Grant: Operating Grant: SPOR Innovative Clinical Trial Multi-Year Grant

Canada is the only developed country where people access healthcare services care by doctors for free but more than half of medications are paid for out-of-pocket. We are measuring the effects of providing adult family practice patients with free and convenient access to a carefully selected set of medications. This is a randomized controlled trial. People who have had trouble affording medications are recruited at routine family practice visits. Each person is randomly assigned to either receive usual access to medications or to receive access to a carefully selected set of essential medications without copayments, dispensing fees or deductibles - in other words, "for free" at the point of service. The list of medications to which patients would have access is based on the World Health Organization's model list of essential medicines that everyone in the world should be able to access. The medications will be dispensed through a centralized pharmacy model that involves patients receiving medications via mail. We measure how often people take their medications and how well chronic conditions like high blood pressure and diabetes are controlled. We also assess cost impacts to the healthcare system. We will compare these outcomes between people who have usual access to medications and people who get the essential medications for free. The study is being conducted from family practices throughout Ontario, including northern and rural communities. Patients, community representatives and policy makers have been involved in designing the study, and in developing the program of drug delivery and the communication of our findings. A community guidance panel has helped us design parts of the study. We hope that our involvement of community members in the research process will help improve the involvement of the community in future research studies. The results of this research could led to improvements in medication access for people in Ontario.