Common Drug Review Recommendations

Rocchi, A.; Miller, Elizabeth; Hopkins, Robert; Goeree, Ron

doi:10.2165/11593030-000000000-00000

Cited by 41 publications

(29 citation statements)

References 22 publications

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“…Once the clinical hurdle had been passed, the agencies behaved differently. In Canada, cost-effectiveness did not influence the recommendation once clinical factors had been taken into account; rather, price remained as one of four statistically significant predictors of a recommendation 15. In the United Kingdom, Devlin et al16 found that cost-effectiveness explained 85% of NICE decisions.…”

Section: Discussionmentioning

confidence: 99%

Oncology drug health technology assessment recommendations: Canadian versus UK experiences

Chabot¹,

Rocchi²

2014

CEOR

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BackgroundCanada has two health technology assessment (HTA) agencies responsible for oncology drug funding recommendations: the Institut National d’Excellence en Santé et Services Sociaux (INESSS) for the province of Québec and the pan-Canadian Oncology Drug Review for the rest of Canada. The objective of the research was to review and compare the recommendations of these two agencies alongside an international comparator – the National Institute for Health and Care Excellence (NICE) in the United Kingdom – with respect to their recommendations records and the influence of clinical and cost-effectiveness evidence on the recommendations.MethodsRecommendations were identified from the three agencies from January 1, 2002 to June 1, 2013. Recommendations were limited to five cancer sites (lung, breast, colon, kidney, blood) and to metastatic/advanced settings. Descriptive analyses examined the frequency of positive recommendations and factors related to a positive recommendation. For each recommendation, only publicly available information posted on the agency website was used to abstract data.ResultsThere was a wide variation in the rate of positive recommendations, ranging from 48% for NICE to 95% for Canada’s national process (among the 74% of its recommendations that were publicly posted). Interagency agreement was low, with full agreement for only six of the 14 drugs commonly reviewed by all three agencies. Evidence of a survival gain was not necessary for a positive recommendation; progression-free survival was acceptable. Different approaches were taken when addressing unacceptable cost-effectiveness. NICE was most likely to yield a negative recommendation on these grounds, whereas Canada’s national process was most likely to yield a positive recommendation with a required pricing arrangement.ConclusionIn this analysis, the primary reason for the observed divergence between agency recommendations appeared to be the availability of mechanisms in each jurisdiction to address cost-effectiveness subsequent to the HTA assessment process. Furthermore, caution is needed when interpreting cross-agency comparisons between HTA agencies, as recommendations may not correspond directly to subsequent funding decisions and actual patient access. This may be a concern, given the high international profile of assessments conducted by the reviewed HTA agencies.

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Section: Discussionmentioning

confidence: 99%

Oncology drug health technology assessment recommendations: Canadian versus UK experiences

Chabot¹,

Rocchi²

2014

CEOR

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“…8 A CADTH official who was involved in setting up the CDR notes that at the time there were concerns with specific new drugs for multiple sclerosis and Alzheimer's disease, which were very expensive and where expert advice varied. 9 In a "myths versus facts" memo (Canadian Agency for Drugs and Technologies in Health 2011), CADTH responds by arguing there is little difference in cost between drugs that are recommended for listing compared to those that are not recommended; this has been supported by independent research (Rocchi et al 2012).…”

Section: Goals Of the Reformmentioning

confidence: 99%

“…This issue is mentioned in a variety 32 Interview with an expert committee member. 33 Interviews with an expert committee member, a former expert committee member and Torrance. of studies that note limited clinical data is an important predictor of a "do not list" recommendation (Clement et al 2009;Rocchi et al 2012). When it was designed, the CDR addressed shortcomings in drug assessment under the Canadian guidelines regarding limited uptake and the need for greater transparency.…”

Section: Analytical Comparisonmentioning

confidence: 99%

Evaluating the Cost-effectiveness of Pharmaceuticals in Canada

Boothe

2016

HRO-ORS

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“…Biologics are particularly effective at controlling the symptoms of PsA and have been shown to delay disease progression in terms of joint erosion [1]. However, these treatments are expensive, and within resource constrained systems, their value for money has been assessed by health technology assessment (HTA) agencies to determine whether they should be approved for reimbursement in public health care systems [2–4]. Many HTA agencies require robust evidence demonstrating that a drug therapy is cost-effective, as well as clinically effective, to receive a positive reimbursement decision [5].…”

Section: Introductionmentioning

confidence: 99%

Evaluating the cost-effectiveness of biologic treatments for psoriatic arthritis: can we make better use of patient data registries?

et al. 2017

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The primary aim of this study is to explore the extent to which registry data may fulfill the evidence requirements of cost-effectiveness analysis (CEA) studies evaluating biologic therapies for the treatment of psoriatic arthritis (PsA), where trial data are lacking or insufficient. In addition, the paper aims to identify how future data collection in PsA registries might be better tailored to inform CEA research. A review of the literature was performed to identify existing registries containing PsA patients. Where possible, information was extracted on the design and characteristics of the registries. The registries were then appraised according to a set of criteria that was formulated based on the methods currently used to model PsA in the CEA literature. A review of the literature identified 21 potentially relevant registries from around the world containing patients with PsA. There was substantial variation regarding the extent to which the registries, as a whole, were useful for the purposes of CEA studies. There were also notable disparities found in terms of the accessibility of the registries to researchers. The critical review conducted in this study showed that all of the registries identified are potentially useful, at least in some degree, for the purposes of informing CEA studies in PsA. However, no individual registry on its own was found to meet all of the evidence requirements when considering how the disease has been modeled previously.

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Common Drug Review Recommendations

Cited by 41 publications

References 22 publications

Oncology drug health technology assessment recommendations: Canadian versus UK experiences

Oncology drug health technology assessment recommendations: Canadian versus UK experiences

Evaluating the Cost-effectiveness of Pharmaceuticals in Canada

Evaluating the cost-effectiveness of biologic treatments for psoriatic arthritis: can we make better use of patient data registries?

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