Cargando…

Health Technology Assessment Process for Oncology Drugs: Impact of CADTH Changes on Public Payer Reimbursement Recommendations

Public reimbursement systems face the challenge of balancing provision of needed treatments and the reality of limited resources. Canada has a complex system for drug approval and public reimbursement, with jurisdiction divided between the federal government and the provinces/territories. A pivotal...

Descripción completa

Detalles Bibliográficos
Autores principales: Binder, Louise, Ghadban, Majd, Sit, Christina, Barnard, Kathleen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947453/
https://www.ncbi.nlm.nih.gov/pubmed/35323327
http://dx.doi.org/10.3390/curroncol29030127
_version_ 1784674442852433920
author Binder, Louise
Ghadban, Majd
Sit, Christina
Barnard, Kathleen
author_facet Binder, Louise
Ghadban, Majd
Sit, Christina
Barnard, Kathleen
author_sort Binder, Louise
collection PubMed
description Public reimbursement systems face the challenge of balancing provision of needed treatments and the reality of limited resources. Canada has a complex system for drug approval and public reimbursement, with jurisdiction divided between the federal government and the provinces/territories. A pivotal role is that of health technology assessment (HTA), which relies primarily on health economic principles to analyze the value of drugs on a population health basis and make recommendations about public reimbursement. The Canadian Agency for Drugs and Technologies in Health (CADTH) provides recommendations to all provinces but Quebec. This article provides an overview of Canada’s approval and public reimbursement pathway, including the role of HTA and the economic principles on which it relies. Starting in late 2020, CADTH reduced the cost per quality-adjusted life year (QALY) threshold, the metric relied upon in making recommendations to public payers. An analysis of all 56 oncology drug final recommendations issued from January 2020 to January 2022 was conducted and confirms this reduction in the cost per QALY threshold. As a result of this threshold reduction, recommendations to the provinces include, in a number of cases, substantially greater price reductions. The potential implications for successful price negotiation with the pan-Canadian Pharmaceutical Alliance (pCPA), the public negotiating body for the provinces, are discussed.
format Online
Article
Text
id pubmed-8947453
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-89474532022-03-25 Health Technology Assessment Process for Oncology Drugs: Impact of CADTH Changes on Public Payer Reimbursement Recommendations Binder, Louise Ghadban, Majd Sit, Christina Barnard, Kathleen Curr Oncol Article Public reimbursement systems face the challenge of balancing provision of needed treatments and the reality of limited resources. Canada has a complex system for drug approval and public reimbursement, with jurisdiction divided between the federal government and the provinces/territories. A pivotal role is that of health technology assessment (HTA), which relies primarily on health economic principles to analyze the value of drugs on a population health basis and make recommendations about public reimbursement. The Canadian Agency for Drugs and Technologies in Health (CADTH) provides recommendations to all provinces but Quebec. This article provides an overview of Canada’s approval and public reimbursement pathway, including the role of HTA and the economic principles on which it relies. Starting in late 2020, CADTH reduced the cost per quality-adjusted life year (QALY) threshold, the metric relied upon in making recommendations to public payers. An analysis of all 56 oncology drug final recommendations issued from January 2020 to January 2022 was conducted and confirms this reduction in the cost per QALY threshold. As a result of this threshold reduction, recommendations to the provinces include, in a number of cases, substantially greater price reductions. The potential implications for successful price negotiation with the pan-Canadian Pharmaceutical Alliance (pCPA), the public negotiating body for the provinces, are discussed. MDPI 2022-03-01 /pmc/articles/PMC8947453/ /pubmed/35323327 http://dx.doi.org/10.3390/curroncol29030127 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Binder, Louise
Ghadban, Majd
Sit, Christina
Barnard, Kathleen
Health Technology Assessment Process for Oncology Drugs: Impact of CADTH Changes on Public Payer Reimbursement Recommendations
title Health Technology Assessment Process for Oncology Drugs: Impact of CADTH Changes on Public Payer Reimbursement Recommendations
title_full Health Technology Assessment Process for Oncology Drugs: Impact of CADTH Changes on Public Payer Reimbursement Recommendations
title_fullStr Health Technology Assessment Process for Oncology Drugs: Impact of CADTH Changes on Public Payer Reimbursement Recommendations
title_full_unstemmed Health Technology Assessment Process for Oncology Drugs: Impact of CADTH Changes on Public Payer Reimbursement Recommendations
title_short Health Technology Assessment Process for Oncology Drugs: Impact of CADTH Changes on Public Payer Reimbursement Recommendations
title_sort health technology assessment process for oncology drugs: impact of cadth changes on public payer reimbursement recommendations
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8947453/
https://www.ncbi.nlm.nih.gov/pubmed/35323327
http://dx.doi.org/10.3390/curroncol29030127
work_keys_str_mv AT binderlouise healthtechnologyassessmentprocessforoncologydrugsimpactofcadthchangesonpublicpayerreimbursementrecommendations
AT ghadbanmajd healthtechnologyassessmentprocessforoncologydrugsimpactofcadthchangesonpublicpayerreimbursementrecommendations
AT sitchristina healthtechnologyassessmentprocessforoncologydrugsimpactofcadthchangesonpublicpayerreimbursementrecommendations
AT barnardkathleen healthtechnologyassessmentprocessforoncologydrugsimpactofcadthchangesonpublicpayerreimbursementrecommendations