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A decade of the Common Drug Review

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Within the health care arena, how many examples of federal, provincial and territorial collaboration can you name?  How many have endured for over a decade?  One such example is The Canadian Agency for Drugs and Technologies in Health (CADTH) Common Drug Review.

For a new prescription drug to be sold in Canada, it must first be reviewed by Health Canada to ensure that it meets Canadian standards for efficacy, safety and quality of manufacturing. The next step is to consider the relative benefits, safety and cost-effectiveness of this new drug compared to existing treatment options. This is where the CADTH Common Drug Review fits.

On behalf of 18 publicly funded drug plans, the CADTH Common Drug Review has been answering the question of how a new drug compares to existing therapies for more than 10 years.

Process
How does the process work? All publicly funded drug plans (except Quebec), cooperated to build, improve and fund the CADTH Common Drug Review. If a pharmaceutical or biotech company wants their drug to be considered for inclusion on the publicly funded drug plans formulary, they submit all relevant clinical and economic information to CADTH for review. Patient groups are invited to provide input to identify unmet needs of existing options and treatment outcomes of greatest importance to patients.

A review team made up of epidemiologists, pharmacists, physicians, health economists, information specialists and at least one external physician with specialist expertise in the relevant clinical area, prepare a systematic review of the clinical evidence and a critique of the drug sponsor’s economic evaluation. External experts of methodology help ensure the analysis is of the highest quality and the most appropriate techniques are used.

The reports produced by the review team are discussed by the Canadian Drug Expert Committee (CDEC), comprised of highly qualified health care experts and public members from across Canada, who provide advice and formulary listing recommendations. Each of the 18 publicly funded drug plans then uses this information to make their jurisdictional listing decision. The reasons behind CDEC’s recommendations are publicly available, and one may track the progress of new drugs moving through the review process (www.cadth.ca).

Since 2003, 72 different pharmaceutical companies have used the CADTH Common Drug Review process and 264 recommendations for publicly funded drug plans have been made.

The CADTH Common Drug Review continues to evolve and improve. Transparency enhancements and patient engagement (through a patient group input process) are just some of the initiatives that CADTH has recently introduced.

Contribution by specialists
The diversity of drugs being examined during any period is vast. For example, right now, CADTH is reviewing drugs to manage chronic obstructive pulmonary disease, heart failure, ulcerative colitis, schizophrenia, vitreomacular adhesion, chronic migraine, Parkinson’s disease, growth hormone deficiency in adults and children, Turner’s Syndrome, and polyarticular juvenile idiopathic arthritis. To be able to identify relevant comparators and fully appreciate the clinical considerations in these diverse fields, CADTH is tremendously grateful to the all external experts who participate on each team. CADTH is also grateful to patient groups, who share lived experience; and to the pharmaceutical and biotech companies who submit all relevant clinical and economic information on their drugs for review.
Every drug reviewed enlists the support of one or more clinical experts. Experts in the fields of health economics or review methodology are invited to participate as required.  If you are interested in becoming involved, please contact CADTH.
For more information on CADTH and the CADTH Common Drug Review, visit our website:

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