COMPUS Overview Denis Bélanger Heather Bennett Steve Graham SECRET COMPUS Overview Denis Bélanger Heather Bennett Steve Graham COMPUS Expert Review Committee Orientation March 28, 2007

COMPUS structure COMPUS Optimal Therapy Outreach & Interventions Elaine MacPhail, Program Advisor COMPUS Barb Shea, Vice President Optimal Therapy Outreach & Interventions Denis Bélanger, Director Topics and Reseach Heather Bennett, Manager Optimal Practices Steve Graham, Director Outreach & Interventions Sandra Rees, Manager Implementation Support

COMPUS Products and Services SECRET COMPUS Products and Services Evidence-based optimal drug therapy information on assigned drugs or drug categories Optimal Therapy Reports Evidence-based intervention tools Optimal Drug Therapy Resources MPUP Collection Interventions Database Academic Detailing Templates COMPUS plays a key role in contributing to evidence-based pharmaceuticals management in Canada by carrying out a number of activities to promote the optimal prescribing and use of drugs. COMPUS Provides: Optimal drug therapy information and supporting tools to help influence prescribing behaviour Resources to provide: a collaborative place to post your optimal drug therapy intervention and find out about other projects across Canada – sign-up and get-in-touch with peers; a publicly accessible “go to” place for evidence on the effectiveness of strategies and tools designed to influence drug prescribing and use. This unique source of evidence about what works to improve prescribing and use will assist decision makers when targeting resources to programs or policies designed to lead to optimal use; A collection of the best examples of Academic Detailing tools to provide a template for anyone considering academic detailing and for those already providing academic detailing 3

Initial priorities for COMPUS SECRET Initial priorities for COMPUS Identified by the F/P/T Pharmaceutical Issues Committee: Why? Large deviations from optimal use (over/under-use) Size of patient population Impact on health outcomes & cost-effectiveness Benefit to multiple jurisdictions Potential to effect change Measurable outcomes Proton Pump Inhibitors (PPIs) Diabetes Management Within each of these two priority areas, a COMPUS Advisory Committee made up of jurisdictional representatives, appointed by the Ministers of Health, identifies drug prescribing and use issues to be addressed by COMPUS. Working in collaboration with the Advisory Committee, COMPUS scopes out the project giving consideration to: availability of evidence availability of a technology infrastructure to measure outcomes timing of potential deliverables feasibility of implementation of initiatives within the jurisdictions linkages to primary care therapeutic controversy Over time, COMPUS will address additional topics based on jurisdictional needs. The Canadian Institute for Health Information (CIHI) reports drug spending (prescribed and non-prescribed drugs) makes up the second largest proportion of health dollars, at almost 18% of the health care budget. This trend is expected to continue. CIHI reported total drug expenditure would reach $24.8 billion in 2005, compared with $16.7 billion five years ago. Prescribed drugs make up 83% of drug spending. Effective use of medicines can improve drug-related health outcomes and patient quality of life. Inappropriate prescribing and/or drug use have been identified as key factors in rising health care costs.

SECRET COMPUS Process COMPUS gathers and incorporates input from a range of stakeholders, including patients and consumers, health care providers, and pharmaceutical manufacturers, throughout various stages of its work. Direction and advice is provided through various channels, including: the COMPUS Advisory Committee (CAC) the COMPUS Expert Review Committee (CERC) stakeholder input and expert advice.

COMPUS Stakeholders Stakeholders Patients and consumers SECRET COMPUS Stakeholders Stakeholders Patients and consumers Pharmaceutical industry Physicians and others who prescribe drugs Pharmacists, nurses, and others who influence medication use Drug plan managers Partners Other Canadian and international agencies with relevant expertise and experience COMPUS is committed to providing all interested stakeholders, partners and clients with opportunity to provide their input into the optimal therapy process. This transparent process provides COMPUS with invaluable information and/or insight.

COMPUS Advisory Committee SECRET COMPUS Advisory Committee Established in 2004, the CAC includes representatives from the F/P/T health ministries and related health organizations Provides advice to the CADTH Board and the COMPUS Directorate on priority areas for optimal drug therapy initiatives, COMPUS activities and products, and other issues

COMPUS Expert Review Committee (CERC) SECRET COMPUS Expert Review Committee (CERC) Established in 2006, CERC is an independent expert advisory body of health and other professionals with expertise in drug therapy and the evaluation of evidence Appointed by, and reports to, the CADTH Board of Directors Makes evidence-based recommendations related to the identification, evaluation and promotion of optimal drug prescribing and use in Canada CERC is made up of eight core members (including six experts and two public members) and typically four specialist experts (for topic specific issues). Public members represent the broad public interest and have the same responsibilities and expectations, and are subject to the same terms and conditions as all members of the committee. Members appointed by the Board Of Directors in February 2007.

SECRET Questions