Timeliness of the Oncology Drug Review Process for Public Funding in Canada

Younis, Tallal; Skedgel, Chris

doi:10.3747/co.24.3825

Cited by 3 publications

(2 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While it is known that the provincial and territorial payers base their funding decisions on the pCODR review, jurisdictional priorities, budget impacts, and program mandates [8], the factors most associated with funding decisions and timeliness are unknown [9][10][11]. To better understand the factors associated with positive funding decisions and timeliness, we investigated the determinants of the cancer drug funding process in Canada including the pCODR recommendation, list price, tumor type, and agent class.…”

Section: Introductionmentioning

confidence: 99%

Determinants of the Cancer Drug Funding Process in Canada

et al. 2022

View full text Add to dashboard Cite

Background: Canada has a publicly funded healthcare system with a complex drug funding process. After Health Canada approval to market a drug, the pan-Canadian Oncology Drug Review (pCODR) (now renamed the CADTH reimbursement review) makes a non-binding funding recommendation to the Canadian provinces (except Quebec), which each then decide whether the drug will be publicly funded. We identified the determinants of funding in this process. Methods: We analyzed drugs for advanced lung (n = 15), breast (n = 8), colorectal (CRC) (n = 7), melanoma (n = 10), and neuroendocrine (NET) (n = 3) cancers undergoing the funding decision process from 2011 to 2019. Determinants of funding assessed in the model included list price, cancer type, drug class, and pCODR recommendation. The primary outcome was the correlation between list price and time to funding (TTF: Health Canada approval to first provincial funding). Secondary outcomes included an exploratory analysis of predictors of drug funding. Results: We analyzed 43 drugs: targeted agents 72%, immunotherapy 20%, chemotherapy 7%. A total of 72% were funded in at least one province. Median TTF was 379 days (IQR 203–601). Median list price (28-day course) was CAD 8213 (IQR CAD 5391–9445). Higher list price was not correlated with TTF (correlation coefficient −0.20, p = 0.28). There was no association between list price and pCODR recommendation or the decision to fund in at least one province. A positive pCODR recommendation correlated with the provinces’ funding decisions (p < 0.001), where 89% of drugs with a positive recommendation were funded and 100% of drugs with a negative recommendation were not funded. Tumor type was predictive of TTF (p < 0.001): CRC drugs were the slowest at a median of 2541 days (IQR 702–4379), and NETs were the quickest at a median of 0 days (IQR 0–502). Cancer type predicted decision to fund in at least one province (p = 0.005), with funding for 100% of NET drugs at the high end and 29% of CRC drugs at the low end. Drug class was predictive of TTF (p = 0.01): 465 days (IQR 245–702) for targeted agents, 443 days (IQR 298–587) for chemotherapy, and 339 days (IQR 164–446) for immunotherapy. Conclusions: Determinants of drug funding included cancer type, drug class, and pCODR recommendation but not list price. Factors other than cost were more heavily weighted in the funding decisions of cancer drugs in Canadian provinces.

show abstract

Section: Introductionmentioning

confidence: 99%

Determinants of the Cancer Drug Funding Process in Canada

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Once a file is submitted to Health Canada, it may take up to one year to obtain approval, depending on the type of regulatory submission filed [1]. Subsequently, oncology drugs undergo health technology assessment (HTA), either by the Institut National d'Excellence en Santé et en Services Sociaux (INESSS) in Quebec or by the Canadian Agency for Drugs and Technologies in Health (CADTH) for the rest of Canada [2][3][4]. These bodies provide information on the clinical and economic evidence about the drug and recommendations to advise provincial decision-makers on funding.…”

Section: Introductionmentioning

confidence: 99%

Novel Therapies for the Treatment of HER2-Positive Advanced Breast Cancer: A Canadian Perspective

et al. 2022

View full text Add to dashboard Cite

The advent of anti-HER2 targeted therapies has dramatically improved the outcome of HER2-positive breast cancer; however, resistance to treatment in the metastatic setting remains a challenge, highlighting the need for novel therapies. The arrival of new treatment options and clinical trials examining the efficacy of novel agents may improve outcomes in the metastatic setting, including in patients with brain metastases. In the first-line setting, we can potentially cure a selected number of patients treated with pertuzumab + trastuzumab + taxane. In the second-line setting, clinical trials show that trastuzumab deruxtecan (T-DXd) is a highly effective option, resulting in a shift from trastuzumab emtansine (T-DM1) as the previous standard of care. Moreover, we now have data for patients with brain metastases to show that tucatinib + trastuzumab + capecitabine can improve survival in this higher-risk group and be an effective regimen for all patients in the third-line setting. Finally, we have a number of effective anti-HER2 therapies that can be used in subsequent lines of therapy to improve patient outcomes. This review paper discusses the current treatment options and presents a practical treatment sequencing algorithm in the context of the Canadian landscape.

show abstract

Conditional Funding Recommendations for Drugs in Canada: A Cross-Sectional Analysis

Graili¹

2023

Appl Health Econ Health Policy

View full text Add to dashboard Cite

Timeliness of the Oncology Drug Review Process for Public Funding in Canada

Abstract: -

Cited by 3 publications

References 5 publications

Determinants of the Cancer Drug Funding Process in Canada

Determinants of the Cancer Drug Funding Process in Canada

Novel Therapies for the Treatment of HER2-Positive Advanced Breast Cancer: A Canadian Perspective

Conditional Funding Recommendations for Drugs in Canada: A Cross-Sectional Analysis

Contact Info

Product

Resources

About