Faculty
Schulich School of Medicine & Dentistry
Supervisor Name
Dr. Shehzad Ali
Keywords
CADTH, pCODR, methodological limitations, reimbursement, pharmacoeconomic submissions
Description
Cancer is the leading cause of death in Canada, carrying a mortality rate of 1 in 4 Canadians. As new therapeutic options are developed, high drug costs place a huge burden on patients and the healthcare system. Due to budget limitations, not all pharmaceuticals can be publicly funded, so difficult decisions must be made for which drugs are funded and in what contexts. The pan-Canadian Oncology Drug Review (pCODR) evaluates submissions for new oncological pharmaceuticals to make reimbursement recommendations. Comprehensive analyses assessing limitations in recent oncology drug submissions have not yet been performed. The objective of this project, therefore, was to characterize common limitations in recent oncological drug submissions and to determine the impacts of their reanalyses on the incremental cost-effectiveness ratio (ICER). Oncological pharmaceutical appraisals for which pCODR generated a final recommendation in 2019, 2020, and 2021 were included (n= 64). An extraction form was created with 18 categories for grouping of limitations. Limitation frequencies and effects of pCODR’s reanalyses on ICER (in $/Quality Adjusted Life Year (QALY)) were extracted. The most commonly identified limitations pertained to extrapolation and costs. Reanalyses for limitations pertaining to natural history characterization/model structure, comparators, and duration of treatment effect resulted in the greatest median impacts on ICER. Recognizing common limitations and assessing their impacts on ICER can assist in improving the quality of future drug submissions. It can help to ensure that CADTH receives robust submissions for which they can efficiently and accurately make reimbursement recommendations. Furthermore, such characterizations can inform potential adjustments to be made to existing guidelines to assist drug manufacturers in avoiding common limitations in their submitted models.
Acknowledgements
Thank you to Dr. Shehzad Ali, the Western USRI program, and the Schulich School of Medicine & Dentistry for this opportunity as well as their ongoing support and guidance throughout this project.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Document Type
Poster
Methodological challenges in pharmacoeconomic submissions for cancer drug reimbursement in Canada from 2019-2021
Cancer is the leading cause of death in Canada, carrying a mortality rate of 1 in 4 Canadians. As new therapeutic options are developed, high drug costs place a huge burden on patients and the healthcare system. Due to budget limitations, not all pharmaceuticals can be publicly funded, so difficult decisions must be made for which drugs are funded and in what contexts. The pan-Canadian Oncology Drug Review (pCODR) evaluates submissions for new oncological pharmaceuticals to make reimbursement recommendations. Comprehensive analyses assessing limitations in recent oncology drug submissions have not yet been performed. The objective of this project, therefore, was to characterize common limitations in recent oncological drug submissions and to determine the impacts of their reanalyses on the incremental cost-effectiveness ratio (ICER). Oncological pharmaceutical appraisals for which pCODR generated a final recommendation in 2019, 2020, and 2021 were included (n= 64). An extraction form was created with 18 categories for grouping of limitations. Limitation frequencies and effects of pCODR’s reanalyses on ICER (in $/Quality Adjusted Life Year (QALY)) were extracted. The most commonly identified limitations pertained to extrapolation and costs. Reanalyses for limitations pertaining to natural history characterization/model structure, comparators, and duration of treatment effect resulted in the greatest median impacts on ICER. Recognizing common limitations and assessing their impacts on ICER can assist in improving the quality of future drug submissions. It can help to ensure that CADTH receives robust submissions for which they can efficiently and accurately make reimbursement recommendations. Furthermore, such characterizations can inform potential adjustments to be made to existing guidelines to assist drug manufacturers in avoiding common limitations in their submitted models.