AN OBSERVATIONAL ANALYSIS OF PCPA ACTIVITIES
Author(s)
Mills F1, Rocchi A2
1InnomarConsulting, Oakville, ON, Canada, 2Athena Research, Burlington, ON, Canada
OBJECTIVES : The pan-Canadian Pharmaceutical Alliance (PCPA) has been active since 2011, negotiating confidential prices on behalf of provincial and federal public drug plans. The objectives of this analysis were two-fold: (1) identify patterns of implicit prioritization and (2) characterize the role of health economics at the PCPA. METHODS : PCPA activities were assessed based on the archive of drugs handled through their organization, as posted on their website. This analysis examined characteristics of drugs considered for negotiation, and the duration of negotiations, from inception to August 2017. The dataset contained 208 drug-indications from the PCPA archives: drugs with a decision to negotiate (155) or a decision not to negotiate (53). Statistical analyses compared: the ICERs of drugs that were negotiated versus DNN for pCODR and for CDR drugs; ICERs of drugs that were negotiated at pCODR and DNN at CDR; number of days between HTA recommendation and decision to negotiate and DNN (the "in consideration" phase); number of days in consideration + negotiation by presence of a price condition for CDR and pCODR; and number of days in consideration versus ICER – pCODR then CDR. RESULTS : There was close but imperfect alignment between HTA agency recommendation and the PCPA’s decision to negotiate. ICERs of negotiated drugs approached $200K/QALY for oncology drugs, and $100K/QALY for non-oncology drugs – suggesting a substantial discount would be required to achieve conventionally ‘acceptable’ value-for-money. ICERs were influential on CDR recommendations (and increasingly used to guide pCPA negotiations) but did not appear to influence pCODR recommendations. The in consideration period was shorter for oncology versus non-oncology drugs (53 versus 263 days), and also differed markedly between therapeutic areas. CONCLUSIONS : These findings reveal an implicit prioritization pattern at the PCPA, as well as the evolving role of health economics in Canada’s two-stage reimbursement process.
Conference/Value in Health Info
2018-05, ISPOR 2018, Baltimore, MD, USA
Value in Health, Vol. 21, S1 (May 2018)
Code
PHP204
Topic
Health Technology Assessment
Topic Subcategory
Decision & Deliberative Processes
Disease
Multiple Diseases