CIRS Agenda_2015

HTA and Market Access Programme Research

Canadian HTA/Payer Agency Metrics Assessment Project

As part of her programme of doctoral research, CIRS Research Fellow Dr Nicola Allen investigated Benchmarking Canadian HTA agency and provincial payer decision making.

Prior to the inception of the Common Drug Review (CDR) in 2002, multiple provincial, territorial and federal drug plans performed their own HTA to determine coverage for new drugs. The Canadian Agency for Drugs and Technologies in Health (CADTH) established the CDR to standardise the  Canadian HTA environment by reducing the duplication of HTA and ultimately decrease the time taken for patients to access new and innovative medicines. The CDR is recognised by all provincial and territorial public drug programmes  except Quebec. Institut national d’excellence en santé et en services sociaux (INESSS) is the agency responsible for HTA activities in Québec.

The objectives of the study were to

  • Evaluate impact of the CDR on provincial resources and reimbursement decision making
  • Understand how provincial decision makers use CDR assessment dossiers
  • Identify additional assessments that are not considered for the CDR recommendation required by provinces or for which additional data must be provided
  • Understand how the patient voice is included in the decision-making process

Results of surveys and interviews indicate that when additional information is gathered, this is to supplement the CDR assessment to enable appraisal of the drug in the local context. This can include province-specific data such as: budget impact, consideration of existing formulary benefits and determining positioning in therapy.