Health care and the election
By Letter to the Editor on March 26, 2019.
If you want to educate yourself about the status of our health-care system prior to our upcoming election, I suggest you focus on one word – sugammadex. If you educate yourself about this one drug you can gain perspective on how patient-centeredness, responsible stewardship, professionalism, collaboration, transparency, honesty, and individual risks within the health-care system translate to you. You can start by Googling albertadoctors.org/leaders-partners/leaders/sections/section-members/anesthesia and contacting the anesthesia section of the Alberta Medical Association. Then I suggest, in light of the upcoming election, you ask your MLA what they understand the issues are and what their positions are. Dr. Scott A. Lang Calgaryt 7-6
Yes, it is unfortunate that you as an anaethetist are not allowed to use this because of the expense. At approximately $100 /dose, two questions must be asked. How can Alberta afford it, and how many patients would experience better surgical outcomes with shorter hospital stays. If an accurate ( not biased) statistical model can predict a benefit for all (tax payers and patients alike) then it is a drug worth funding.
Thank you for your comments. I find myself at a disadvantage not knowing anything about you so some of my comments may require further details. My intent is to inform and provide my personal opinion – not to offend. In response to your comments:
– Sugammadex is more expensive than traditional alternatives. Cost-effectiveness has been assessed by many internationally reputable organizations and via the literature. Alberta is the only jurisdiction in the developed world in which sugammadex is not available – even in a restricted manner that supports responsible stewardship. What is magical about Alberta?
– The main points in the letter are to focus on patient-centeredness, responsible stewardship, professionalism, collaboration, transparency, honesty, and individual risks within the health-care system as they translate to you. You seem to know a little about sugammadex. The vast majority of people know little – including some anesthesiologists (the Canadian spelling). How is that transparency or patient-centeredness? AHS has made an executive decision not to make sugammadex available despite recommendations from its own subject-matter experts and the anesthesia section of the Alberta Medical Association claiming it is concerned about cost and anesthesiologists cannot be trusted to be responsible stewards. The drug has been available since 2016 – lots of time to collaborate especially considering it was clear it was coming down the pipeline for a decade or more before. How is that consistent with professionalism and collaboration? How is a lack of awareness consistent with patient-centeredness, honesty, and allowing patients to participate in decisions that affect their care? As far as costs are concerned, again, there is no transparency from either AHS or Merck. Costs can be adjusted in many ways. There is no doubt in the minds of subject matter experts worldwide that sugammadex can be used in a cost-effective manner and that, regardless, it should be immediately available at the point-of-care for special situations. Finally, if Alberta wishes to claim high moral ground by linking its decision to saving the public from unnecessary costs why has it not collected data to support its decision and publish it so the entire world can learn from a unique situation? It has had over 3 years to do that and would have been, in my mind, the professional and ethical thing to do. From my perspective Alberta has taken a dangerous path enabled by the fact that sugammadex is a drug which few people know about and even fewer people care about and, therefore, it is easy to ensure a lack of awareness and generate false facts. The bottom line, at the very least, is that patients suffer. I have no doubt about that. Remember, sugammadex is only one drug – a drug I am intimately familiar with. There are many more in the same situation.