Cost Trends of Potentially Inappropriate Medications Among Older Adults between 2012 and 2021 in Quebec, Canada: A Population-Based Repeated Cross-Sectional Study
Author(s)
Magalie Gagnon, Other1, Jason R. Guertin, PhD1, Caroline Sirois, PhD1, Marc Simard, PhD2, Benoit Cossette, PhD3, Marie-Eve Gagnon, MSc, RN, Other4;
1Université Laval, Québec, QC, Canada, 2Institut national de santé publique du Québec, Québec, QC, Canada, 3Université de Sherbrooke, Sherbrooke, QC, Canada, 4Université du Québec à Rimouski, Levis, QC, Canada
1Université Laval, Québec, QC, Canada, 2Institut national de santé publique du Québec, Québec, QC, Canada, 3Université de Sherbrooke, Sherbrooke, QC, Canada, 4Université du Québec à Rimouski, Levis, QC, Canada
Presentation Documents
OBJECTIVES: Potentially inappropriate medications (PIMs) are frequent in older adults, contributing to hospitalizations, adverse events, and healthcare burden. We aimed to estimate direct PIM cost trends from 2012 to 2021 among older women and men in Quebec, Canada.
METHODS: Using medico-administrative data, we assessed costs (in 2024 Canadian dollars) of PIMs claimed by adults ≥65 years covered by the public drug plan. Costs for 16 PIM classes, identified using 2015 and 2019 Beers criteria, were calculated by fiscal year and stratified by sex and age group (65-74, 75-84, ≥85). We computed average costs/enrollee and usage prevalence for the costliest PIM classes. Trends were estimated using univariate linear regression with 95% confidence intervals.
RESULTS: We found a non-statistically significant decrease in total PIM claim costs, from $206 million in 2012 to $186 million in 2021 (trend: -2.9[-17.4; 11.6]), representing 5.4% of medication expenditures for adults ≥65 in 2021. The reduction in total costs was more accentuated in women, whose annual costs were higher than those of men in all age groups. Average cost/enrollee decreased from $179 to $119 (trend: -7[-19; 5]), with a drop from $216 to $142 for women and $132 to $92 for men. Costs/enrollee were higher in 75-84 and ≥85 age groups. Costliest PIM classes included proton-pump inhibitors, benzodiazepines, antipsychotics, antidepressants, estrogens (women), and hypoglycemic agents (men). Cost trends did not always follow prevalence trends for these PIM classes.
CONCLUSIONS: PIM costs among older adults slightly decreased from 2012 to 2021. Appropriate prescribing and deprescribing appear crucial for reducing these costs.
METHODS: Using medico-administrative data, we assessed costs (in 2024 Canadian dollars) of PIMs claimed by adults ≥65 years covered by the public drug plan. Costs for 16 PIM classes, identified using 2015 and 2019 Beers criteria, were calculated by fiscal year and stratified by sex and age group (65-74, 75-84, ≥85). We computed average costs/enrollee and usage prevalence for the costliest PIM classes. Trends were estimated using univariate linear regression with 95% confidence intervals.
RESULTS: We found a non-statistically significant decrease in total PIM claim costs, from $206 million in 2012 to $186 million in 2021 (trend: -2.9[-17.4; 11.6]), representing 5.4% of medication expenditures for adults ≥65 in 2021. The reduction in total costs was more accentuated in women, whose annual costs were higher than those of men in all age groups. Average cost/enrollee decreased from $179 to $119 (trend: -7[-19; 5]), with a drop from $216 to $142 for women and $132 to $92 for men. Costs/enrollee were higher in 75-84 and ≥85 age groups. Costliest PIM classes included proton-pump inhibitors, benzodiazepines, antipsychotics, antidepressants, estrogens (women), and hypoglycemic agents (men). Cost trends did not always follow prevalence trends for these PIM classes.
CONCLUSIONS: PIM costs among older adults slightly decreased from 2012 to 2021. Appropriate prescribing and deprescribing appear crucial for reducing these costs.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE384
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Geriatrics