Presentation (CTI)

OBJECTIVES: Health Technology Assessment (HTA) bodies continue to streamline the process of bringing effective drugs to patients. This includes simplified economic approaches (SEA) using cost-minimization analysis (CMA) and cost comparison (CC). CDA-AMC revised its Procedures in 2020 to accept CMA, as of 2023 INESSS does not conduct a reanalysis of the budget impact for products submitted with a CMA or where the 3-year budget impact is below $10M, and in 2022 NICE introduced a proportionate approach to technology appraisals that included CC. This analysis examined the usage of SEA in CDA-AMC, INESSS and NICE submissions and their associated recommendations.
METHODS: We extracted CDA-AMC reviews with SEA received after October 2020 with a final recommendation. The corresponding SEA reviews were analyzed for INESSS and NICE to compare across HTA bodies.
RESULTS: Of the 259 CDA-AMC reimbursement reviews analyzed, 234 (90.35%) included cost-utility or cost effectiveness analyses (CUA/CEA), 17 (6.56%) included CMA, and 8 (3.09%) included CC. 23/25 (92.00%) CDA-AMC SEA submissions received recommendations to reimburse with clinical criteria and/or conditions; of those 100.00% included cost parity/savings criteria. Based on the sample 25 SEA reviewed by CDA-AMC, INESSS had 2 CUA, 11 CMA, and 4 cost consequence manufacturer submissions. 3/11 (27.27%) CMA received full recommendations to reimburse and 8/11 (72.73%) had conditions, of which 7/8 (87.50%) included cost criteria. From the sample 25 examined by NICE, only one drug submission and one reanalysis included a CMA. None of the sample 25 underwent the NICE proportionate approach pilot.
CONCLUSIONS: Since the streamlined approaches to technology appraisals were introduced, there has been some consistency between the SEA submitted to Canadian HTA bodies, but not with NICE. Greater utilization and consistency in the use of SEA may allow for additional streamlined reviews in the future.