Treating trauma focus of medical marijuana firm

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Veterans Affairs urged to better manage drug plan, marijuana costs

Post by Trooper on Wed 04 May 2016, 15:28

The federal auditor general is urging Veterans Affairs Canada to step up efforts to secure lower drug prices and look for ways to control spending on medical marijuana.

The auditor general’s latest report, tabled Tuesday in the House of Commons, found the department doesn’t have an adequate process in place for making evidence-based decisions related to its drug benefits list, nor does it have procedures in place to help ensure its formulary review committee systematically reviews evidence to support decisions about changes to the list.

Read: Drug plan trends report: How drug plans are addressing skyrocketing costs

The report set out four recommendations. The first is that the department explore ways to contain the costs of medical marijuana because Veterans Affairs’ expenditures have risen significantly since new regulations by Health Canada took effect in 2013.

Medical marijuana has become the highest-cost item paid for under the drug component of Veteran Affairs’ benefits program, according to the report, and the department expects expenditures could reach $25 million in the 2016-17 fiscal year — almost a third of the drug costs under the plan.

The department has been covering the costs of medical marijuana for the past seven years and advised the auditor general that it covered only the amount recommended by a physician or medical professional. More specifically, it has approved coverage for 10 grams per day, per veteran, which the auditor general says is double the amount identified as being appropriate in Veterans Affairs’ consultations with external health professionals, and three-times the amount Health Canada has reported as being commonly used by individuals for medical purposes.

The department has agreed to implementing a policy to contain the costs. In fact, Veterans Affairs Minister Kent Hehr said in a statement he requested a departmental review about six weeks ago to assess how the department provides marijuana for medical purposes as a benefit to veterans.

“We will use the results of the review, as well as information gathered from our consultations, to provide options which will ensure the ongoing health, safety and well-being of our veterans,” he added. “I look forward to providing an update on the review in the coming months.”

In relation to the auditor general’s findings on medical marijuana, Mike Blais, president and founder of Canadian Veterans Advocacy, calls the report “a generalized statement that affects doctor-client confidentiality. [It] doesn’t know why they are being prescribed or what they’re being prescribed.

“When we talk to cost, where was the government when [it] initiated this program, when it said it was OK for these growers to start production in Canada for medical marijuana? Every other pharmaceutical product that Canadians are provided have some form of regulatory control on it and a reference price.

“This is a viable, non-narcotic alternative that has worked very effectively on a scientific-test base, that is uncontaminated by politics and not contaminated by an illegal market. It’s disingenuous for us to be victims of this when the government should have been front and centre when [it] brought this in in 2008, defining what the cost would be.”

Another recommendation is that Veterans Affairs should periodically review whether strategies are leading to reduced costs for drugs and pharmacy services. The auditor general found that despite Veterans Affairs Canada’s entry into agreements with pharmacy associations in British Columbia and Saskatchewan, it continued to benefit from the agreed-upon reductions even through its deal with B.C. had expired in 2012.

In response, Veterans Affairs says it will bring in regular assessments and reviews of its formulary in addition to looking at strategies used by other drug plans. It also said it has begun working with other federal organizations and the pan-Canadian Pharmaceutical Alliance to explore opportunities.

The auditor general is also recommending that Veterans Affairs develop a well-defined approach to drug-use monitoring to help it manage its drug benefits program.

The report said the department had directed its provider, Medavie Blue Cross, to monitor claims data for high-risk use patterns for some drugs, such as narcotics and sedatives. However, the auditor general found the department hadn’t documented the direction it provided to Medavie. It also hadn’t directed Medavie Blue Cross to monitor and report regularly on trends in the drugs that veterans commonly use, such as antidepressants and non-steroidal anti-inflammatory drugs.

Veterans Affairs has agreed to enhancing its drug-use monitoring process. “Accordingly, the department intends to develop an efficient approach, governance structure and oversight to establish safeguards, monitor trends and determine potential risks that could affect the health and well-being of its veteran population,” according to the report.

The final recommendation from the auditor general is for Veterans Affairs Canada to implement a decision-making framework to decide which drugs to pay for and to what extent.

In response, Veterans Affairs has said it will implement the recommendations by May 2017. “We will act to implement each of these recommendations to make sure the health-care benefits program is efficient and effective for those using it,” said Hehr in a statement.

“We will also work to improve the delivery system in our department, across the government, and in partnership with the regulated health professionals who provide direct care to our veterans.”

Veterans Affairs Canada’s health-care benefits program provides drug benefits for eligible veterans, some of whom have complex health needs such as mental-health conditions, according to the report. In the 2014-15 fiscal year, the drug component of the benefits program covered drugs for roughly 51,000 veterans at a cost of $80 million.

http://www.benefitscanada.com/news/veterans-affairs-urged-to-better-manage-drug-medical-marijuana-costs-80819
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Re: Treating trauma focus of medical marijuana firm

Post by Dove96 on Thu 05 May 2016, 08:20

Thank you Trooper. Lots of good information.

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Re: Treating trauma focus of medical marijuana firm

Post by Panserbjørn on Thu 05 May 2016, 09:32

I have recently gone through the process of getting a medical cannabis prescription while still serving. I went through Marijuana for Trauma. Now 3B as of April 19th. I did not fill the prescription while serving because VAC would not cover it. I then filled the prescription the 2nd of May, purchasing it myself because I did not know how to get it covered by VAC.

Apparently the prescription that was written had the incorrect expected release date. My Licensed Producer actually caught the mistake today and is now putting in for VAC coverage as we speak.

If anyone has any questions, I will answer anything that I can.

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Viewpoint: Clarify pot policy for veterans

Post by Trooper on Fri 06 May 2016, 10:16

Your welcome Dove , more then happy to provide the info.

Thanks for that Panserbjørn and BTW welcome to the CSAT Forum.

Auditor General Michael Ferguson has raised important questions about the increasing use of medical marijuana by Canadian military veterans.

As authorities contemplate enforcement actions and zoning bylaws relevant to marijuana dispensaries, and the federal Liberal government prepares for legalization in 2017, Ferguson is urging the Department of Veterans Affairs to address the amount of medical cannabis being prescribed to veterans. He found the quantity prescribed was “poorly documented” and not always evidence-based.

Ferguson focused more broadly on how Veterans Affairs has been managing drug benefits for former servicemen and women, some of whom have complicated health issues and suffer from mental health conditions such as post-traumatic stress disorder. The AG made it plain that it’s time to cut through the haze and clarify marijuana policy for veterans.

The core problem rests with the amount of cannabis veterans are authorized to take. In 2014, Veterans Affairs doubled the amount to 10 grams per day for eligible veterans. Yet, for Health Canada this is twice the amount it considers safe. An internal Health Canada document showed that more than five grams has the potential to increase risks to the cardiovascular, pulmonary and immune systems, as well as psychomotor performance. It has a chance of increasing the risk of drug dependence.

Ferguson’s office could not find any evidence to support this decision to increase the threshold. Veterans Affairs Minister Kent Hehr expressed shock in March that his department lacked an “informed policy” on the use of medical cannabis, even as number of claims by veterans for medical marijuana grew more than tenfold over the past two years.

According to figures provided by Veterans Affairs, 112 veterans were reimbursed for medical marijuana in 2013-14, The following year, it was 628. By March 2016 that number has risen to 1,320.

Mike Blais, president and founder of Canadian Veterans Advocacy, has been abundantly clear about veterans’ consumption of medical marijuana: “I think there should be no cap, and that every case should be judged on individual merit and that the doctor’s prescription is paramount.”

At the same time, Canadian Forces have taken an alternative stand. In 2014, H.C. MacKay who was then the deputy surgeon general of the Canadian Forces, made clear that “with respect to marijuana use for medical purposes, we have identified what appears to be a very significant policy divergence between Veterans Affairs Canada and Canadian Armed Forces.”

In short, even though Veterans Affairs was funding medical marijuana, the military’s health service did not recognize it for medical use. With respect to PTSD, the Canadian Forces have also suggested there is insufficient evidence to authorize marijuana use and could even be detrimental to veterans’ health.

Marijuana remains a highly contested medicine for various scientific, political and social reasons. That is obvious. However, the auditor general report reaffirms how it and the policies surrounding the medical treatments for Canadian veterans require significant clarification.

http://thestarphoenix.com/opinion/letters/0506-edit-richert-view
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Re: Treating trauma focus of medical marijuana firm

Post by Dove96 on Fri 06 May 2016, 10:55

The statistics show an increase of Cannabis for Veterans. I would like to know if there is a study to show if there is a decrease of narcotic or other prescriptions for those same Vets.
Since taking Cannabis for breakthrough pain I no longer take Oxy, Targon or Nabilone. I think that is significant since those medications caused asthma and stomach problems.

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Re: Treating trauma focus of medical marijuana firm

Post by bigrex on Fri 06 May 2016, 12:22

I agree dove, and I would also like to see the average costs associated with each of those replaced prescriptions. I mean if they are going to attack the use of cannabis by Veterans, as if it is costing too much, they also need to show how much it would cost for traditional pharmaceutical treatments.
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Re: Treating trauma focus of medical marijuana firm

Post by teentitan on Fri 06 May 2016, 12:30

I think the biggest question here is name one pharmacutical drug that has been studied by VAC? Also have they ever put a limit on a drug that is prescribed by a doctor?

If they cannot answer either of these questions then why are they questioning MM?

But seeing as this is VAC....one important stat that should be disclosed in the report is how many vets get the max 10g a day. That's all people will see 10g a day is what vets get.
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Re: Treating trauma focus of medical marijuana firm

Post by Panserbjørn on Fri 06 May 2016, 13:30

The problem comes into play when a LP offers rewards for fulfilling your prescription, especially on a point based system. It promotes veterans to completely fill their prescription whether it is needed or not.

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Re: Treating trauma focus of medical marijuana firm

Post by Trooper on Fri 06 May 2016, 16:22

My question would be why are the doctors prescribing 10mg a day when Health Canada says this is twice the amount over what is considered safe for daily use ?
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Re: Treating trauma focus of medical marijuana firm

Post by bigrex on Fri 06 May 2016, 19:01

Health Canada doesn't want it used at all, medically or not. Remember all those TV ads they put out leading up to the election? So even though there is a new health minister, all the same bureaucrats, that were put in place by Harper, are likely still in place. So I would not put it past them to fudge the numbers, or misconstrue data, to suit them.
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High cost of Cannabis

Post by Dove96 on Fri 06 May 2016, 19:43

They would also have to consider the cost of consequential claims for stomach ulcers and other ailments caused by the harsh medications.


Last edited by Dove96 on Sat 07 May 2016, 07:51; edited 2 times in total

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Re: Treating trauma focus of medical marijuana firm

Post by teentitan on Fri 06 May 2016, 22:01

Rex this is a committee put together by Hehr so let's not use the Harper bugaboo bureaucrats that will fudge the numbers ok? Those days are over. Whatever the outcome is it's on Hehr and the Liberals. Afterall aren't they the ones who want to legalize it?
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Re: Treating trauma focus of medical marijuana firm

Post by bigrex on Fri 06 May 2016, 23:05

Yes, it is the Liberals that are in power, now, but we all know how the bureaucrats can bugger up a political agenda when they want to. And right now, a good number of senior bureaucrats were put into place by Harper.
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Re: Treating trauma focus of medical marijuana firm

Post by RCN-Retired on Sat 07 May 2016, 03:10

No, I think the bureaucrats have been in place for a lot longer then Harper. It was not Harper that penned the NVC, let's keep things in perspective problems with VAC and bureaucrats have been in place a very long time and they will stay in place unless one of two things happen.
1. Get rid of a few problematic bureaucrats, or
2. The PM or Hehr grow some stones and give the senior bureaucrats their marching orders with the understanding their jobs are on the line.
Forget all these damn bonuses these guys have been given over the years for screwing us and fix the system now!
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Re: Treating trauma focus of medical marijuana firm

Post by Panserbjørn on Sat 07 May 2016, 10:05

Trooper wrote:My question would be why are the doctors prescribing 10mg a day when Health Canada says this is twice the amount over what is considered safe for daily use ?

My Google-fu is probably lacking. However I could not find anywhere that Health Canada says what is a safe prescription amount, except when specifically talking about THC which they say is 10mg/day. The doctor's are prescribing up to and rarely over the 10g/day of cannabis, or cannabis oil.

Honestly, I would take 10g/day if it meant no pills and no pain. The Sativa variant of cannabis doesn't couch-lock you like the Indica variant. Yet can still be as effective in relieving your pain.

I am only prescribed 1g/day for the first three months because I have never smoked, or used cannabis ever in my life. I notice the pain dissapating while taking medical cannabis, however with only 1g/day that is short lived.

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