Sending the Right Signals: How

can HTA Optimally inform PLAs

in the Content of pCPA?

Carole R Chambers

April 8, 2014

Session D3 - Panelist

• How many of you in this room can recall

when:

• There was no pCPA?

• There were no PLAs?

• There were no HTAs?

• There were no P&T Committees?

• Or in other words there was the Canadian

market and Physician/Patient only for access

Initially the manufacturer agreements

were usually completed post listing and

in a mainly single source market …..

• PLAs really only arrived for cancer in

the latest 2000s

• Product listing agreements found us

negotiating a price PRIOR to listing and

that had not been the historical case

• We began joint negotiating with other

provinces

• Still physician expert submissions the

norm which is not a HTA

• panCanadian discussions not that

successful due to the wide variation in

Canadian oncology programs

• iJODR was the first ‘real’ health technology

assessment point at the national level for

cancer– observer status though so not full

engagement but many lessons learned to

inform the future

• Solidified a tri-provincial negotiating team

• New drugs continued to arrive…

• Is the system sustainable?

• What is cost effective?

• Are programs equitable?

• KEY driver to the escalation of drug

costs is the addition of NEW agents.

• So many players - any relief in sight?

• pCODR has taken us into the virtual

space with national participation and

enhanced transparency

• pCPA was a natural consequence to

national recommendations for improved

cost effectiveness

• Global HTAs and Global pricing are

entering the discussions …

Quality dimensions applicable to drug access

• Safe

• Effective

• Patient centred

• Timely

• Efficient

• Equitable