Getting Canadian Drug Reviews to Work for Patients

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I was struck by the findings of a recently released report by the Canadian Diabetes Association.  Entitled In the Balance: A Renewed Vision for the Common Drug Review; this report serves as a real wake-up call to Canadians with chronic health conditions.

The report focuses in on the Common Drug Review (CDR), a federal/provincial/territorial review process that takes place after Health Canada has approved a drug's safety and efficacy, and approved it for sale. The process leads to a recommendation to participating publicly-funded drug plans about whether or not a drug should receive coverage on the public drug formulary.

Following a study on the Common Drug Review by the House of Commons Standing Committee of Health, Joy Smith, M.P. (Kildonan-St. Paul) and Chair of the Standing Committee said that the CDR "process is not perfect and the Health Committee would like to see some changes."

What are the issues in providing medications to those who need them safely and quickly?

The Canadian Diabetes Association identified key challenges, which include:

  • Continued duplication in the review process
  • Lack of agreement between CDR recommendations and drug plan decisions
  • Differences in length of time to reach decisions
  • Concerns over the appeals process
  • Emphasis on cost effectiveness at the expense of other decision-making criteria, such as patient experience

The CDA makes some important suggestions for improving the Common Drug Review, including:

  • The introduction of greater transparency in the public engagement and CDR review process.
  • The introduction of a better balance in decision making criteria between cost-effectiveness, clinical effectiveness and other factors that affect patient experience, through enhanced patient engagement mechanisms.  

The report also expresses concern that CDR recommends fewer drugs for coverage than in many other countries:"There is evidence that Canada's public drug plan reimbursement lags behind other OECD countries for chronic diseases and conditions." and there is unequal access to diabetes drugs within each province and plan " For diabetes drugs, access is unequal across participating drug plans."

As the June Canadian Diabetes Association CDR Summit is underway, I look forward to hearing continued discussion on policies that can help ensure quick patient access to vital, new medications.