Author
Brett J Skinner, Ph.D.
Introduction
Like several other countries around the world, Canada has a quasi-regulatory process of health technology assessment (HTA) to evaluate the cost-effectiveness of new drugs and medical devices, in order to make evidence-based recommendations regarding reimbursement of these medical technologies by the publicly funded health care system. The number of experts and the type of expertise employed by HTA agencies varies by jurisdiction.
Objective
To compare the supply of expertise employed by the various HTA advisory committees in Canada relative to the United Kingdom and Australia; and relative to the demand for expertise.
Data
Biographical data on the members of six HTA advisory committees were obtained from: the Canadian Common Drug Review (CDR) Canadian Drug Expert Committee (CDEC), the pan-Canadian Oncology Drug Review (pCODR) pCODR Expert Review Committee (pERC), the Institut national d’excellence en santé et en services sociaux (INESSS) Comité scientifique d’évaluation des médicaments aux fins d’inscription (CSEMI); the UK’s National Institute for Health and Clinical Excellence (NICE) Technology Appraisal Committees (TAC), the Scottish Medicines Consortium (SMC) New Drugs Committee (NDC); and Australia’s Pharmaceutical Benefits Scheme (PBS) Pharmaceutical Benefits Advisory Committee (PBAC).
Results
Unlike the UK and Australia, Canada lacked any expert medical representation for several therapeutic areas including: haematology, nephrology, urology, rheumatology, orthopaedics, psychiatry and infectious disease; and lacked any integrated expert representation from the pharmaceuticals industry. The representation (i.e. current supply) of medical expertise in Canada does not match the therapeutic distribution of submissions received by the CDR (i.e. retrospective demand) nor of new drugs in the development pipeline (i.e. prospective demand).
Conclusions
The analysis suggests that there are representation gaps on Canada’s HTA advisory committees.
