Background And Objective: Before listing by drug plans, new drugs that receive regulatory bodies' approval are assessed by the Health Technology Assessment agencies, including the Canadian Agency for Drugs and Technologies in Health (CADTH). Considering the impact of CADTH recommendations on payers' listing decisions, the growing number of high-cost drugs, and conditional listings, conditional recommendations have increasingly been of interest to the users of CADTH recommendations. This study aims to review the conditional reimbursement recommendations issued by CADTH and explores the reasons for those recommendations.
Methods: All final drug reimbursement recommendations posted on the CADTH website since 1 January, 2003 were reviewed. Recommendations were included if accepted for review by 1 May, 2021 and completed before 1 January, 2022. The complete records excluding 'requests for advice' were categorized into 'reimburse,' 'do not reimburse,' and 'reimburse with criteria/condition(s)'. The identified variables were extracted and analyzed descriptively.
Results: Of the 889 submissions, 785 (88.6%) completed recommendations were considered relevant to the study purpose. Of 750 recommendations, excluding 35 (4.5%) 'requests for advice,' 500 (66.6%) were 'reimburse with criteria/condition(s)'. 'Clinical criteria' at 481 (96.2%), 'cost-effectiveness improvement to an acceptable level' at 132 (26.4%), and 'the treatment cost not to exceed the cost of the alternative option(s)' at 118 (23.6%) were the most frequently reported conditions. The most frequent reasons for conditional reimbursement were 'clinical benefit and economic evaluation' at 304 (60.8%). Of conditional recommendations, 468 (93.6%) included more than one reason.
Conclusions: CADTH has facilitated patient access to innovative drugs even with limited evidence by conditional recommendations. The clinical criteria are the cornerstone of conditional recommendations. CADTH has developed the assessment process over time.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s40258-022-00781-6 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Sex and Cardiac Operations: Are We Being Fair to Our Female Patients?
Heart Lung Circ
January 2025
Division of Cardiovascular Research, School of Medcine, University of Dundee, Ninewells Hospital, Dundee, UK. Electronic address:
Background: Research suggests that although men have a higher cardiovascular disease (CVD) rate, women with CVD are more likely to experience a poorer prognosis, possibly owing to incorrect diagnosis and poorer treatment. A question not yet addressed is whether some of this inequality could be due to sex bias when selecting patients for operation.
Method: The participants were from the Scottish Heart Health Extended Cohort who had been admitted to hospital with a cardiovascular diagnosis over the study period.
Treatment of rheumatoid arthritis-associated interstitial lung disease: An appraisal of the 2023 ACR/CHEST guideline.
Curr Treatm Opt Rheumatol
December 2024
Division of Rheumatology, Inflammation, and Immunity, Brigham and Women's Hospital, Boston, MA USA.
Purpose Of Review: To summarize the current treatment landscape of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) in the context of the recent 2023 American College of Rheumatology/American College of Chest Physicians guideline for ILD treatment in systemic autoimmune rheumatic diseases.
Recent Findings: The guideline conditionally recommends mycophenolate, azathioprine, and rituximab for first-line RA-ILD therapy, with cyclophosphamide and short-term glucocorticoids as additional options. For RA-ILD progression after first line, mycophenolate, rituximab, nintedanib, tocilizumab, cyclophosphamide, and pirfenidone are conditionally recommended, while long-term glucocorticoids are conditionally recommended against.
Clinical trials have shown favorable effects of exercise on frailty, supporting physical activity (PA) as a treatment and prevention strategy. Proteomics studies suggest that PA alters levels of many proteins, some of which may function as molecules in the biological processes underlying frailty. However, these studies have focused on structured exercise programs or cross-sectional PA-protein associations.
View Article and Find Full Text PDFAntipsychotic continuation during pregnancy and risk of postpartum relapse in women with schizophrenia: nationwide register-based study.
Br J Psychiatry
January 2025
Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea; Department of Public Health, Graduate School, Yonsei University, Seoul, Korea; Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA; and Harvard Center for Population and Development Studies, Cambridge, Massachusetts, USA.
Background: Women with schizophrenia frequently discontinue antipsychotic medications during pregnancy. However, evidence on the risk of postpartum relapse associated with antipsychotic use during pregnancy is lacking.
Aims: To investigate the within-individual association between antipsychotic continuation during pregnancy and postpartum relapse in women with schizophrenia.
Sarcolemma resilience and skeletal muscle health require O-mannosylation of dystroglycan.
Skelet Muscle
January 2025
Department of Molecular Physiology and Biophysics, and Department of Neurology, Howard Hughes Medical Institute, Senator Paul D. Wellstone Muscular Dystrophy Specialized Research Center, Roy J. and Lucille A. Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA.
Background: Maintaining the connection between skeletal muscle fibers and the surrounding basement membrane is essential for muscle function. Dystroglycan (DG) serves as a basement membrane extracellular matrix (ECM) receptor in many cells, and is also expressed in the outward-facing membrane, or sarcolemma, of skeletal muscle fibers. DG is a transmembrane protein comprised of two subunits: alpha-DG (α-DG), which resides in the peripheral membrane, and beta-DG (β-DG), which spans the membrane to intracellular regions.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!