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Is There an Economic Rationale for Cancer Drugs to Have a Separate Reimbursement Review Process for Resource Allocation Purposes?

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Abstract

In Canada, there are two separate review processes for the public reimbursement of drugs: one for cancer drugs (originally called the Joint Oncology Drug Review [JODR] and now called the pan-Canadian Oncology Drug Review [pCODR]) and one for drugs in all other disease areas (called the Common Drug Review). We explore whether a justification that is derived from an economic perspective has been provided, in Canada or elsewhere, for cancer drugs to have a separate reimbursement review process (i.e. to be ‘treated separately’) relative to drugs in all other disease areas. Literature reviews and internet searches were undertaken to identify, collect and analyze relevant documents that would provide information regarding whether an economic rationale has been provided for cancer drugs to be treated separately for resource allocation purposes. Although a number of reasons for cancer drugs to be treated separately were cited both by the JODR and pCODR and in the peer-reviewed literature, a rationale derived from an economic perspective did not appear to be documented. From an economic perspective, separating cancer drugs for resource allocation purposes is likely to impede drug plan decision makers’ ability to allocate resources in a manner that maximizes the total aggregate health benefit for the population from available resources. While we acknowledge the challenges that cancer drugs pose to drug reimbursement decision makers, we suggest that separating the reimbursement review of cancer drugs requires further scrutiny.

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Notes

  1. In this paper we included all rationales given for cancer drugs to be treated separately from drugs in other disease areas for resource allocation purposes and then appraised whether any of these rationales were derived from an economic perspective.

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Acknowledgements

Dr. Heather McDonald was responsible for conception and planning of the work that led to this paper and for preparing the draft and final submitted version of this paper. Drs. Charles, Elit and Gafni were responsible for conception and planning of the work that led to this paper and for critical revision of the manuscript for important intellectual content. No funding was received by any of the authors for the preparation of this paper. Heather McDonald is employed by Bayer Inc., but the work on this paper was part of a PhD dissertation. This paper was not seen by Bayer Inc. personnel, and Bayer Inc. did not have input on the content of this paper.

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Correspondence to Heather McDonald.

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McDonald, H., Charles, C., Elit, L. et al. Is There an Economic Rationale for Cancer Drugs to Have a Separate Reimbursement Review Process for Resource Allocation Purposes?. PharmacoEconomics 33, 235–241 (2015). https://doi.org/10.1007/s40273-014-0238-7

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