Canadian Expert Patients in Health Technology Conference Nov 7 – 8, 2016: Day 2

1. pan-­‐Canadian
Pharmaceu0cal
Alliance
Office
Canadian
Expert
Pa0ents
in
HTA
(CEPHTA)
Value-­‐Based
Pricing:
Challenges
&
Opportuni0es
November
8,
2016
1

2. pCPA
Objec0ves
The
objec0ves
of
the
pCPA
are
to
provide
value
to
the
broader
health
care
systems
of
the
Par0cipa0ng
Organiza0ons
and
to
improve
pa0ent
care
by
nego0a0ng
drug
reimbursement
collec0vely
to:
1. Increase
access
to
clinically
effec0ve
and
cost
effec0ve
drug
treatment
op0ons;
2. Improve
consistency
of
decisions
among
Par0cipa0ng
Organiza0ons;
3. Achieve
consistent
and
lower
drug
costs
for
Par0cipa0ng
Organiza0ons;
and
4. Reduce
duplica0on
of
effort
and
improve
use
of
resources.
2

3. Brand
Nego0a0ons
Process
6

4. pCPA
Ac0vity
2010
-­‐
2014
2015
2016
(10
months)
55
(completed)
41
(completed)
100
(37
completed
+
37
ac9ve
+
26
post-­‐HTA)
Brand*
Generics**
Biosimilars*
1
(completed)
0
4
(1
completed
+
2
ac9ve
+
1
post-­‐HTA)
*Brand
/Biosimilars
–
number
of
products
nego1ated.
Note
-­‐
does
not
include
ALL
nego1a1on
ac1vity
of
pCPA
(i.e.
other
ac1vity
includes
decisions
to
not
nego1ate
collec1vely
a@er
considera1on
of
a
product
and
nego1a1ons
for
products
that
are
not
based
on
recent
HTA
recommenda1on)
0
108
341
CADTH
Recommenda9ons
2013/14:
53
2014/15:
47
2015/16:
71

5. 5
Time
Since
HTA
Recommenda/on
pCPA
Considera.on
Ac.ve
Nego.a.on
Completed
LOIs
since
Jan.
1
2016
Brilinta
(AE)
Yondelis
Imbruvica
(MC)
Keytruda
Invokamet
Sunvepra
Praluent
Inspiolto
Respimat
<3
Descovy
XigDuo
Cotellic
Months
EgriNa
Kyprolis
Opdivo
(NSCLC)
Truvada
Ilaris
Cosentyx
(PA)
Nucala
Cosentyx
(AS)
Trulicity
Eylea
(MES)
Reves.ve
Xolair
(AS)
Avas.n
(PROC)
Basaglar
Breo
Ellipta
Vimizim
(MA)
Zepa.er
Strensiq
3-­‐6
Humira
(HS)
Sovaldi-­‐Harvoni
Entresto
Months
Pheburane
Fycompa
Genvoya
Jardiance
Grastofil
Blincyto
Jakavi
Opdivo
(MM)
Technivie
Humira
(UC)
Ferriprox
Naglazyme
Xgeva
Repatha
Revlimid
Jardiance
Arnuity
Ellipta
6-­‐9
Spiriva
Respimat
Iclusig
Months
Forxiga
Avas.n
(CC)
Zaxine
Kalydeco
Entyvio
Lemtrada
9-­‐12
Neupro
Prolia
Months
Cyramza
(GC)
Ofev
Xolair
(CIU)
Prezcobix
Januvia
>12
Sylvant
Xeljanz
Months
Esbriet
Simponi
SC
Cimzia
Otezla
(PA)
Adempas
(PAH)
Plegridy
Vec.bix
Cosentyx
Tafinlar/Mekinist
Zydelig
Brand
-­‐
Summary
as
of
October
31,
2016

6. Value
Based
Pricing
“Innova0ve
Agreements”
6
Performance/Outcome
Based
Agreements
Data
Outcome/Value
Measure
Risk
Sharing
Structure
Challenge:
implementa0on
–
traceability/tracking
infrastructure
Opportunity:
small/iden0fiable
pa0ent
popula0ons
Challenge:
measurability
and
abri-­‐bu-­‐tab-­‐ility
Opportunity:
demonstrable
effect
Challenge:
front-­‐end
funding
responsibility
Opportunity:
structure
rebates
around
uncertainty
–
when
highest,
rebate
is
highest

7. Joint
Approach
–
Required
Roles
Public
Drug
Plans
• Increase
capacity
to
use
available
data
• Con0nue
to
remain
open
to
consider
proposals
• Provide
guidance
on
expecta0ons
for
OBA
Pa0ents
• Informed
consent
• Ac0vely
involved
in
monitoring
• Par0cipa0on
in
research
• Amenable
to
change
Manufacturers
• Invest
in
study
design
and
data
infrastructure
• Recognize
complexity
and
impact
on
0melines
7