BC Methadone Maintenance System: Performance Measures 2011/2012 Appendix A: Report Figures and Data

Transcription

1 BC Methadone Maintenance System: Performance Measures 2011/2012 Pharmaceutical Services Division & Population and Public Health Division British Columbia Ministry of Health February 2013

2 You may download the full report from:

3 Table of Contents REPORT DATA Figure Figure Figure Figure Figure Figure Figure Figure Figure Figure Figure Figure i

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5 Figure 2 Cumulative Patient Count 16,000 14,000 12,000 10,000 8,000 6,000 4,000 2,000 - Methadone Maintenance Patients by Health Authority, 2001/2002 to 2011/ Interior 02 Fraser 03 Vancouver Coastal 04 Vancouver Island 05 Northern BC Total Patient Health Authority Fiscal Year Total Patients 01 Interior 2001/ / / / / /2007 1, /2008 1, /2009 1, /2010 1, /2011 1, /2012 1, Fraser 2001/2002 2, /2003 3, /2004 3, /2005 3, /2006 3, /2007 3, /2008 3, /2009 3, /2010 4, /2011 5, /2012 5, Vancouver Coastal 2001/2002 2, /2003 3, / 2012 Patient Health Authority Fiscal Year Total Patients 03 Vancouver Coastal 2003/2004 3,080 (continued) 2004/2005 3, /2006 3, /2007 3, /2008 3, /2009 3, /2010 3, /2011 4, /2012 4, Vancouver Island 2001/2002 1, /2003 1, /2004 1, /2005 1, /2006 1, /2007 1, /2008 1, /2009 2, /2010 2, /2011 2, /2012 2, Northern 2001/ / / / / / / / / / / BC Total 2001/2002 7, /2003 8, /2004 7, /2005 8, /2006 8, /2007 8, /2008 9, / , / , / , / ,894 1

6 Figure 3 New Patient Count New Methadone Maintenance Patients by Health Authority, BC, 2001/2002 to 2011/2012 2,500 2,000 1,500 1, Interior 02 Fraser 03 Vancouver Coastal 04 Vancouver Island 05 Northern BC Total Patient Health Authority Fiscal Year New Patients 01 Interior 2001/ / / / / / / / / / / Fraser 2001/ / / / / / / / / / / Vancouver Coastal 2001/ / / 2012 Patient Health Authority Fiscal Year New Patients 03 Vancouver Coastal 2003/ (continued) 2004/ / / / / / / / Vancouver Island 2001/ / / / / / / / / / / Northern 2001/ / / / / / / / / / / BC Total 2001/2002 1, /2003 1, /2004 1, /2005 1, /2006 1, /2007 1, /2008 1, /2009 1, /2010 1, /2011 2, /2012 2,264 2

7 Figure 4 Prescriber Count Notes: Methadone Maintenance Program Active Prescribers by Health Authority, BC, 2001/2002 to 2011/ Interior 02 Fraser 03 Vancouver Coastal 04 Vancouver Island 05 Northern BC Total - Data obtained August 21, 2012 from Health Ideas/PharmaNet database - Methadone prescribers counted if they prescribed at least one PharmaCare accepted claim for methadone maintanence (PINS: , , , ) during the fiscal year - Precribers limited to MSP prescribers with valid College of Physicians and Surgeons of BC licence number Health Authority Fiscal Year Number of MMP Prescribers 01 Interior 2001/ / / / / / / / / / / Fraser 2001/ / / / / / / / / 2012 Health Authority Fiscal Year Number of MMP Prescribers 02 Fraser (continued) 2009/ / / Vancouver Coastal 2001/ / / / / / / / / / / Vancouver Island 2001/ / / / / / / / / / / Northern 2001/ / / / / / / / / / / BC Total 2001/ / / / / / / / / / /

8 Figure 5 Pharmacist Count 4 3,000 2,500 2,000 1,500 1, Methadone Maintenance Pharmacists by Health Authority, BC, 2001/2002 to 2011/ Interior 02 Fraser 03 Vancouver Coastal 04 Vancouver Island 05 Northern BC Total Pharmacy Health Authority Fiscal Year Total MMP Pharmacists 01 Interior 2001/ / / / / / / / / / / Fraser 2001/ / / / / / / / / / / / 2012 Pharmacy Health Authority Fiscal Year Total MMP Pharmacists 03 Vancouver Coastal 2001/ / / / / / / / / / / Vancouver Island 2001/ / / / / / / / / / / Northern 2001/ / / / / / / / / / / BC Total 2001/ /2003 1, /2004 1, /2005 1, /2006 1, /2007 1, /2008 1, /2009 2, /2010 2, /2011 2, /2012 2,546

9 Figure 6 Methadone Maintenance Pharmacies by Health Authority, BC, 2001/2002 to 2011/ Notes: Data obtained September 2, 2011 from Health Ideas/PharmaNet database / 2012 Pharmacies Count - Methadone pharmacies counted if they filled at least one PharmaCare accepted claim for methadone maintanence (PINS: , , , ) during the fiscal year - Witnessed Ingestion Pharmacies counted if filled claim for specific PINs for methadone taken on-site (PINs: , ) - Carry Home Pharmacies counted if filled claim for specific PINs for methadone taken off-site (PINs: , ) - Population figures includes only pharmacies active in PharmaNet during the fiscal year 01 Interior 02 Fraser 03 Vancouver Coastal 04 Vancouver Island 05 Northern BC Total Pharmacy Health Authority Fiscal Year MMP Pharmacies per 100 Pharmacies Total MMP Pharmacies 01 Interior 2001/ / / / / / / / / / / Fraser 2001/ / / / / / / / / / / continued on next page... 5

10 Figure 6 data continued from previous page Pharmacy Health Authority Fiscal Year MMP Pharmacies per 100 Pharmacies Total MMP Pharmacies 03 Vancouver Coastal 2001/ / / / / / / / / / / Vancouver Island 2001/ / / / / / / / / / / Northern 2001/ / / / / / / / / / / BC Total 2001/ / / / / / / / / / /

11 Figure 7 Provincial Government and PharmaCare Methadone Expenditures, BC, 2001/2002 to 2011/2012 Total Costs $45,000,000 $40,000,000 $35,000,000 $30,000,000 $25,000,000 $20,000,000 $15,000,000 $10,000,000 $5,000, / 2012 $3,500 $3,000 $2,500 $2,000 $1,500 $1,000 $500 0 Average PharmaCare Paid Average BC Cost Total BC Cost Total PharmaCare Paid Average Cost Per Patient Notes: - Data obtained September 2, 2011 from Health Ideas/PharmaNet database - Data includes all PharmaCare accepted claims for methadone maintanence (PINS: , , , ) during the fiscal year - BC Costs include total cost to PharmaCare, patients, or other 3rd party insurers of ingredients, dispensing fees, and interaction fees for witnessed ingestion - PharmaCare Paid costs include on costs to PharmaCare for ingredients, dispensing fees, and interaction fees - Median costs include an estimate of interaction fees for individual patients; actual interaction fee is paid in bulk to pharmacies Fiscal Year Patients Average PharmaCare Paid Total PharmaCare Paid Average BC Cost Total BC Cost 2001/2002 7,755 $2,147 $16,646,864 $2,377 $18,429, /2003 8,029 $2,592 $20,811,537 $2,917 $23,418, /2004 7,967 $2,674 $21,303,616 $2,963 $23,604, /2005 8,318 $2,722 $22,642,611 $3,034 $25,237, /2006 8,563 $2,751 $23,555,163 $3,088 $26,442, /2007 8,998 $2,782 $25,029,135 $3,138 $28,236, /2008 9,466 $2,958 $27,999,245 $3,325 $31,477, / ,372 $2,747 $28,490,085 $3,110 $32,255, / ,385 $2,826 $32,170,225 $3,187 $36,282, / ,703 $2,837 $36,032,632 $3,214 $40,826, / ,894 $2,899 $40,276,077 $3,301 $45,867,722 7

12 Figure 8a Medical Services Plan Methadone Expenditures for Methadone Maintenance Treatment Only, BC Total, 2001/2002 to 2011/2012 Figure 8b Medical Services Plan Methadone Expenditures for Methadone Maintenance Treatment Only, by Health Authority, 2001/2002 to 2011/2012 Million $ Million $ Interior Fraser Vancouver Coastal Vancouver Island Northern / / 2012 Notes: 1. Data includes MSP fee-for-service services by date of service for selected Fee item 39 - METHADONE OR BUPRENORPHINE/NALOXONE TREATMENT ONLY for fiscal years 2001/2002 to 2011/2012, paid to December 31, Services exclude visit/procedural premiums, no charge referrals and tray fees (but corresponding expenditures are reported). 3. Data exclude third party billings (e.g, ICBC, WCB). Practitioner Health Authority Fiscal Year Expenditure 1 - Interior 2001/2002 $661, /2003 $577, /2004 $624, /2005 $664, /2006 $732, /2007 $821, /2008 $865, /2009 $1,023, /2010 $1,174, /2011 $1,362, /2012 $1,618, Fraser 2001/2002 $1,185, /2003 $1,184, /2004 $1,234, /2005 $1,288, /2006 $1,101, /2007 $1,244, /2008 $1,321, /2009 $1,432, /2010 $1,799, /2011 $2,040, /2012 $2,865,334 Practitioner Health Authority Fiscal Year Expenditure 3 - Vancouver Coastal 2001/2002 $2,613, /2003 $3,057, /2004 $2,556, /2005 $2,540, /2006 $2,734, /2007 $2,792, /2008 $3,022, /2009 $3,322, /2010 $4,054, /2011 $4,738, /2012 $4,834, Vancouver Island 2001/2002 $1,014, /2003 $1,178, /2004 $1,211, /2005 $1,369, /2006 $1,444, /2007 $1,483, /2008 $1,677, /2009 $1,823, /2010 $2,059, /2011 $2,263, /2012 $2,360,815 continued on next page... 8

13 Figure 8 data continued from previous page Practitioner Health Authority Fiscal Year Expenditure 5 - Northern 2001/2002 $113, /2003 $187, /2004 $83, /2005 $59, /2006 $27, /2007 $46, /2008 $58, /2009 $66, /2010 $85, /2011 $82, /2012 $92, Unknown 2003/2004 $4, /2006 $ /2010 $6,447 BC Total 2001/2002 $5,588, /2003 $6,185, /2004 $5,715, /2005 $5,921, /2006 $6,041, /2007 $6,387, /2008 $6,945, /2009 $7,667, /2010 $9,180, /2011 $10,487, /2012 $11,771,476 9

14 / / / / / / / / / / / Figure 10 % adherence to minimum effective stabilization dose guideline Adherence to Minimum Effective Dose Guideline, by Health Authority, BC, 2001/2002 to 2011/ % 60% 55% 50% 45% 40% 35% Patient Health Authority Interior 02 Fraser Vancouver Coastal Fiscal Year Vancouver Island 05 Northern BC Total % Adherance to Minimum Effective Dose Guidelines 01 Interior 2001/ % 2002/ % 2003/ % 2004/ % 2005/ % 2006/ % 2007/ % 2008/ % 2009/ % 2010/ % 2011/ % 02 Fraser 2001/ % 2002/ % 2003/ % 2004/ % 2005/ % 2006/ % 2007/ % 2008/ % 2009/ % 2010/ % 2011/ % Patient Health Authority 03 Vancouver Coastal Fiscal Year % Adherance to Minimum Effective Dose Guidelines 2001/ % 2002/ % 2003/ % 2004/ % 2005/ % 2006/ % 2007/ % 2008/ % 2009/ % 2010/ % 2011/ % 04 Vancouver Island 2001/ % 2002/ % 2003/ % 2004/ % 2005/ % 2006/ % 2007/ % 2008/ % 2009/ % 2010/ % 2011/ % 05 Northern 2001/ % 2002/ % 2003/ % 2004/ % 2005/ % 2006/ % 2007/ % 2008/ % 2009/ % 2010/ % 2011/ % BC Total 2001/ % 2002/ % 2003/ % 2004/ % 2005/ % 2006/ % 2007/ % 2008/ % 2009/ % 2010/ % 2011/ % 10

15 Figure 11 Percentage of People Started on Methadone Maintenance Treatment Retained at 12 Months, by Health Authority, BC, 2001/2002 to 2010/2011 BC Total Vancouver Coastal 60% 60% Percent retained 50% 40% 30% Percent retained 50% 40% 30% 20% 20% 60% Interior 60% Vancouver Island Percent retained 50% 40% 30% Percent retained 50% 40% 30% 20% 20% 60% Fraser Percent retained 50% 40% 30% 20% 01 / / / / / / / / / / % Northern Percent retained 50% 40% 30% 20% continued on next page... 11

16 Figure 11 data continued from previous page Notes: - Data obtained August from Health Ideas/PharmaNet database & September 6, 2011 from Hospital Discharge Abstract Database (DAD) - Hospital Admissions are measured as unique records of entry into DAD Person years calculated as days of methadone maintanence treatment divided by 36,500 - Hospital costs for years 2001/02 to 2003/04 apply cost per weighted case of $5,010 to resource intensity weights (RIW) of each admission; this is the 2008/09 cost per weighted case - Hospital costs for years 2004/05 to 2009/10 apply cost per weighted case of $5,390 to resource intensity weights (RIW) of each admission; this is the 2009/10 cost per weighted case /10 RIWs not available for years 2001/02 to 2003/04 - Median cost excluded because fewer than 50% of patients admitted to hospitals during methadone maintanence * 2009/10 figures may be incomplete because patients admitted to hospitals in 2009/10 but not discharged until 2010/11 will not appear in 2009/10 data Patient Health Authority Fiscal Year Retention After 1 Year (%) 01 Interior 2001/ % 2002/ % 2003/ % 2004/ % 2005/ % 2006/ % 2007/ % 2008/ % 2009/ % 2010/ % 02 Fraser 2001/ % 2002/ % 2003/ % 2004/ % 2005/ % 2006/ % 2007/ % 2008/ % 2009/ % 2010/ % 03 Vancouver Coastal 2001/ % 2002/ % 2003/ % 2004/ % 2005/ % 2006/ % 2007/ % 2008/ % 2009/ % 2010/ % Patient Health Authority Fiscal Year Retention After 1 Year (%) 04 Vancouver Island 2001/ % 2002/ % 2003/ % 2004/ % 2005/ % 2006/ % 2007/ % 2008/ % 2009/ % 2010/ % 05 Northern 2001/ % 2002/ % 2003/ % 2004/ % 2005/ % 2006/ % 2007/ % 2008/ % 2009/ % 2010/ % BC Total 2001/ % 2002/ % 2003/ % 2004/ % 2005/ % 2006/ % 2007/ % 2008/ % 2009/ % 2010/ % 12

17 Figure 12 Hospitalizations per 100 Person Years During Methadone Maintenance, by Health Authority, BC,, 2001/2002 to 2010/ No. of hospitalisations per 100 person years Interior 02 Fraser 03 Vancouver Coastal 04 Vancouver Island 05 Northern BC Total Notes: - Data obtained August from Health Ideas/PharmaNet database - Deaths of all causes recorded within 30 days of episode of methadone maintanence therapy Person years calculated as days of methadone maintanence treatment divided by 36,500 Patient Health Authority Fiscal Year Admissions per 100 Person Years Total Hospital Admissions 01 Interior 2001/ / / / / / / / / / Fraser 2001/ / / / / / / / / / continued on next page... 13

18 Figure 12 data continued from previous page Patient Health Authority Fiscal Year Admissions per 100 Person Years Total Hospital Admissions 03 Vancouver Coastal 2001/ / / / / / / / / / Vancouver Island 2001/ / / / / / / / / / Northern 2001/ / / / / / / / / / BC Total 2001/ / / / , / , / , / , / , / , / ,249 14

19 Figure 13 All-cause Mortality During Methadone Maintenance Treatment, BC Total, 2001/2002 to 2011/ No. of total deaths per year 2011 / 2012 No. of deaths per 100 person years Annual # of Total Deaths Deaths per 100 Person Years Notes: - Data obtained August from Health Ideas/PharmaNet database - Deaths of all causes recorded within 30 days of episode of methadone maintanence therapy Person years calculated as days of methadone maintanence treatment divided by 36,500 Fiscal Year Total Deaths in Methadone Maintenance Treatment Deaths per 100 Person Years 2001/ / / / / / / / / / /

20 Figure 14 No. of deaths per 100 person years Deaths by Any Cause per 100 Person Years During Methadone Maintenance by Health Authority, BC, 2001/2002 to 2011/ Interior 02 Fraser 04 Vancouver Island 05 Northern 03 Vancouver Coastal BC Total Notes: - Data obtained August from Health Ideas/PharmaNet database - Deaths of all causes recorded within 30 days of episode of methadone maintanence therapy Person years calculated as days of methadone maintanence treatment divided by 36,500 Patient Health Authority Fiscal Year Deaths per 100 Person Years 01 Interior 2001/ / / / / / / / / / / Fraser 2001/ / / / / / / / / / / / 2012 Patient Health Authority Fiscal Year Deaths per 100 Person Years 03 Vancouver Coastal 2001/ / / / / / / / / / / Vancouver Island 2001/ / / / / / / / / / / Northern 2001/ / / / / / / / / / / BC Total 2001/ / / / / / / / / / /