A REVIEW OF PUBLIC COVERAGE OF CDR REVIEWED DRUGS

Author(s)

Bosnic N1, Landry K2
1PMPRB, Ottawa, ON, Canada, 2Patented Medicine Prices Review Board, Ottawa, ON, Canada

OBJECTIVES: This PMPRB study analyzes the coverage of drugs reviewed by the CDR across Canadian public drug plans, and examines both the number of drugs and the extent of reimbursement. METHODS: The drugs reviewed by the CDR from December 2003 through June 2015, along with their listings as of December 2015, were obtained from IMS Brogan’s iMAM and public formularies. The sales data for 2015 was retrieved from the IMS Brogan Private Drug Plan and IMS AG MIDAS™ databases. The coverage rates for 10 provincial drug plans and the NIHB were calculated as simple and weighted percentages of all select drugs. The analysis also includes an inter-jurisdictional comparison using simple agreement descriptive statistics.  RESULTS: The CDR issued positive recommendations for 55% of the analyzed drugs, with provinces following the CDR recommendation in 78% of the cases. With sales weighting, most provinces listed all major drugs. An inter-jurisdictional comparison of all CDR drugs indicates medium to high rates of coverage agreement, ranging from 50% to 86% across all pairs of the public drug plans. When weighted by sales, the percentage of coverage agreements notably increases. CONCLUSIONS: The study results suggest a relatively high coverage and inter-jurisdictional agreement of the CDR drugs, and highlights differences across public drug plans. These findings are expected to inform policy discussions around a national formulary.

Conference/Value in Health Info

2017-05, ISPOR 2017, Boston, MA, USA

Value in Health, Vol. 20, No. 5 (May 2017)

Code

PHP67

Topic

Health Policy & Regulatory, Health Service Delivery & Process of Care, Health Technology Assessment

Topic Subcategory

Decision & Deliberative Processes, Formulary Development, Reimbursement & Access Policy

Disease

Multiple Diseases

Your browser is out-of-date

ISPOR recommends that you update your browser for more security, speed and the best experience on ispor.org. Update my browser now

×