This document discusses the challenges public payers face with expensive drugs for rare diseases. It outlines the formation of a working group between Alberta, British Columbia, and Ontario to explore evidence-based approaches. The working group identified major themes of communication, evidence, pricing, and access. Opportunities exist to improve communication with patients and clinicians, establish robust evidence standards, assess cost-effectiveness and affordability, and balance timely access with stakeholder accountability. The working group's goal is to develop sustainable, evidence-informed solutions that promote equity and transparency for rare disease patients.
A Rare International Dialogue (Saturday May 11, 2019)
Designing Pathways to Patient-Centered Care
Bone marrow as a Vehicle for Correction of Rare Disorders: Donna Wall, The Hospital for Sick Children
Real-World Data and Real-World Evidence Webinar
Panelists
Tara Cowling, Medlior
Laurie Lambert, CADTH
Craig Campbell, London Health Sciences
Sandra Anderson, Innomar Strategies
Brad Alyward, Canadian Organization for Rare Disorders
Durhane Wong-Rieger, Canadian Organization for Rare Disorders
A Rare International Dialogue (Saturday May 11, 2019)
Designing Pathways to Patient-Centered Care
Bone marrow as a Vehicle for Correction of Rare Disorders: Donna Wall, The Hospital for Sick Children
Real-World Data and Real-World Evidence Webinar
Panelists
Tara Cowling, Medlior
Laurie Lambert, CADTH
Craig Campbell, London Health Sciences
Sandra Anderson, Innomar Strategies
Brad Alyward, Canadian Organization for Rare Disorders
Durhane Wong-Rieger, Canadian Organization for Rare Disorders
This webinar provides insight into how the drug approval process affects what prescription drugs are available to patients in Canada. The presentation will cover the following topics: Who is responsible for prescription drug approval in Canada? How does the drug approval process impact patient access to medication? How can patients be involved in the drug approval process?
Please share this video with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● A discussion on disparities in provincial reimbursement for cancer medications, and what patients can do about it
● Explanation of the different ways that cancer treatments are managed and funded across Canada, and outline the impact this has on patients depending on where they live in the country
View the video: https://youtu.be/NN3AcGYMXac
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Webinar 1 (Oct 9, 2020 at 12 -1 pm ET): Does Canada need an Orphan Drug Policy to incentivize drug development and submissions? What was the rationale for Orphan Drug legislation in other countries? What has been the impact of those legislations? Why did Canada develop and never implement a Canadian Rare Disease Strategy and what has been the aftermath? What is Canada’s Rare Disease Strategy and how has it influenced healthcare?
Key issues:
• Rationale and impact of Orphan Drug legislation around the world (1983 – today)
• Proposed Canadian Orphan Drug Framework and what could have resulted (2014)
• Proposed Canada’s Rare Disease Strategy and what did/did not result (2015 – today)
Given the benefits and challenges that have been raised about Orphan Drug Legislation and the current procedures for reviewing rare disease drugs across Canadian agencies (Health Canada, PMPRB, CADTH/INESSS, pCPA, provincial drug plans), should Canada still pursue a dedicated Orphan Drug Policy and, if so, what should it address? What are the opportunities for stimulating and supporting research and development for rare disease therapies in Canada and what are specific policies needed?
Presentation:
Durhane Wong-Rieger, CORD Panel Discussion
Rebecca Yu (Takeda Canada)
Nicola Worsfold (Jesse’s Journey Canada)
Sandra Anderson (Innomar Strategies)
Nahya Awada (PhD Candidate Carleton University)
In this presentation, Bill Dempster and Johanne Chambers of 3Sixty Public Affairs walk through the different steps in bringing a new medicine through the regulatory review process, health technology assessment and funding, highlighting where patients can make a difference, and how their role is rapidly expanding.
This webinar provides insight into how the drug approval process affects what prescription drugs are available to patients in Canada. The presentation will cover the following topics: Who is responsible for prescription drug approval in Canada? How does the drug approval process impact patient access to medication? How can patients be involved in the drug approval process?
Please share this video with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● A discussion on disparities in provincial reimbursement for cancer medications, and what patients can do about it
● Explanation of the different ways that cancer treatments are managed and funded across Canada, and outline the impact this has on patients depending on where they live in the country
View the video: https://youtu.be/NN3AcGYMXac
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
Pinterest - https://www.pinterest.com/survivornetwork
YouTube - https://www.youtube.com/user/Survivornetca
Webinar 1 (Oct 9, 2020 at 12 -1 pm ET): Does Canada need an Orphan Drug Policy to incentivize drug development and submissions? What was the rationale for Orphan Drug legislation in other countries? What has been the impact of those legislations? Why did Canada develop and never implement a Canadian Rare Disease Strategy and what has been the aftermath? What is Canada’s Rare Disease Strategy and how has it influenced healthcare?
Key issues:
• Rationale and impact of Orphan Drug legislation around the world (1983 – today)
• Proposed Canadian Orphan Drug Framework and what could have resulted (2014)
• Proposed Canada’s Rare Disease Strategy and what did/did not result (2015 – today)
Given the benefits and challenges that have been raised about Orphan Drug Legislation and the current procedures for reviewing rare disease drugs across Canadian agencies (Health Canada, PMPRB, CADTH/INESSS, pCPA, provincial drug plans), should Canada still pursue a dedicated Orphan Drug Policy and, if so, what should it address? What are the opportunities for stimulating and supporting research and development for rare disease therapies in Canada and what are specific policies needed?
Presentation:
Durhane Wong-Rieger, CORD Panel Discussion
Rebecca Yu (Takeda Canada)
Nicola Worsfold (Jesse’s Journey Canada)
Sandra Anderson (Innomar Strategies)
Nahya Awada (PhD Candidate Carleton University)
In this presentation, Bill Dempster and Johanne Chambers of 3Sixty Public Affairs walk through the different steps in bringing a new medicine through the regulatory review process, health technology assessment and funding, highlighting where patients can make a difference, and how their role is rapidly expanding.
Patient-centered pharmacovigilance represents a pivotal shift in the landscape of healthcare, emphasizing the active involvement of patients in the monitoring and reporting of adverse drug reactions. Unlike traditional pharmacovigilance, which primarily relies on healthcare professionals to identify and document adverse events, this approach recognizes patients as critical stakeholders in ensuring medication safety. By empowering patients to share their experiences, concerns, and observations regarding medication effects, whether positive or negative, healthcare systems can gain a comprehensive understanding of drug safety and efficacy in real-world settings. Patient-centered pharmacovigilance fosters a collaborative partnership between patients, healthcare providers, and regulatory agencies, promoting transparency, accountability, and ultimately, better patient outcomes. Through increased patient engagement and the utilization of patient-reported data, this approach enables healthcare systems to identify potential safety issues earlier, tailor treatment strategies to individual needs, and enhance overall drug safety surveillance efforts.
Rare Disease Patient Registries:
Key to Drug Development and Access
Tuesday, May 3 @ 12:00 – 1:00 pm EDT
Slides:
USA National Institutes of Health RaDaR
NORD IAMRARE (Pam Gavin, VP)
Canada INFORM RARE (Beth Potter, CHEO; Pranesh Chakraborty, CHEO; Kim Angel, Can MPS Society; John Adams, CanPKU)
Summer 2020 PMPRB Webinar Series: Webinar 2 (July 16, 2020)
Hearing From Those Who Really Matter. This Webinar will take place after the PMPRB’s promised rescheduled “public forums” and “research webinars.”
Roundtable
Lindy Forte, Principal Consultant, Patient Access Solutions
Dr. Shawn Whatley, family physician, Munk Senior Fellow, Macdonald Laurier Institute and past president of the OMA
Barbara Jaszewski, Advisor Cloud and past global vice president of pricing and market access
Catherine Boivin, SMA Patient
Durhane Wong-Rieger, President & CEO, CORD
Moderator: Bill Dempster, CEO, 3Sixty Public Affairs
About this Webinar: This presentation will discuss the pathway to pharmaceutical treatments in Canada that involve health technology assessment reviews and decision making. Observations on the current challenges and the importance of patient input to inform decision making will also be discussed. Finally, the key elements that can be critical to successful outcomes will be presented.
Please share this video with anyone who may be interested!
Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR
In this webinar:
● Takeaways from a roundtable held on June 1st about patient-centred pharmacare in Canada
● Reports from patient groups and other subject matter experts
● A cohesive vision and set of values for national pharmacare in Canada
View the video: https://youtu.be/HMy_gsTDkfI
Follow our social media accounts:
Twitter - https://twitter.com/survivornetca
Facebook - https://www.facebook.com/CanadianSurvivorNet
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July 22, 2021 : Aligning on Rare Drug Strategy, PMPRB, and Federal Election
Engage with our Expert Panel in a Townhall style meeting to add your voice on these important issues in preparation for upcoming federal election.
Panelist
Alexandra Chambers (Novartis)
Peter Brenders (BeiGene)
Angela Genge (The Neuro)
Fred Horne (3Sixty Public Affairs)
Leanne Ward (CHEO)
Geneva Pharma Forum on Pharmacovigilance: Partnering for
Patient Safety (Geneva, 20 November 2012), Jeremiah Mwangi, Director, Policy and External Affairs, IAPO
Financial Protection and Improved Access to Health Care: A Spotlight on Pharm...HFG Project
Presented at “Financial Protection and Improved Access to Health Care: Peer-to-Peer Learning Workshop Finding Solutions to Common Challenges” in Accra, Ghana, February 2016. To learn more, visit: https://www.hfgproject.org/ghana-uhc-workshop
On this webinar, we’ll hear from experts on the issue and invite an open conversation with stakeholders. We need discussion, shared questions and answers and a review of case studies, which is why we are hosting this session.
Panelist:
Neil Palmer, Principal Consultant, WN Palmer & Co. and former PMPRB staff
Michael Dietrich, Executive Director, Policy, Innovative Medicines Canada
Laurene Redding, Global Head, Strategic Pricing (ex-China), BeiGene
Durhane Wong-Rieger, President & CEO, CORD
Moderator: Bill Dempster, CEO, 3Sixty Public Affairs
CORD Rare Drug Conference: June 8-9, 2022
Registries and Real-World Data
INFORM RARE: Beth Potter, Alexandra Wyatt, Pranesh Chakraborty,
Monica Lamoureux, John Adams, Kim Angel
CORD Rare Drug Conference: June 8-9, 2022
Registries and Real-World Data
INFORM RARE: Beth Potter, Alexandra Wyatt, Pranesh Chakraborty,
Monica Lamoureux, John Adams, Kim Angel Opportunities and Challenges for Data Management
CORD Rare Drug Conference June 8-9, 2022
Global, International, and National Rare Disease Networks
Rare Disease Research Network and National Children’s Hospital - Marshall
Summar, Rare Disease Institute
CORD Rare Drug Conference: June 8-9, 2022
Global, International, and National Rare Disease Networks
WHO-RDI Global Rare Disease Network - Matt Bolz-Johnson, EURORDIS
CORD Rare Drug Conference: June 8-9, 2022
Global, International, and National Rare Disease Networks
Canadian Network of Rare Disease Centres of Excellence - Paula Robeson, Children’s Healthcare Canada
CORD Rare Drug Conference: June 8 - 9, 2022
The Ottawa Pediatric Bone Health Research Group and The Canadian Consortium for Children’s Bone Health/Canadian Alliance for Rare Disorders of the Skeleton - Leanne Ward, CHEO
CORD Rare Drug Conference: June 8-9, 2022
What is status of Canadian access for RD drugs?
• Canada access and Rest of World - Alexandra Chambers, Novartis
• Canada access to essential rare disease drugs - Nigel Rawson
More from Canadian Organization for Rare Disorders (20)
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
Managing Value for Sponsors and Users in Public and Private Drug Plans: Angie Wong (Ontario Ministry of Health & Long Term Care
1. Expensive
Drugs
for
Rare
Diseases:
Challenges
and
Opportuni9es
for
Public
Payers
Angie
Wong,
Director
Drug
Programs
Policy
&
Strategy
Branch,
Ontario
Public
Drug
Programs
November
8,
2016
2. Agenda
• Background on Expensive Drugs For Rare
Diseases (EDRD)
• Key Themes & Challenges
• Summary
2
4. Background
• Recognize that rare diseases are complex, multi-
system and usually have a high burden of illness
• Growing gap between patients’ needs, patient and
provider expectations, system sustainability and
industry innovation and profitability
• Patient involvement in funding decisions
4
6. National Approaches to Rare Disease Drugs
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
FABRY INITIATIVE
NATIONAL PHARMACEUTICAL
STRATEGY
1989
NATIONAL AGENCY FOR HEALTH TECHNOLOGY ASSESSMENT
HEALTH CARE INNOVATION
WORKING GROUP
PAN-CANADIAN PHARMACEUTICAL ALLIANCE
EDRD Working
Group
Case-by-Case P/T Decisions
8. EDRD Working Group
• January 2015: Provincial & Territorial (P/T) Health
Ministers supported the establishment of a P/T
Expensive Drugs for Rare Diseases (EDRD)
Working Group (WG)
• Objective: to explore the management of DRDs
with evidence-based approaches.
• Alberta, British Columbia and Ontario co-lead this
WG.
8
9. Major Themes of Framework
• Communication
• Evidence
• Pricing
• Access
9
10. Communication
Objective:
• Recognize the need to enhanced communications
with patients and clinicians.
Key Opportunity:
• Need to bring forward objective information
• Opportunity to hear from stakeholders on
perspectives
10
12. Pricing:
• DRDs typically cost
hundreds of thousands of
dollars per patient per year
• Assessing cost-
effectiveness
12
Fair and affordable pricing to support
reasonable access to effective drugs for
rare diseases
• Opportunity costs
• Affordability and
sustainability
13. Access
Objective:
• Consistent implementation of CADTH
recommendations
Key Challenges:
• Timely access and stakeholder pressures
• Exceptions and compassionate access
• Balancing industry accountability including post
marketing evidence generation
13
14. Types of Managed Access Programs
Performance based schemes
Managed Access Programs
Financial Based Outcome Based
market share
price volume
utilization or
price cap
manufacturer
funded
treatment
initiation
conditional coverage performance linked
reimbursement/outcomes
guarantee
patient level
population level
coverage with
evidence
development
conditional
treatment start
or continuation
only in research only for research
Adapted From: Sullivan, S. (2009). ISPOR Plenary.
Available from http://www.slideshare.net/raredisorders/rare-disease-access-issues-2015-v2