New Target Zero Initiative Aims to Help Improve Access to New Drugs

Target Zero is a new initiative that aims to improve the time to access for patients in Canada for new drugs that are proven to be effective.

The ambitious goal of Target Zero is to achieve zero days between Health Canada’s regulatory approval of a drug and CADTH’s reimbursement recommendation to participating public drug plans.

With Target Zero, we are demonstrating a new level of cooperation with partner organizations in Canada’s drug regulatory and reimbursement environment. The initiative provides another opportunity for us to work with Health Canada, the pharmaceutical and life science industries, the pan-Canadian Pharmaceutical Alliance, and patient and clinician groups.

The initiative will focus on essential parts of the drug reimbursement review pathway and identify measures that can improve the timeliness of patient access to new drugs. Building on the lessons learned in Canada and other countries, the goal is to significantly increase collaboration, coordination, and information sharing within the drug review process, while reducing overall timelines.

Factors Influencing Reimbursement Review Timelines

There are several factors that influence the timing of our reimbursement recommendations, including when we start our work (which is determined by the timing of drug submissions by industry) and whether the submission is filed before or after Health Canada has approved the drug and issued a Notice of Compliance (NOC).

Over the past several years, we have continually worked to minimize delays between a new drug’s regulatory approval from Health Canada and our reimbursement recommendation to participating public drug plans and the pan-Canadian Pharmaceutical Alliance. These improvements include our organization accepting submissions up to 180 days before Health Canada’s anticipated regulatory decision, which enables a parallel review process between Health Canada and CADTH.

Between 2021 and 2023, less than half of the drugs (48%) submitted for review were submitted before Health Canada’s regulatory decision (pre-NOC). During the same period, 16% of total drug submissions were filed before Health Canada’s regulatory decision, leveraging the parallel review process and allowing us to deliver draft reimbursement recommendations between 3 and 28 days after Health Canada’s approval of the drugs.

Through the Target Zero campaign, we are intensifying our efforts to encourage greater uptake by industry of the option to file early. By collaborating more closely with the pharmaceutical industry we can identify barriers and opportunities to make this process work better. Our goal is for the number of submissions filed through the parallel review process to grow from less than half of submissions to 50% to 75% annually.

In December 2023, the Government of Canada announced the creation of the Canadian Drug Agency (CDA). The CDA will be established from CADTH, in partnership with provinces and territories, and build from our existing mandate and functions. The Target Zero campaign is consistent with this development and will increase collaboration and cooperation within Canada’s pharmaceutical ecosystem.



“We are launching Target Zero to demonstrate our commitment to finding solutions to improve the pharmaceutical ecosystem and to working with the pharmaceutical and life sciences industry and our partners in the drug reimbursement ecosystem. Our collective goal through Target Zero is to work together in the interest of people in Canada to help patients and health systems efficiently realize the value of a new generation of treatments.” 

Suzanne McGurn
President and CEO, CADTH

“We are pleased to work alongside CADTH on the Target Zero campaign to help improve Canada’s pathway for reimbursing new medicines. Through this campaign, CADTH continues to demonstrate a commitment to thinking differently and finding new ways for industry, health systems, and patient groups to work collaboratively to bring innovative medicines to patients as safely and quickly as possible.”

Brigitte Nolet
President and CEO, Roche Canada Pharma 

“Patient organizations play a critical role in Canada’s pharmaceutical ecosystem and make enormous contributions to the evaluation of new drugs. In the spirit of collaboration, the Gastrointestinal Society is proud to support Target Zero and CADTH’s efforts to work shoulder-to-shoulder with patients on earlier coverage of potentially life-changing new drugs.”

Gail Attara
Chief Executive Officer, Gastrointestinal Society


“The Target Zero initiative directly supports the efforts of provinces and territories to provide our citizens with timely access to cost-effective drugs that will improve their quality of life. The successful implementation of this solution-oriented campaign relies on the collective efforts of each partner in the drug reimbursement ecosystem. Target Zero is complementary to other actions being taken by Health Canada, the pan-Canadian Pharmaceutical Alliance, and provinces and territories to accelerate access to innovative drugs.”

 Patrick Dicerni
CADTH Board Member and Assistant Deputy Minister of the Health Programs and Delivery Division and Executive Officer, Ontario Public Drug Programs


“The pan-Canadian Pharmaceutical Alliance is committed to collaborating with health system partners on initiatives that will increase access to cost-effective drugs. Target Zero is an excellent example of how all the organizations within Canada’s reimbursement ecosystem can help build a pathway that drives better outcomes for patients and better value for health systems.”

Douglas Clark
Chief Executive Officer, pan-Canadian Pharmaceutical Alliance