HTA – Time to patient
What is an HTA?
Health Technology Assessment (HTA) is a careful look at health technologies and interventions to see how they affect our health, includes both their direct and indirect consequences [1]. The goal of this multidisciplinary process is to assess how important a health technology is and how it can be used in health systems around the world [1]. This process involves many experts from different fields, also known as a multidisciplinary process. They use evidence, in a transparent and responsible process, to support decision-makers, like policymakers, in making choices about new health technologies. In Canada, the Canadian Agency for Drugs and Technologies in Health (CADTH) is one of the main, not-for-profit organizations responsible for supporting healthcare decision-makers with recommendations about various health technologies, such as drugs, diagnostics tests, and medical-related devices and procedures [2] They make recommendations for all parts of Canada, except Quebec, where another agency called the Institut national d’excellence en santé et en services sociaux (INESSS)
Why is HTA important for Cancer drugs and innovative treatments in oncology:
Health Technology assessments are important to consider cancer treatments, as they provide patients access to new treatments. For example, in Canada, CADTH and INESSS provide recommendations as to whether provincial and territorial public reimbursement plans should publicly reimburse new cancer drugs based on the “value” they provide for public health [3]. Following a positive endorsement by CADTH and/or INESSS, cancer drugs move forward to the pan-Canadian Pharmaceutical Alliance (pCPA) for public drug price negotiations [3]. If the price negotiations are successful between the pCPA and drug manufacturers, each province and territories will then decide whether to add these cancer drugs to their public reimbursement plan [3].
It is important to know, before these HTA processes can start, the drug manufacturers must submit their product to Health Canada for approval for sale [3]. After approval, drug manufacturers can request a review of their suggested price from the Patented Medicines Prices Review Board (PMPRB), a federal agency. This whole HTA process ensures effective treatments are available and affordable for people with cancer while considering the societal costs of each approved treatments.
Why is HTA important for Cancer drugs and innovative treatments in oncology:
Health Technology assessments are important to consider cancer treatments, as they provide patients access to new treatments. For example, in Canada, CADTH and INESSS provide recommendations as to whether provincial and territorial public reimbursement plans should publicly reimburse new cancer drugs based on the “value” they provide for public health [3]. Following a positive endorsement by CADTH and/or INESSS, cancer drugs move forward to the pan-Canadian Pharmaceutical Alliance (pCPA) for public drug price negotiations [3]. If the price negotiations are successful between the pCPA and drug manufacturers, each province and territories will then decide whether to add these cancer drugs to their public reimbursement plan [3].
It is important to know, before these HTA processes can start, the drug manufacturers must submit their product to Health Canada for approval for sale [3]. After approval, drug manufacturers can request a review of their suggested price from the Patented Medicines Prices Review Board (PMPRB), a federal agency. This whole HTA process ensures effective treatments are available and affordable for people with cancer while considering the societal costs of each approved treatments.
Figure 1. Overview of Steps Involved in the Review and Reimbursement of New Cancer Drugs
Current landscape of HTA in Canada
- Slowest HTA process: 19th out of 20 OECD countries
- Canada’s HTA process is almost twice as long as most peer countries
- 732 days to access drugs in their provincial/territorial public plan compared to 226 days to access drugs in a private plan (reimbursed by insurance)
- Only 1 in 5 new medicines that are available globally, are reimbursed by public plans in Canada
What are the Canadian Cancer Treatment Hackathons:
To tackle the challenges associated with accessing new cancer treatments, Colorectal Cancer Canada launched the “Canadian Cancer Treatment Hackathons”. During which key individuals involved in HTA are invited to examine the current process for treatment review and reimbursement and offer innovative suggestions to accelerated access to new and innovative treatments for Canadians.
Who are the participants of CCC’s Hackathons (stakeholders):
- patient groups
- health technology assessment leaders
- policy experts
- industry leaders & economic experts
- government officials
- academics
- clinicians.
What has been in impact of the previous Hackathons:
During the first two Canadian Cancer Treatment Hackathons, participants examined ways to crunch the time to access new medicines within the current process in Canada, and learned from other countries that have been successful with an accelerate HTA process.
The third Hackathon took it a step further by ask participants to design a completely new framework for decision-making around timely access to new medicines in Canada for patients.
During our fourth Hackathon, participants were asked build upon the ideas discussed in the first three Hackathons and to evaluate how international and emerging practices could be applied in Canada to improve access to new medicines.
The Fifth Hackathon brought together key stakeholder groups to discuss key priorities from past hackathons and develop “impactful actions” aimed at expediting public access to new treatments.
Key Activities of the Canadian Cancer Treatment Hackathons:
Figure 2. Canadian Cancer Treatment Hackathon Timeline
To learn more about the Hackathons, find the outcome reports here:
References
- Health technology assessment – Global (who.int)
- About CADTH | CADTH
- Health Technology Assessment Process for Oncology Drugs: Impact of CADTH Changes on Public Payer Reimbursement Recommendations – PMC (nih.gov)
- Access to Medicine | Innovative Medicines Canada
- 2021-pdf-en-final.pdf (cancer.ca)
- Potential Life‐Years Lost: The Impact of the Cancer Drug Regulatory and Funding Process in Canada – PMC (nih.gov)
