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Research suggests links between universal drug coverage and reduction in deaths from diabetes

Toronto, August 13, 2012

By Leslie Shepherd

Dr. Gillian Booth
Dr. Gillian Booth

Universal drug coverage may reduce the number of deaths from diabetes and its complications, new research suggests.

The study by researchers at St. Michael's Hospital and the Institute for Clinical Evaluative Studies found that low-income Ontarians under 65 have a 51 per cent higher risk of dying from diabetes than those with higher incomes.

The gap between rich and poor is substantially reduced at age 65, when drug costs are subsidized through a provincial drug benefit program.

"Our findings suggest that prescription drug coverage may be one of many strategies that could potentially help to close the gap in health between rich and poor," said Dr. Gillian Booth, an endocrinologist and researcher at St. Michael's and lead author of the study published online in the journal Diabetes Care today.

"From our observations, as many as 5,000 deaths and nearly 2,700 heart attacks of strokes could have been avoided among younger and middle-age adults with diabetes if the gap between wealthier and poorer individuals had been identical to that seen among older groups," said Dr. Booth, who is also an adjunct scientist at ICES.

The study was based on the administrative health claims records of more than 600,000 Ontarians with diabetes between 2002 and 2008. It found that socioeconomic status, based on median household incomes from the 2001 Canadian Census, was a strong predictor of death and nonfatal heart attack or stroke among those under 65.

One year after a heart attack, younger individuals in the lowest income category had 33 per cent higher rates of death compared to those of the same age in the highest income category, the study found.

Although not measured directly in the study, Dr. Booth said the findings suggest that universal prescription drug coverage could potentially help bridge the gap in cardiovascular risk and death between rich and poor groups with diabetes.

Recent research suggests that low-income groups without adequate insurance coverage are more likely to restrict their use of prescription drugs because of costs, which have risen significantly over the last decade. Lower income groups already share a disproportionate burden of diabetes and experience more complications from diabetes.

Diabetes rates in Ontario have doubled in the last 12 years, with one in 10 people now being diagnosed with the disease and one in four adults over 65 living with it. The Canadian Diabetes Association forecasts that with the aging population and dramatic rise in obesity, one in four Ontarians will live with diabetes by 2020.

Dr. Booth's study was undertaken as part of the POWER (Project for an Ontario Women's Health Evidence-Based Report) Study, a comprehensive overview of women's health and health care in relation to income, education, ethnicity and geography.

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Center, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.