Antibiotic Options Available
to Cataract Patients
Dear Cataract Patient,
You have been given a prescription for a 4th generation fluoroquinolone antibiotic in preparation for your medically required cataract operation. I have made the decision to prescribe this drug as it is one of the most effective medications for preventing infection associated with cataract surgery. There are now two 4th generation fluoroquinolone drops available in Canada. The manufacturers of each new drug had submitted their information to the government of BC in the summer of 2004 and I had anticipated that by now PharmaCare would approve and cover these drugs. Unfortunately as of January 15, 2005. PharmaCare still covers only the older 3rd generation fluoroquinolone known as Ocuflox (ofloxacine). We have used Ocuflox for a number of years and although it remains effective it is no longer the best antibiotic at killing bacteria on and in the eye.
The drug manufacturer tells me that the wholesale cost of Vigamox is $12.00 per bottle and the patient price including dispensing fee varies from $18.00 to $27.00 depending upon the dispensing pharmacy.
I understand that when the government refuses to change their formulary to include new and better drugs they deem the drug “NOT TO BE A BENEFIT” and they pay nothing towards its cost. This means that a government bureaucrat rather than your ophthalmologist is choosing your therapy. My recommendation is to use the newer drug however I understand the realities of extra costs. Since PharmaCare has chosen not to cover the 4th generation drug you may use this letter as my authority to ask your pharmacist to substitute Ocuflox (ofloxacine) for the prescribed Vigamox (moxifloxacin hydrochloride). The instructions for use are the same for either antibiotic.
The government’s spin doctors have called their plan “Fair Pharmacare”. If indeed their plan was intended to be fair, two reasonable questions are:
• When a new drug is shown to be scientifically superior for a particular purpose what is a reasonable time period before the government includes the new drug in their “Pharmacare” formulary?
• When the government refuses to accept a new and better drug as a benefit for a medically necessary service why doesn’t the government pay the amount of the older less effective drug leaving the patient to pay only the difference in cost for the better drug?
A cynic might conclude that “Fair PharmaCare” means exactly the opposite and that anyone using the phrase is more interested in restricting patient benefits rather than in securing the best health outcomes for British Columbians!
Should you wish to ask your MLA or Health Minister about their “Fair Pharmacare” plan, I have provided their contact information below.
Yours Sincerely,
Murray McFadden, MD
Contact information for your MLA is available at
http://www.legis.gov.bc.ca/mla/3-1-6.htm
Contact information for Honourable Shirley Bond - Minister of Health Services is available at http://www.gov.bc.ca/healthservices/cont/
The Acting Director of PharmaCare can be contacted at
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