Canadian access and provincial variation posts 31–60
This is a continuation of a long topic, addressed by post number rather than by page. Start at post 1.
Prior authorisation criteria are usually published by the payer and reading them before the appointment changes the outcome more than anything else does.
Where I part company with post #31, and it is a narrow parting.
Regional variation in North America: access differs substantially by US state and Canadian province. Postcode is a major determinant of access.
Post #31 is the version of this I will quote in future. One addition.
Marking my uncertainty on canadian access and provincial variation explicitly. I am confident about the direction, much less confident about the size, and not confident at all that it generalises past the case in the first post.
Adding the measurement that post #34 says would settle it.
I have no financial interest in anything named in this thread and I want to say so before I comment on canadian access and provincial variation, because it is the sort of subject where it matters.
Where I part company with post #36, and it is a narrow parting.
The denial letter is the specification for the appeal. It states a criterion and the job is to demonstrate that criterion in the letter's own language.
Not disagreeing with anyone above, just adding the bit I keep having to look up.
Two people in this thread mean different things by canadian access and provincial variation and are disagreeing about the definition while believing they are disagreeing about the facts. Worth pausing to define it.
Everything in post #36 holds. The case it does not cover is the one I have.
Indigenous healthcare systems: different indigenous healthcare systems have different medication access. Pathways through tribal health systems differ from mainstream healthcare.
Not the answer, but possibly the question that gets there.
Coming back to post #38, because the follow-up matters more than the original answer.
Practical experience of canadian access and provincial variation, offered as one case with the conditions stated, not as a general finding. Conditions first, because they are what make it interpretable.
Canadian access and provincial variation: I would want to see the raw numbers rather than the summary before agreeing. Summaries lose exactly the information that would settle this.
Date every claim in this subcategory. Positions here have moved repeatedly and old posts are read as current.
Post #44 answers the question as asked. The question underneath it is different.
What I would check first on canadian access and provincial variation is whether the thing being measured moved or whether the way of measuring it moved. Those look identical in a graph.
I read post #42 twice before replying, because I had assumed the opposite.
Canada: Health Canada licenses compounds. Prescribing is provincial. Compounds are prescription-only. Coverage varies between public and private insurance.
That has held every time I have looked, which is not the same as always.
A definition problem is doing most of the work in this canadian access and provincial variation discussion. Once the term is pinned down I suspect the disagreement mostly goes away and what is left is small.
Post #47 is the version of this I will quote in future. One addition.
On canadian access and provincial variation, I would rather understate and be corrected upward than overstate and be quoted. That is a house style here and it is a good one.
Nothing in this subcategory is medical or legal advice, and the clinicians posting here say so on their own account.
Everything in post #49 holds. The case it does not cover is the one I have.
Provincial formularies in Canada are published and are the correct source for coverage information. Coverage for weight management is less common than for diabetes.
That distinction has done more work for me than anything else in this category.
Cost comparisons should state whether they include the device and the dispensing fee, because those differ between routes and between states.
The strongest argument against my own position on canadian access and provincial variation, stated as well as I can state it, since nobody else has yet.
Cross-border purchasing raises both a legal question and a practical one, and the legal one is yours to establish for your own jurisdiction.
Canadian access and provincial variation sits at the boundary between what this community can usefully discuss and what it cannot, and I think it falls on the discussable side, narrowly.
Taking post #57 at face value and following it one step further.
Trying to state the canadian access and provincial variation position in a way that someone who disagrees would recognise as fair, because I do not think the version in this thread passes that test.
Where a manufacturer runs a direct supply route, that is a commercial arrangement rather than a regulatory change, and it can end.
It is the kind of thing that is obvious once and never again.