CADTH_2014_D3_Sending_the_Right_Signals__How_Can_HTA_Optimally_Inform_PLAs_in_the_Context_of_pCPA__Brad Alyward
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CADTH_2014_D3_Sending_the_Right_Signals__How_Can_HTA_Optimally_Inform_PLAs_in_the_Context_of_pCPA__Brad Alyward

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Sending The Right Signals: How Can HTA Optimally Inform PLAs in the Context of pCPA

Sending The Right Signals: How Can HTA Optimally Inform PLAs in the Context of pCPA

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  • 1. Sending the Right Signals: How can HTA Optimally Inform PLAs in the context of pCPA? Brad Alyward Nova Scotia Department of Health and Wellness
  • 2. Introduction Provide a brief overview of: • Health Technology Assessment (HTA) • Product Listing Agreement (PLA) • pan-Canadian Pricing Alliance (pCPA)
  • 3. HTA, PLAs and the pCPA
  • 4. I get HTA, but PLAs… PLA (Product Listing Agreement): A confidential agreement between manufacturer(s) and a Province or Territory which is used to formalize the terms and conditions of a product funding decision.
  • 5. …and pCPA?? pCPA (pan-Canadian Pricing Alliance): • Collaboration between Provinces and Territories • Announced by the Premiers in August 2010 • Currently co-led by Ontario and Nova Scotia • Identify opportunities to conduct joint negotiations for brand name drugs • Increased value to the health care system
  • 6. Drug Funding Challenges • Canadians and governments want consistent access to clinically effective medications. • All public drug funders facing the same issues; value, affordability and sustainability. • Rising costs increased the need to negotiate terms to improve value to the system. • Need for confidential prices and the resulting product listing agreements (PLAs).
  • 7. The Goals of PCPA • Increase access to drug treatment options. • Improve the consistency of drug listing decisions across the country. • Capitalize on the combined buying power of jurisdictions. • Reduce duplication of negotiations and improve utilization of resources. • Achieve consistent pricing and lower drug costs.
  • 8. The Role of HTA Before PCPA Manufacturer submits Health Canada issues NOC and DIN Manufacturer submits pCODR products CDR products Non pCODR, Non CDR Yes decisions and No decisions Province specific review where applicable JURISDICTIONAL DECISION Variation in terms of: Listing status Drug cost Coverage criteria Product listing agreement
  • 9. HTA in the Context of PCPA MANUFACTURER SUBMISSION pCODR PRODUCTS CDR PRODUCTS PCPA PCPA NEGOTIATIONSNo Negotiations Defer to P/T Level CONFIRM LEAD AND PARTICIPATING JURISDICTIONS MANUFACTURER INFORMED OF DECISION NEGOTIATION Province specific review where applicable SIGNED LETTER OF INTENT PLA WITH INDIVIDUAL JURISDICTIONS
  • 10. HTA Informs PCPA Negotiations FINAL RECOMMENDATION (pERC, CDEC) LIST LIST IN A SIMILAR MANNER LIST WITH CRITERIA / CONDITIONS LIST IF COST EFFECTIVENESS IMPROVED DO NOT LIST AT SUBMITTED PRICE DO NOT LIST CLINICAL/COST EFFECTIVENESS CLEAR RECOMMENDATIONS CLINICAL/COST EFFECTIVENESS UNCERTAIN Pan-CANADIAN PRICING ALLIANCE NEGOTIATIONS PLA Terms INDIVIDUAL JURISDICTIONS