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

Pooyeh Graili1

  • 1Quality HTA, Oakville, ON, Canada. pg@qualityhta.com.

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PubMed
Summary

The Canadian Agency for Drugs and Technologies in Health (CADTH) frequently issues conditional drug reimbursement recommendations, primarily based on clinical benefit and economic evaluations, to facilitate patient access to new therapies.

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Area of Science:

  • Health Technology Assessment
  • Pharmaceutical Policy
  • Drug Reimbursement Strategies

Background:

  • New drugs undergo assessment by Health Technology Assessment (HTA) agencies like the Canadian Agency for Drugs and Technologies in Health (CADTH) before being listed by drug plans.
  • The increasing number of high-cost drugs and conditional listings has heightened interest in CADTH's conditional recommendations.
  • CADTH's recommendations significantly influence payer decisions regarding drug listing.

Purpose of the Study:

  • To review conditional reimbursement recommendations issued by CADTH.
  • To explore the underlying reasons for CADTH's conditional recommendations.
  • To analyze trends in drug reimbursement criteria over time.

Main Methods:

  • A review of all final drug reimbursement recommendations posted on the CADTH website from January 1, 2003, to January 1, 2022.
  • Categorization of recommendations into 'reimburse,' 'do not reimburse,' and 'reimburse with criteria/condition(s)'.
  • Descriptive analysis of extracted variables, focusing on the characteristics and reasons for conditional recommendations.

Main Results:

  • Out of 785 relevant completed recommendations, 66.6% were 'reimburse with criteria/condition(s)'.
  • The most common conditions were 'clinical criteria' (96.2%), 'cost-effectiveness improvement' (26.4%), and 'treatment cost not exceeding alternatives' (23.6%).
  • The primary reasons for conditional reimbursement were 'clinical benefit and economic evaluation' (60.8%), with most conditional recommendations citing multiple reasons.

Conclusions:

  • Conditional recommendations by CADTH enable patient access to innovative drugs, even with limited evidence.
  • Clinical criteria are fundamental to CADTH's conditional reimbursement decisions.
  • CADTH has evolved its assessment processes for drug reimbursement over time.