Author
Nigel SB Rawson, Ph.D.
Introduction
Health technology assessment has been called the fourth ‘hurdle’ in the process of getting drugs to patients. The impact of pan-Canadian Pharmaceutical Alliance (pCPA) negotiations and Common Drug Review (CDR) recommendations on provincial benefit listings was evaluated to assess whether the pCPA has become another hurdle to new drug access for Canadian patients.
Objective
To investigate the impact of pCPA negotiations and CDR recommendations on the listing of drugs in provincial benefit lists to assess whether the pCPA has become another hurdle to new drug access for Canadian patients.
Methods
Periodically, lists are released of products that (a) have completed joint pCPA negotiations, (b) the pCPA decided not to negotiate, or (c) the pCPA recommended individual provincial negotiations. CDR recommendations for non-oncology products in the pCPA lists available at the end of 2015 were identified and listing rates using the benefit schedules of the nine pCPA provinces and Quebec calculated.
Results
Drugs with pCPA completed negotiations had high listing rates, regardless of their CDR recommendation. Most of the drugs for which the pCPA decided not to negotiate had a negative CDR recommendation and few were listed in the pCPA provinces, but nearly 30% were listed in Quebec. Drugs with individual provincial negotiations had overall listing rates of 60-100%. Since drugs for rare disorders have a higher probability of a negative CDR recommendation, their provincial listing rates were generally lower.
Conclusion
The analysis demonstrates that the pCPA is another hurdle in the ability of Canadians to access new drugs, with the stumbling block appearing to be cost, which particularly impacts patients wanting access to drugs for rare disorders. The results also indicate that the pCPA’s objectives of increasing access to treatment options and improving consistency of coverage criteria across Canada are not being met.
