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Quebec lowers restrictions on prescribing cholesterol lowering medication

Quebec improves access to some cholesterol treatments, but some options still aren't covered in Ontario

(NC) Quebec patients now have a better access to cholesterol-lowering medication, as the Regie de l'assurance maladie Quebec ruled on December 12 that physicians may now prescribe Lodalis (colesevelam hydrochloride)* without having to fill out a special authorization form.

While the Quebec Government recognizes the value of increasing access to cholesterol-lowering medication, such as Lodalis, the Ontario Government has yet to consider this a priority.

High cholesterol is also a serious problem in Ontario. About 40 per cent of Canadians – that's 5.4 million Ontarians – have high cholesterol, a condition that puts them at risk for circulatory problems, heart disease and stroke.

“High cholesterol is a serious health issue, and it is critical that patients have access to any treatment option that can help them reach target,” says Dr. Alice Cheng, Endocrinologist at Trillium Health Partners and St. Michael's Hospital, and Assistant Professor at the University of Toronto. “We as doctors need to be able to use every tool available, knowing that patients will be able to access them, to optimize care for all Ontarians living with high cholesterol.”

Statins are the standard of care for high cholesterol, but while they are effective for many, up to ten per cent of patients cannot tolerate statins. Furthermore, more than one-in-three (37 per cent) do not reach target cholesterol levels on statin treatment alone, and may require adjunct therapy to achieve lower cholesterol . This means that in Ontario, as many as 2 million Ontarians will not be able to lower their cholesterol sufficiently using only statins.

Access to alternate and adjunct treatment options is also vital for Canadians over the age of 65, as they typically face a more acute prognosis and higher mortality rate for heart disease, can benefit most from treatment, and often financially rely on provincial drug coverage to access much needed medications. While LODALIS is covered under many health insurance plans, 61 per cent of the patient population that might need LODALIS do not have private insurance, making it difficult for them to access the treatment if and when they need it.

“Unmanaged high cholesterol puts patients at risk for serious complications like heart disease and stroke. This is especially true for high-risk patients, like those with diabetes and the elderly,” says Dr. Cheng. “We need to ensure that all Ontarians have access to the treatments they need to manage their high-cholesterol, including statin and non-statin therapies.”

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Sources: Heart and Stroke Foundation. 2012 Statistics. Accessed December 9, 2013. http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.3483991/k.34A8/Statistics.htm#bloodcholesterol

Heart and Stroke Foundation. Getting your cholesterol in check. Accessed December 9, 2013. http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.3484161/

. Rajesh K Nair RK, Karadi RL et al. Managing patients with 'statin intolerance': a retrospective study. The British Journal of Cardiology. May 2008; 16(3): 158–160 Goodman SG, Langer A, Bastien NR, et al. Prevalence of dyslipidemia in statin‐treated patients in Canada: results of the DYSlipidemia International Study (DYSIS). The Canadian journal of cardiology. Nov 2010;26(9):e330‐335.

Goodman SG, Langer A, Bastien NR, et al. Prevalence of dyslipidemia in statin‐treated patients in Canada: results of the DYSlipidemia International Study (DYSIS). The Canadian journal of cardiology. Nov 2010;26(9):e330‐335.

David Fitchett, Kenneth Rockwood. Management of Heart Disease in the Elderly Patient. CCS 2002 conference. http://www.ccs.ca/download/consensus_conference/consensus_conference_archives/2002_ES_final.pdf Accessed December 12, 2013.

Sunlife Canadian Health Index 2013. Accessed December 9, 2013. http://cdn.sunlife.com/static/canada/sunlifeca/About%20us/Canadian%20Health%20Index/Canadian_Health_Index_2013_en.pdf?wt.ac=en-ca:Web:SLF_evergreen:CHI_HP:CHI:2013_Report

TELUS Health Product Coverage Report, Lodalis, October, 2012


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