Background/Purpose: Medication costs for patients with a rheumatic disease can add up as they may be on numerous and/or costly medications including anti-inflammatory medications, disease-modifying antirheumatic drugs and/or biologic medications. The number of biologic medications available to treat rheumatic diseases has steadily increased over the last decade. Biologic medications generally cost over 10,000 Canadian dollars annually. In Ontario, Canada, the Trillium Drug Program (TDP) funds patients who approximately spend greater than 4% of their after-tax household income on prescription drugs. From 2005 to 2015, the TDP has increased its coverage of medications that cost greater than $10,000 annually, from 20 to 124 medications, respectively.¹ However, the gaps in knowledge about the TDP is not clear among resident physicians and patients. The purpose of the study was to determine what resident physicians and patients know about the TDP.

Methods: This research survey project was approved by the Queen’s University Health Sciences & Affiliated Teaching Hospitals Research Ethics Board. Qualtrics survey software was used to distribute anonymous questionnaires to Queen’s University residents (family medicine and core internal medicine) and patients at a private rheumatology clinic. Two types of patient surveys were completed: a general patient questionnaire and a specific questionnaire for patients on expensive biologic medications.

Results: 50/55 residents have heard of the TDP but only 11/50 residents know how a patient would apply for it. The general patient survey revealed that 18/27 patients have heard of the TDP but only 2/18 patients know how to apply for it. Of these two patients, one patient has applied. The other patient did not think that they would qualify for it and so has not applied. The survey of patients on expensive medications revealed that 3/7 patients have a private drug plan and 6/7 patients have heard of the TDP. All six of these patients have heard of this program through a healthcare professional. 5/6 of the patients know how to apply for the TDP. 4 of these 5 patients has applied to the TDP and one has not as they do not think they need it.

Conclusion: The survey results reveal that resident physicians and patients generally do not know how to apply to the TDP, although they have heard of the program. On the other hand, the patients who are on expensive medications generally do know how to apply to the TDP and have done so. This is likely due to guidance by a healthcare professional. Due to these gaps in knowledge about the TDP, we have created an information sheet to educate patients about the TDP.

Reference:

1. Tadrous M, Greaves S, Martins D et al. Catastrophic drug coverage: utilization insights from the Ontario Trillium Drug Program. CMAJ [Internet]. 2018 Mar 26;6(1):E132-E138. Available from: http://cmajopen.ca/content/6/1/E132.full#ref-18

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/gaps-in-knowledge-about-the-ontario-trillium-drug-program/