New guidelines aimed at cutting back the use of pricey diagnostic imaging, a bulk-purchasing plan for brand-name drugs and a push for more homecare are at the heart of a plan to wrestle down health care costs across the country.
The strategy, crafted by Prince Edward Island Premier Robert Ghiz and his Saskatchewan counterpart, Brad Wall, is slated to be presented Friday at the Council of the Federation meeting in Niagara-on-the-Lake, Ont.
It is meant to build on a previous plan authored by the pair and adopted last year to better co-ordinate between provinces after the federal government encouraged premiers to take the lead on setting national health policy.
"In the long-term, there's a confluence between better care and bending the cost-curve down," Mr. Wall told The Globe and Mail Wednesday.
Unnecessary diagnostic imaging tests – x-rays, ultrasounds and MRIs – have long been cited as a burden on the system. The Canadian Association of Radiologists estimated in 2009 that as many as 30 per cent of CT scans performed are not needed. The premiers propose fixing this by implementing a set of guidelines over the next year that would govern when patients should be referred for the tests and when they should not.
The guidelines, which will be drawn up with the help of diagnostic imaging professionals, will focus in particular on imaging for back pain and minor head trauma.
"It's really about making sure that we work with our health care professionals so that we're not implementing tests that don't need to be done," Mr. Ghiz said in an interview. "And there could be a huge savings there, because sometimes we just order tests or people ask for tests, but if we put together a set of guidelines that all health care providers follow, then it will lead to more appropriateness of care."
The premiers' push for the provinces to team up to buy brand name drugs en masse is an expansion of a program they put in place last year. Those measures saw every province and territory, excluding Quebec, get better deals on six generic drugs by purchasing them together. In total, they saved some $100-million.
On Friday, Mr. Ghiz and Mr. Wall are expected to announce between seven and 12 brand-name pharmaceuticals that will be added to the plan. The move, which should save about $10-million annually, will be trickier than buying generics, as it will likely involve negotiating with pharmaceutical companies.
But Mr. Wall contends that, if the provinces can rally pharmacies behind them, they can see the same success as they did with last year's plan.
"We need to make sure we have our pharmacies on side across the country," Mr. Wall said. "The success we had on prescription drugs ought not be underestimated, because it's unprecedented."
The push for seniors' care is the longest-term component of the plan. It calls for provinces to share ideas on moving seniors out of expensive hospital beds and helping them stay in their own homes longer. One program Mr. Ghiz cites is a system in Nova Scotia that provides home visits from health care professionals in rural areas.
He also wants more help from the federal government to support programs like these through a fund that would pay to develop innovative health care models.
"I hope it's going to be on the agenda in the 2015 election and it will hopefully lead to more dialogue in the future," he said. "An innovation fund around seniors' care in this country – I think if you were a smart federal party, you would have that in your platform in 2015."