Certainly, as Andre Picard points out (Bid to scrap drug watchdog is mean-spritied and unjustified, May 29), the B.C. Pharmacare program has cut its budget through use of therapeutic substitution and other measures emanating from the Therapeutics Initiative. However, these practices often result in enormous costs to the health care system, including increased physcian visits and hospitalizations, for example. Policies which involve switching stable patients to the cheapest drug assume that every person responds equally to a drug, which is not the case, with sometimes disasterous results. This is punitive to the citizens of B.C., who instead of being "healthier, wealthier and wiser" as Picard claims, suffer from a lack of timely access to the right drugs. Far from a "gem of Canadian public policy", the Therapeutics Initiative is a driver of myopic, regressive policies which only take the price of a drug into account.
--Lynn Macdonald, Kelowna, B.C.; Member, Best Medicines Coalition

In 1985 we moved our young family from BC to NB. Two of our three children were born in Kamloops and BC has always retained a place in our hearts. Diagnosed in 1983 with Rheumatoid Arthritis made life challenging but I was lucky and was able to achieve a remission. 1987 saw the disease return with a vengeance. Thanks to an excellent health insurance policy, I am able to access the medications my specialist prescribes. In following the recent debate on the Therapeutic Initiative, if I lived in BC and was dependent on the public plan, my treatment would be chosen by a government focused on cost-containment and not a Rheumatologist, whose prime concern is my best health outcome. The costs of under treating Rheumatoid Arthritis far surpass the price of even the most expensive medication to treat the disease. What keeps me awake at night is that the BC policies could be far reaching, even to the opposite coast of Canada to NB.

Linda Wilhelm
Midland, Kings Co., NB