassett
Author Affiliation
Centre for Health Services and Policy Research, University of British Columbia (UBC), Vancouver, BC Canada V6T 1Z3. bmintzes@chspr.ubc.ca
Source
Res Social Adm Pharm. 2005 Jun;1(2):310-30
Date
Jun-2005
Language
English
Publication Type
Article
Keywords
Advertising as Topic
Canada
Data Collection
Drug Therapy
Drug Utilization
Humans
Legislation, Drug
Pharmaceutical Preparations
Physician's Practice Patterns
Public Opinion
Questionnaires
Risk assessment
Abstract
Canada is strongly influenced by US cross-border direct-to-consumer advertising (DTCA) and has held consultations to discuss introduction of DTCA since 1996. This article describes a survey of Canadian drug policy experts carried out in 2001, during one such legislative review. The survey results are compared to more recent DTCA policy developments.
We recruited key informants on pharmaceutical policy to complete a faxed questionnaire that queried their opinions on DTCA information quality, effects on drug and health care use, and regulatory issues. Respondents were asked about the evidence they had used to back their opinions. Analysis was descriptive.
Of 79 identified potential participants, 60 (76%) participated, 40% of whom were from federal and provincial government; 3% were private insurers; 18%, 15%, and 8% were from health professional groups, consumer groups, and patient groups, respectively; 8% and 7% were from pharmaceutical and advertising industries, respectively. Opinions were highly polarized on the effects of DTCA on drug and health care use. Advertising and pharmaceutical industry respondents were generally positive, public sector, health professional and consumer groups generally negative. Over 80% believed DTCA leads to higher private and public drug costs and more frequent physician visits. Fewer judged billboards or television to be appropriate media for DTCA than magazines or the Internet, and most believed that children and adolescents should not be targeted.
Given the polarization observed within this survey, we examined how DTCA policy has evolved in Canada since 2001. The federal government has legislative authority over DTCA, but bears few of the additional costs potentially incurred through policy change. These fall to the provinces, which provide an eroding patchwork of public coverage for prescription drugs in the face of rapidly increasing costs. No new federal legislation has been tabled since 2001. However, considerable shifts in administrative policy have occurred, all supportive of expanded advertising. Thus, the law continues to be restrictive but its application less so.
PubMed ID
17138480 View in PubMed
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Pharmaceutical sales representatives and patient safety: a comparative prospective study of information quality in Canada, France and the United States.

https://arctichealth.org/en/permalink/ahliterature114969
Source
J Gen Intern Med. 2013 Oct;28(10):1368-75
Publication Type
Article
Date
Oct-2013
Author
Barbara Mintzes
Joel Lexchin
Jason M Sutherland
Marie-Dominique Beaulieu
Michael S Wilkes
Geneviève Durrieu
Ellen Reynolds
Author Affiliation
School of Population and Public Health, University of British Columbia, #307, 2176 Health Sciences Mall, Vancouver, British Columbia, V6T 1Z3, Canada, Barbara.mintzes@ti.ubc.ca.
Source
J Gen Intern Med. 2013 Oct;28(10):1368-75
Date
Oct-2013
Language
English
Publication Type
Article
Keywords
Attitude of Health Personnel
Canada
Drug Industry - standards
Drug Information Services - standards
Drug Prescriptions - standards
Drug-Related Side Effects and Adverse Reactions - etiology
France
Health Services Research - methods
Humans
Marketing - standards
Patient Safety
Physician's Practice Patterns - standards
Primary Health Care - standards
Prospective Studies
United States
Abstract
The information provided by pharmaceutical sales representatives has been shown to influence prescribing. To enable safe prescribing, medicines information must include harm as well as benefits. Regulation supports this aim, but relative effectiveness of different approaches is not known. The United States (US) and France directly regulate drug promotion; Canada relies on industry self-regulation. France has the strictest information standards.
This is a prospective cohort study in Montreal, Vancouver, Sacramento and Toulouse. We recruited random samples of primary care physicians from May 2009 to June 2010 to report on consecutive sales visits. The primary outcome measure was "minimally adequate safety information" (mention of at least one indication, serious adverse event, common adverse event, and contraindication, and no unqualified safety claims or unapproved indications).
Two hundred and fifty-five physicians reported on 1,692 drug-specific promotions. "Minimally adequate safety information" did not differ: 1.7 % of promotions; range 0.9-3.0 % per site. Sales representatives provided some vs. no information on harm more often in Toulouse than in Montreal and Vancouver: 61 % vs. 34 %, OR?=?4.0; 95 % CI 2.8-5.6, or Sacramento (39 %), OR?=?2.4; 95 % CI 1.7-3.6. Serious adverse events were rarely mentioned (5-6 % of promotions in all four sites), although 45 % of promotions were for drugs with US Food and Drug Administration (FDA) "black box" warnings of serious risks. Nevertheless, physicians judged the quality of scientific information to be good or excellent in 901 (54 %) of promotions, and indicated readiness to prescribe 64 % of the time.
"Minimally adequate safety information" did not differ in the US and Canadian sites, despite regulatory differences. In Toulouse, consistent with stricter standards, more harm information was provided. However, in all sites, physicians were rarely informed about serious adverse events, raising questions about whether current approaches to regulation of sales representatives adequately protect patient health.
Notes
Comment In: J Gen Intern Med. 2013 Nov;28(11):139423884603
Comment In: J Gen Intern Med. 2013 Nov;28(11):139523897129
PubMed ID
23558775 View in PubMed
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16 records – page 1 of 2.