Main Article Content

J Michael Paterson
Ali Suleiman Suleiman
Janet E Hux
Chaim Bell


Drug history profiles, prescription drug insurance, emergency department, drug adverse events



In Canada, programs are being developed to supply hospital emergency departments and family doctors with electronic access to their patients’ drug history profiles. While some of these programs have access to  databases  that  capture  information  about  all  out-patient  prescriptions  that  are  dispensed  to  an individual, regardless of payer; others do not, and rely upon claims paid by their provincial drug benefit plans. The completeness of these latter profiles is unknown.


To estimate the percentage of Ontario seniors who use private drug insurance (as an indicator of the potential for a ‘public’ drug history profile to be incomplete) and to describe the kinds of medications for which private insurance is used.


Cross-sectional time series analysis of Ontario Drug Benefit (ODB) claims and private drug insurance claims  for Ontario  residents  aged  65  years  or  older  (seniors)  covering  the  period  January  2000  to December 2005.


During the study period, approximately 95% of Ontario seniors filled at least one prescription paid by the provincial drug benefit plan. By comparison, approximately 15-20% filled a prescription paid by a private insurer. Compared to the 20 drugs most frequently subsidized by the ODB Program (all but one of which had ODB full benefit status), the top privately-purchased drugs were more diverse: 8 had ODB full benefit status; 4 had ODB Limited Use status (which requires that patients meet prespecified clinical criteria for coverage); 3 required individual clinical review (prior authorization) by the ODB Program; and 5 were ODB non-benefits.


Many Ontario seniors are at risk for an incomplete ODB drug history profile. Further research is needed to confirm whether this causes problems for physicians and patients.

Abstract 112 | PDF Downloads 86


1. Budnitz DS, Pollock DA, Weidenbach KN, Mendelsohn AB, Schroeder TJ, Annest JL. National surveillance of emergency department visits for outpatient adverse drug events. JAMA 2006;296:1858 -66.
2. Ontario Ministry of Health and Long-term Care. Bulletin Number 4424. Emergency department access to drug claims histories of Ontario Drug Benefit Program and Trillium Drug Program recipients. July 4, 2005. Accessed September 19, 2007 at gram/ohip/bulletins/4000/bul4424.pdf.
3. British Columbia Ministry of Health. Emergency Department Access to PharmaNet. Accessed September 19, 2007 at
4. British Columbia Ministry of Health. Medical Initiatives and Organizations, 2005. Accessed Practice Access to PharmaNet. Accessed September 19, 2007 at September 19, 2007 at
5. Saskatchewan Health. Pharmaceutical Program. Accessed September 19, 2007 at
6. Alberta Netcare Electronic Health Record. Pharmaceutical Information Network. Accessed September 19, 2007 at
7. Manitoba Government. Manitoba Government News Release. January 30, 1998. Health Information Network Activated at Thompson. Thompson General Joins Pilot Program: Praznik. Accessed September 19, 2007 at
8. Tamblyn R, Huang A, Perreault R, et el. The medical office of the 21st century (MOXXI): effectiveness of computerized decision- making support in reducing inappropriate prescribing in primary care. CMAJ 2003;169:549-56.
9. Middlesex Hospital Alliance. Media Release. November 13, 2006. Emergency Departments Connect with Provincial Drug Information. Accessed September 19, 2007 at nt/75/MHA_EDs_Connect_with_Provincial_Drug _Information.pdf
10. Gottlieb LK, Stone EM, Stone D, Dunbrack LA, Calladine J. Regulatory and policy barriers to effective clinical data exchange: lessons learned from MedsInfo- ED. Health Aff 2005;24:1197-204.
11. Statistics Canada. Annual Demographic Statistics, 2005. Catalogue no. 91- 213-XIB. Accessed July
12, 2006 at
12. Ontario Ministry of Health and Long-term Care. Ontario Drug Benefit Formulary/Comparative Drug Index. Accessed January 31, 2007 at gram/drugs/odbf_mn.html
13. Halamka J, Fournier GA. MA-SHARE MedsInfo- ED medication history pilot. Am J Med Qual 2006;21:296-8.
14. Department for Medicaid Services. Medicaid Transformation Grant Proposal: Kentucky Health Information Partnership. Accessed September 19,
2007 at http://www.volunteer-
15. eHealth Initiative. Emerging Trends and Issues in Health Information Exchange. Selected findings from the eHealth Initiative Foundation’s Second Annual Survey of State, Regional and Community- Based Health Information Exchange Initiatives and Organizations, 2005. Accessed September 19, 2007 at
16. Ontario Ministry of Health and Long-term Care. ODB Annual Reports for 2000/01-2004/05. Accessed at
17. Laupacis A, Paterson JM, Mamdani M, Rostom A, Anderson GM. Gaps in the evaluation and monitoring of new pharmaceuticals: proposal for a different approach. CMAJ 2003;169:1167-70.
18. Paterson JM, Laupacis A, Bassett K, Anderson GM. Using pharmacoepidemiology to inform drug coverage policy: initial lessons from a two- province collaborative. Health Aff 2006;25:1436- 43.