CADTH Pharmaceutical Reviews Update — Issue 44

Program Updates

1.    Pilot Expert Committee Extension and Upcoming Call for Nominations

CADTH is pleased to announce a 1-year extension to the Formulary Management Expert Committee (FMEC), the new expert committee announced as a 1-year pilot in June 2023.

The pilot committee was launched with 2 key objectives. The first was to respond to the need of public payers for evidence and recommendations to help them maximize the value of drugs across their lifespan. The second was to create a controlled test-and-learn environment where we can introduce innovative approaches to reviews, methods, deliberative processes, stakeholder inputs, and the communication of outputs.

To date, FMEC has assessed and provided reimbursement recommendations for 8 single drugs, 2 drug classes, and 1 therapeutic area. You can find all their recommendations and related reports on our website (select FMEC as the project filter).

In addition to building on the success of the first year through the pilot extension, we are also seeking 2 new members to join the committee. A call for nominations will take place from March 4 – April 2 to fill these new roles plus 1 existing position. If you, or someone you know, is suitable for one of the available roles, please submit a nomination, or encourage them to submit a nomination. Subscribe to our eAlerts to be notified when the nomination period opens.

2.    New Procedures for Implementation Advice for Health Technologies

We are committed to continuously improving our drug review programs to meet the needs of stakeholders. We are pleased to introduce a new CADTH Procedures for Implementation Advice for Health Technologies document that consolidates and supersedes the following separate documents and processes:

• Procedures for CADTH Review of Nationally Procured Drug Products
• Procedures for Review of Therapeutic Alternatives During a Drug Supply Shortage
• Implementation Advice for a Recommendation (previously described within section 12 of the Procedures for CADTH Reimbursement Reviews)
• Procedures for Medical Imaging Implementation Advice.

In addition to consolidating the existing implementation advice procedures, CADTH has expanded the previous process for issuing implementation advice following the issuance of a reimbursement recommendation. This new process provides a mechanism to issue advice for multiple drugs through a single project, including drugs that have been reviewed through the reimbursement process and those that were never reviewed through the Reimbursement Review process (e.g., older products that predated the establishment of the CADTH process).

3.    Eligibility Screening Not Required for CAR T-cell Therapies

Since 2020, CAR T-cell therapies have been reviewed through the CADTH reimbursement review process. However, sponsors have been required to confirm eligibility with CADTH on a case-by-case basis using an eligibility application form. As the review of CAR T-cell therapies will remain within the scope of the reimbursement review process for the foreseeable future, sponsors are no longer required to obtain confirmation of eligibility prior to filing these applications. This revision is effective immediately and will eliminate unnecessary administrative steps for industry and CADTH. Any sponsors who are uncertain about product eligibility may continue to seek confirmation from CADTH on a case-by-case basis.

4.    Findings from the Lean Review of our Drug Reimbursement Review Program

Last year, CADTH communicated several improvements to our Drug Reimbursement Review Program, including a Lean review to identify process enhancements. We undertook this work as part of our commitment to continuous improvement and to advance our strategic ambitions to anticipate, innovate, and transform.

The Lean review was conducted by Deloitte over 2 months and the findings and recommendations have been reviewed by our Executive Leadership Team. Following the approval of our Executive Leadership Team, we will work to implement select activities over the coming months and across our business units. Read more 

5.    Upcoming Consultation: Provisional Funding Algorithms

The provisional funding algorithm process is used to provide advice to drug programs when they have indicated that there is need to establish an appropriate place in therapy for new oncology drugs relative to the treatments that are currently reimbursed by the drug programs.  
 
We are updating the procedures for provisional funding algorithms to improve their transparency and timeliness. We will post the updated draft procedures for consultation in March.