The Canadian Agency for Drugs and Technologies in Health (CADTH) is venturing into a groundbreaking trial aimed at integrating societal perspectives into the economic assessments of specific new drugs. This innovative pilot initiative represents a significant paradigm shift towards adopting a more comprehensive and holistic approach in appraising the value of pharmaceuticals, meticulously taking into account not only the direct financial burdens placed upon the healthcare system but also examining the expansive repercussions and impacts these drugs have on society as a whole.
Traditionally, when drug sponsors present their products for assessment as part of the CADTH’s Drug Reimbursement Review program, the economic models they submit are predominantly oriented around the perspective of the healthcare payer. Such an approach methodically details the immediate financial implications for the public payer, encompassing expenses related to the medication itself, costs associated with hospital admissions, and charges for outpatient services.
CADTH’s New Approach to Include Societal Impact in Drug Evaluations
This traditional evaluation methodology tends to disregard the wider societal costs that emerge, which may encompass the productivity losses attributed to illness, the out-of-pocket expenses incurred by patients necessitated by treatment, including travel or the need to take time away from work, and the consequential financial strains these factors place on various other government sectors.
Starting with applications targeting the December 2024 expert committee meetings, CADTH will begin considering societal perspectives for drugs undergoing the complex review process. This inclusion will necessitate sponsors to account for a wider array of costs, reflecting the true economic impact of new medications. For drugs eligible for complex review, including cell and gene therapies and those receiving expedited approval from Health Canada, this adjustment aims to provide a more comprehensive evaluation of their cost-effectiveness.
Revolutionizing Economic Assessment: CADTH Mandates Societal Perspectives in Drug Evaluations
The transition to this enriched evaluation framework will be phased, with the societal perspective becoming a mandatory component post-October 1, 2024. Until this deadline, sponsors may continue submitting applications without this broader perspective but will be required to justify its omission. The complex review process itself is designed to offer a thorough economic assessment, involving extensive expert consultation and a nuanced examination of non-traditional studies and implementation challenges.
CADTH’s pilot aligns with practices already established by other health technology assessment bodies across Canada, such as the Institut national d’excellence en santé et en services sociaux (INESSS) and the Public Health Agency of Canada. Both organizations advocate for economic assessments that consider the dual perspectives of healthcare payers and societal impacts. Through this test-and-learn initiative, CADTH aims to validate and present societal perspective analyses effectively, enriching the pharmacoeconomic reports in its Reimbursement Reviews.
Resource: Canadian Agency for Drugs and Technologies in Health, March 28, 2024

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