Rawson Nigel S B, Stewart David J
Macdonald-Laurier Institute, Ottawa, Ontario, Canada.
Canadian Health Policy Institute, Toronto, Ontario, Canada.
Clinicoecon Outcomes Res. 2024 May 25;16:437-445. doi: 10.2147/CEOR.S462872. eCollection 2024.
To evaluate whether time targets for Canadian Agency for Drugs and Technologies in Health (CADTH) reimbursement reviews and pan-Canadian Pharmaceutical Alliance (pCPA) price negotiations are being achieved for oncology drugs.
Recommendations, dates of submission and publication, and indications for oncology medicines issued between January 2014 and December 2023 were recorded from CADTH's reimbursement reports webpage. The date any negotiation began and the date it was completed (successfully or not), or when a decision was made not to pursue negotiation was extracted from the pCPA's webpage. The duration of each CADTH review and pCPA negotiation was calculated, together with time between CADTH's recommendation and start of the pCPA negotiation or a decision not to negotiate. Percentages of reviews completed within CADTH's target and of times taken by the pCPA to decide whether to negotiate and by its price negotiations completed within the relevant targets were calculated.
CADTH achieved its 270-days target in 88.2% to 100% of reviews issued between 2015 and 2019 but only in 65.9% to 73.1% of reviews issued in the last three years of the decade. CADTH's "typical timeline" of 180 days was achieved in under 40% of reviews issued in 2015 and not attained in any review in 2021, 2022 or 2023. The pCPA's target of 60 days for deciding whether to negotiate was achieved for all recommendations issued in 2014 but dropped below 40% for the last seven years of the decade; its target of 130 days for negotiations was achieved for over 85% of the recommendations in 2014 but decreased to only 14.3% in 2016 and then gradually increased to 61.5% in 2023.
CADTH's "typical timeline" and the pCPA's targets were not met sufficiently to be meaningful. Their processes take too long for cancer drugs.
评估加拿大卫生药品和技术局（CADTH）报销审查以及泛加拿大药品联盟（pCPA）价格谈判针对肿瘤药物的时间目标是否达成。
从CADTH报销报告网页记录2014年1月至2023年12月期间发布的肿瘤药物推荐意见、提交和发布日期以及适应证。从pCPA网页提取任何谈判开始日期和完成日期（无论成功与否），或者决定不进行谈判的日期。计算每次CADTH审查和pCPA谈判的时长，以及CADTH推荐意见与pCPA谈判开始或决定不谈判之间的时间。计算在CADTH目标内完成审查的百分比，以及pCPA决定是否谈判的时间和其在相关目标内完成价格谈判的时间所占百分比。
CADTH在2015年至2019年发布的审查意见中有88.2%至100%实现了其270天的目标，但在该十年的最后三年发布的审查意见中仅65.9%至73.1%实现了该目标。CADTH“典型时间表”的180天目标在2015年发布的审查意见中不到40%得以实现，在2021年、2022年或2023年的任何审查中均未实现。pCPA决定是否谈判的60天目标在2014年发布的所有推荐意见中均得以实现，但在该十年的最后七年降至40%以下；其130天谈判目标在2014年超过85%的推荐意见中得以实现，但在[此处原文可能有误，推测为2016年]降至仅14.3%，然后在2023年逐渐增至61.5%。
CADTH的“典型时间表”和pCPA的目标未得到充分实现，没有实际意义。它们的流程对于癌症药物来说耗时过长。
