Summary: Prescriptions Reimbursed by NIHB for Diabetes Medications Among Registered First Nations in Canada, 2000–2013
First Nations have a higher burden of diabetes than other Canadians. This report provides information on the use of diabetes medications among First Nations. These findings can help to inform diabetes program planning and evaluation. Data are derived from prescriptions (claims) reimbursed by Health Canada's Non-Insured Health Benefits (NIHB) Program.
About the Non-Insured Health Benefits Program
Health Canada's NIHB Program provides prescription drug benefits to eligible First Nations people and recognized Inuit. Like other benefit management systems, the NIHB Program collects data that are required for program management and administration.
Background
Between 2008 and 2009, almost 2.4 million Canadians (6.8%) were living with diabetes. It is projected that 3.7 million Canadians will be diagnosed with diabetes in 2019. This increase poses a challenge for Canadian health services. Major disease prevention efforts may be needed to avoid this anticipated rise.
First Nations have a higher burden of diabetes than other Canadians. However, national level diabetes surveillance data sources for First Nations populations are limited. This report uses diabetes medication claims data from the NIHB Program (2000 to 2013) in order to support the:
- surveillance of diabetes in First Nations populations
- population health assessment of diabetes among First Nations populations
The information presented follows standards set out for the use of medication claims data for public health surveillance.
Purpose
The purpose of this report is to present information to support the surveillance of diabetes in First Nations populations. These findings can be used to support decision-making in terms of planning, implementation and evaluation of programs and strategies for diabetes prevention.
Main findings
Our main findings and conclusion are framed by important considerations.
Considerations
Medication claims data can and should be used to support reporting on diabetes among First Nations adults. The findings in this report provide information on:
- who has had a prescription (claim) reimbursed by NIHB for diabetes medications
- the types of diabetes medication that are being reimbursed
However, medication claims data do not provide us with the number of people currently living with diabetes. They also cannot tell us whether this number is increasing, decreasing or stabilizing.
It is important to note that our findings are an underestimate of the true prevalence of the disease. This is because not all individuals who are entitled to benefits use the program. Some reasons include:
- their overall state of well-being
- whether they accessed the NIHB Program
- their ability to access and/or use health care services
- their access to prescriptions through other programs or services
- their use of non-pharmacological treatment like diet and exercise
Several factors can influence the number of people with prescriptions reimbursed for diabetes medication, such as changes to:
- diabetes screening and testing practices
- the NIHB Program (who and what is covered)
Findings
The main findings presented in this report are as follows.
- In 2013, approximately 12% of eligible registered First Nations adults using the NIHB Program had a diabetes prescription (claim) reimbursed. Among them, more people had a prescription reimbursed for oral diabetes medications than insulin.
- When we adjusted for age, more females than males had a diabetes prescription reimbursed by NIHB between 2000 and 2013.
Conclusions
Because there are multiple causes of diabetes, comprehensive surveillance of diabetes should utilize information from multiple sources, including from:
- prevalence and incidence
- risk factors
- treatment
- outcomes
The data presented in this document reveal only a fraction of the issue. They do not replace the need for the use and development of other surveillance and health assessment data sources.