Roberta Labelle was one of the Centre's founding members. Her death in 1991 was unexpected and occurred when broad recognition for her research in health economics was just starting to emerge. In memory of Roberta, CHEPA and the Department of Clinical Epidemiology and Biostatistics collaborated on establishing the Annual Labelle Lectureship Series. In October each year a health services researcher with emerging recognition and an inter-disciplinary approach to research, gives a general interest lecture on a topic in the broadly defined areas of health economics and/or health policy. The Labelle Lecturer is also available for consultations with individuals in and outside McMaster University during the period of his/her visit. An endowment was established to assure the ongoing funding of the Lectureship.

2007: Steve Morgan
Assistant Professor, 
Department of Health Care and Epidemiology, University of British Columbia
Health Economist, Centre for Health Services and Policy Research, UBC

"Expenditure Overdose? Causes, Consequences and Cures for Canada's Pharmaceutical Cost Crises"

Wednesday, October 3, 2007, HSC-1A1, 3:00 pm to 4:30 pm

Discussant:  Robin Tamblyn, Professor, Department of Medicine and Department of Epidemiology and Biostatistics, McGill University

The variety of factors contributing to the growing pharmaceutical cost crisis in Canada – including marketing of “me-too” drugs – were the topic of the 2007 Labelle Lecture given by Steve Morgan, a leading health economist and expert in pharmacare from the University of British Columbia (UBC).
Morgan, who heads the pharmaceutical policy theme at the Centre for Health Services and Policy Research (CHSPR) at UBC, provided some sobering statistics on the escalating costs of prescription drugs in Canada:

• Spending on prescription drugs in Canada topped $21 billion in 2006, an increase of $1.4 billion over the previous year
• Spending on prescription drugs increased on average 11.2 per cent a year from 1997 to 2004
• Canada is now spending 25 per cent more on prescription drugs than on physicians, and within 10 years, at the current rate of growth, that amount would rise to 50 per cent more
• Freezing spending on prescription drugs for just one year would provide enough money to pay for an additional 10,000 doctors.

Morgan explained that while there’s an assumption that much of the increased spending on prescription drugs is due to the aging population, in fact, research in B.C. shows that the older population accounts for only one per cent of the increase. Spending on drugs increased significantly at all age levels in recent years.

“Persons of all ages are using more medicines, and they tend to use new, more expensive medicines rather than older, cheaper ones,” he said. In addition, his research shows that increased spending levels are dominated by drugs for common, chronic conditions such as high blood pressure, high cholesterol, depression and gastrointestinal problems.

Morgan’s research has shown that the pharmaceutical cost crisis is also driven by an increase in treatment rates, a lowering of the thresholds at which treatment begins, and an increase in the costs per course of treatment.

The development and promotion of “me-too drugs” – those that don’t offer significant therapeutic advantage over competitors, but are new enough to earn patents – are a major component of the pharmaceutical crisis, Morgan explained. Research in B.C. has shown that a very small percentage of the drug costs increase is caused by breakthrough drugs – the first of their kind to treat a condition. Me-too drugs accounted for 80 per cent of drug expenditures in recent years, and on average they are four times more expensive than the comparable, older alternatives.

He said that it’s crucial for Canada to collect better information on the outcomes of drug use, in order to assess whether the spending is warranted.

“We need to figure out whether we are getting value for money on the current trends, or would we better to spend more on doctors and less on drugs,” he said.

In addition, Canadian health care policymakers need to look at the way drugs are purchased, in order to realize cost savings while ensuring drug manufacturers will continue to invest in research and development. He cited the prescription drug situation in New Zealand, where governments buy in bulk and offer incentives to drug companies to provide more competitive pricing, as a possible model for Canada to consider.

For Morgan’s complete PowerPoint presentation at the lecture, click here.

Biosketch:
Steve Morgan is an assistant professor in the Department of Health Care and Epidemiology at UBC. His research focuses on pharmaceutical policy, health care financing and processes for promoting evidence-based decision-making. He earned a BA in economics at the University of Western Ontario, an MA in economics at Queen's University, and a PhD in economics at UBC. He also did post-doctoral work at the Centre for Health Economics and Policy Analysis. He holds career awards from the Canadian Institutes of Health Research and the Michael Smith Foundation for Health Research. 

Past Labelle Lectureship Speakers

2006:  Pascale Lehoux 
Associate Professor, Department of Health Administration, University of Montreal 
"Technology Innovation in Health Care: Who's Calling the Shots?"

2005:  Jennifer Prah Ruger
Assistant Professor, Division of Global Health, Yale School of Public Health
"Health and Global Health Governance: What's Justice Got to do With It?"

2004:  Valerie Steeves
Assistant Professsor, Department of Criminology, University of Ottawa
Why Are They Doing This To Us:  Will Changes in Data Health Privacy Legislation Kill Research as We Know It?

2003:  Meredith Rosenthal
Assistant Professor of Health Economics and Policy, Harvard School of Public Health
Paying for Quality in Health Care: Poison or Panacea?

2002:  Mark Sculpher
Centre for Health Economics, University of York, United Kingdom
Assessing Health Technologies: Should Canada take the NICE Path?

2001:  Jean-Mane Berthelot
Health Analysis and Modeling Group, Statistics Canada
For Our Eyes Only: The Importance of Record Linkage in Health Research

2000:  Peter Ubel
Department of Medicine and Program on Medical Decision Making, University of Michigan
The Unbearable Rightness of Bedside Rationing

1999:  Colleen Flood
Faculty of Law, University of Toronto
Reinventing Health Care: A Legal, Economic and Political Analysis of Reform in New Zealand and Canada

1998:  Lisa Bero
Department of Clinical Pharmacy and Institute for Health Policy Studies, University of California, San Francisco
Evidence-based Policy: Oxymoron or Just Plan Moronic?

1997:  Mandy Ryan
Health Economics Research Unit, University of Aberdeen, Scotland
Assessing the Benefits of Health Interventions: A Role for Conjoint Analysis?

1996:  Jane Weeks
Dana-Farber Cancer Institute and Harvard Medical School
Outcome Measures in Oncology: A New Paradigm for Patient Care and Clinical Research

1995:  Peter Singer
Centre for Bioethics and Department of Medicine, University of Toronto
Living Wills: From Legislatures to Living Rooms

1994:  Steven Katz
Departments of Internal Medicine and Health Care Management and Policy, University of Michigan
Learning from Canada/U.S. Health Care Comparisons: Can a River Flow in Two Directions?

1993:  Alayne Mary Adams
Harvard Centre for Population and Development Studies
The “Black Box” Between Intervention and Outcome: Exploring the Dynamics of Health Change

1992:  Andrew M. Jones
Econometrics and Social Studies, University of Manchester, UK
Starters, Quitters, and Smokers: Choice or Addiction?