MCA removes Oxy from Drug Formulary

The Mohawk Council of Akwesasne passed a resolution on Tuesday that accepted a recommendation from the Akwesasne Non-Insured Health Benefits (ANIHB) program to remove oxycontin from the drug formulary. This removal will take effect on January 1, 2012 with the exception limited only to prescriptions for palliative care patients.

“The MCA is strongly forging forward to continue following the Prescription Drug Abuse strategy that was developed,” said Tsi Snaihne District Chief Karen Loran. “The strategy has been worked on by Chief Rachel Roundpoint, Chief John Adams and myself along with representatives from the Departments of Health, Community and Social Services; Justice, the Ahkwesahsne Mohawk Board of Education and the Akwesasne Mohawk Police Service.”

The MCA has heard concerns from the community and as a result developed a Prescription Drug Abuse Strategy. The ANIHB program made the recommendation for the removal of the drug oxycontin; they administer approvals for payment of prescription drugs listed on the Drug Formulary. After the implementation date payment for oxycontin prescriptions will be reviewed for approval on a case-by-case instance by a team that includes the Family Physician, Pharmacist, Community Health Nurses, Home Care Nurses and the ANIHB.

“We will be working with a case management team in order to bring someone in from each of the different programs within the organization,” said ANIHB Program Manager Cynthia Francis-Mitchell. “We will be making this a formal practice to network the programs within each department to look at not just one aspect of a person’s health but their entire holistic health.”

When a person is prescribed oxycontin it typically is for pain management. The patient starts by being prescribed a non-steroidal anti-inflammatory drug as an interim measure before opiates are considered. With ANIHB program Akwesasne updates their Drug Formulary to match one produced by Health Canada in most instances for medications dealing with monitoring cholesterol, high blood pressure, diabetes and other illnesses. It is up to MCA whether they want to include a prescription drug onto the Drug Formulary and whether they want to use the same guidelines or set theirs to a high standard in order to be prescribed.

In the instance of pain management there are other alternatives available instead of only using drug therapy. The use of massage and physiotherapy are alternatives that can help to rehabilitate some injuries, and there are other services available within the Department of Health programs that can help you access these alternatives.

“In a lot of scenarios there are too many doctors involved and it is hard to keep track of who is prescribing what to the patient,” said Francis-Mitchell. “Developing this case management system is fine tuning the system and is a positive approach to the health team working together.”

Currently the pharmacy located in Kanonhkwastheriio does not carry oxycontin, patients prescribed the drug must find a pharmacy off the territory to fill their prescriptions. This decision to remove the drug from the Formulary does not mean that a person can’t be prescribed it; rather it means that the ANIHB program will no longer pay for the prescription or reimburse the patient for the expense.

“We are all going to try and continue to make sure that the Prescription Drug Abuse Strategy is implemented,” said Chief Loran. “This is to ensure that a proactive approach to each community members’ health needs are being taken.”