2.1 Scope and Objectives
The review encompassed Veterans receiving reimbursements of MMP between 2008 and March 31, 2016. The data provided background information and included 2015-16 population data from which a file review sample was drawn. The MMP data included Canadian Armed Forces (CAF) and war service members only, Royal Canadian Mounted Police (RCMP) members were excluded.
The objectives of this review were as follows:
- To provide a recipient profile (i.e., demographics, costing, usage, etc.);
- To assess VAC's internal governance and compliance with applicable departmental policies and guidelines, as well as administrative processes;
- To identify any gaps particularly in the area of Veteran health, safety and well-being; and
- To review the benefits, services and programs that the Department is providing to Veterans in receipt of marijuana for medical purposes.
2.2 Methodology
| Methodology | Source |
|---|---|
| Interviews | Conducted interviews with staff at VAC Head Office and area offices, and Medavie Blue Cross (third-party contractor). The purpose of the interviews was to obtain an understanding of the history of senior management decisions, the approval process, the collection and use of data and reports, and to learn about current treatments and alternative treatments. |
| Documentation Review | Reviewed Health Canada Regulations,, VAC guidance documents, business processes, reports, briefing notes, and available research in regards to marijuana for medical purposes. |
| Data Analysis | Analysed Client Service Delivery Network and health claims processing data to create a recipient profile; to review the benefits and services being provided to Veterans in receipt of MMP and to identify any gaps in the area of well-being. |
| File Review | Assessed compliance with applicable guidelines and business processes. Reviewed a random sample of 50 authorizations of MMP. |
Limitation
The lack of a complete Veteran health profile and MMP usage presents a limitation on the review team’s data analysis. VAC collects health related information in relation to VAC programs and benefits. However, VAC does not collect data on recipients' health problems, health system utilization and health practices outside its own benefit data. For example, there is no data on family physician and other types of physician visits, emergency department visits, or in-patient hospital service use.
Conclusive evidence for the safe and effective use of MMP is limited. Clinical trials are difficult to conduct as marijuana is an illegal substance in many countries. As new information emerges, VAC continues to monitor and evaluate MMP.