TABLE 3.

Estimated Change in Annual Spending for the Copay and IBD Policies by the Ministry of Health for Users of Prescription Inhalers Over 65 Years of Age (2003 Canadian Dollars)

Expenditure Component	Decrease (−) or Increase (+) in Millions
	Copay Policy			IBD Policy
	95% Low	Base	95% High	95% Low	Base	95% High
Inhaled prescription medications*	−0.264	−1.927	−3.590	−4.436	−6.129	−7.822
Excess emergency CAE hospitalizations†‡	30.464	2.379	5.690	2.039	6.456	11.671
Excess physician visits‡§	0.809	1.512	2.223	3.650	4.884	6.129
Policy development and implementation costs (variable)				0.178	0.198	0.218
Policy development and implementation costs (fixed)	0.014	0.015	0.017	0.316	0.351	0.386
Total	0.095	1.979	4.340	1.747	5.760	10.581
Total (excluding fixed costs)	0.081	1.963	4.323	1.431	5.409	10.195
Total (excluding physician visits)	−0.714	0.467	2.117	−1.903	0.876	4.452

^*Estimated amount spent by the MOH on ingredient costs and dispensing fees for inhaler medications for patients 65 years of age and older, adjusted for inflation to 2003 Canadian dollars.

^†The estimated number of excess emergency CAE admissions was 9.0 per 1000 person-years [copay; 95% confidence interval (CI), −1.8 to 21.5] and 19.2 admissions per 1000 person-years (IBD; 95% CI, 6.1–34.7). There were 55,500 person-years of follow-up time contributed by older chronic inhaler patients during the copay policy, and 45,000 person-years contributed during the first 10 mo of the IBD policy.

^‡The mean cost for CAE admissions in fiscal year 2003/2004 was $6232.

^§The estimated number of excess physician visits was 605 per 1000 person-years (copay; 95% CI, 324–889) and 1476 visits per 1000 person-years (IBD; 95% CI, 1103–1852).

^||The mean observed paid cost per visit day in 2003 was $60.10.