Costs of Initiated Potentially Inappropriate Medication in 2021-2022 in Quebec, Canada
Author(s)
Marie-Eve Gagnon, MSc, RN, Other1, Magalie Gagnon, Other2, Jason R. Guertin, PhD2, Caroline Sirois, PhD2, Marc Simard, PhD3, Benoit Cossette, PhD4;
1Université du Québec à Rimouski, Levis, QC, Canada, 2Université Laval, Québec, QC, Canada, 3Institut national de santé publique du Québec, Québec, QC, Canada, 4Université de Sherbrooke, Sherbrooke, QC, Canada
1Université du Québec à Rimouski, Levis, QC, Canada, 2Université Laval, Québec, QC, Canada, 3Institut national de santé publique du Québec, Québec, QC, Canada, 4Université de Sherbrooke, Sherbrooke, QC, Canada
Presentation Documents
OBJECTIVES: Usage of potentially inappropriate medications (PIMs) in older adults contributes to hospitalizations and adverse drug events (ADEs). Avoiding their initiation could prevent significant health and economic burdens. We aimed to estimate the direct costs of PIMs initiated in 2021-2022 among older adults in Quebec, Canada.
METHODS: Using claim data, we assessed the direct cost of PIMs initiated in 2021-2022 among adults aged ≥65 covered by the public drug plan who had not claimed these PIMs in the preceding year. Costs for 16 PIM classes, identified using 2019 Beers criteria, were calculated in 2024 Canadian dollars (CAD) and stratified by sex and age group (65-74, 75-84, ≥85).
RESULTS: Total claim cost of PIMs initiated in 2021-2022 was CAD 23.7 million (M). PIM initiation was higher among women (18.2%) compared to men (14.6%) and was highest in the 65-74 age group, decreasing with advancing age. Five PIM classes alone accounted for 87.3% of total PIM initiation costs: proton-pump inhibitors (CAD 5.3M women, CAD 3.7M men), antipsychotics (CAD 3.0M, CAD 2.4M), benzodiazepines (CAD 2.0M, CAD 1.3M), antidepressants (CAD 1.3M, CAD 0.7M), and muscle relaxants (CAD 0.6M, CAD 0.4M). Although the direct cost only represents 0.7% of medication expenditures for adults aged ≥65, avoiding these most initiated classes could have saved over CAD 20M with additional savings considering indirect costs associated to ADEs.
CONCLUSIONS: To reduce negative health outcomes and public healthcare expenditures, initiatives preventing potentially inappropriate prescribing should prioritize the most frequently initiated classes and those associated with frequent and serious ADEs.
METHODS: Using claim data, we assessed the direct cost of PIMs initiated in 2021-2022 among adults aged ≥65 covered by the public drug plan who had not claimed these PIMs in the preceding year. Costs for 16 PIM classes, identified using 2019 Beers criteria, were calculated in 2024 Canadian dollars (CAD) and stratified by sex and age group (65-74, 75-84, ≥85).
RESULTS: Total claim cost of PIMs initiated in 2021-2022 was CAD 23.7 million (M). PIM initiation was higher among women (18.2%) compared to men (14.6%) and was highest in the 65-74 age group, decreasing with advancing age. Five PIM classes alone accounted for 87.3% of total PIM initiation costs: proton-pump inhibitors (CAD 5.3M women, CAD 3.7M men), antipsychotics (CAD 3.0M, CAD 2.4M), benzodiazepines (CAD 2.0M, CAD 1.3M), antidepressants (CAD 1.3M, CAD 0.7M), and muscle relaxants (CAD 0.6M, CAD 0.4M). Although the direct cost only represents 0.7% of medication expenditures for adults aged ≥65, avoiding these most initiated classes could have saved over CAD 20M with additional savings considering indirect costs associated to ADEs.
CONCLUSIONS: To reduce negative health outcomes and public healthcare expenditures, initiatives preventing potentially inappropriate prescribing should prioritize the most frequently initiated classes and those associated with frequent and serious ADEs.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
EE489
Topic
Economic Evaluation
Topic Subcategory
Cost/Cost of Illness/Resource Use Studies
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, SDC: Geriatrics