How does Canada compare internationally on new drugs?

A new analysis in the Canadian Medical Association Journal found that Canada was missing out on some drugs approved in the United States and Europe. However, it also said that the analysis “suggests that most of them would reach few Canadians and would have a limited health impact if they were approved.” It found that one-third of the new substances approved in those regions between 2016 and 2020 had not been submitted for a review by Health Canada, though the study said it expected that number to drop to between 20% and 30% in coming years. That’s despite Canada’s high drug spending overall. In 2021, Canada had the fourth highest drug spending among countries in the Organisation for Economic Co-operation and Development. Read: A ‘game-changing moment’: using real-world evidence to approve drugs However, the analysis says that most of those substances would have had a “limited health impact” and not reached many Canadians. More than 75% of the substances that weren’t submitted to Health Canada would have joined similar drugs marketed in the same therapeutic class. More than three-quarters would have been in pharmacologic subgroups that have more than five drugs in them already. And all but one that were reviewed by Germany’s version of the Canadian Agency for Drugs and Technologies in Health were found not to provide any additional therapeutic benefit over existing treatments. Most came from small manufacturers and were for “modest patient populations.” Sixty percent of those had no sales in 2021 in the Patented Medicine Prices Review Board’s 11 competitor countries; of those that did, many were less than $10 million in other countries. Etelcalcetide, which is used for hyperparathyroidism for patients on dialysis, was the highest-selling new active substance in the comparator countries in 2021. Canada had 29 other drugs marketed in etelcalcetide’s pharmacologic subgroup. The second-highest was vibegron, which is prescribed for overactive bladder. Canada had 178 drugs marketed in this pharmacologic subgroup, and only Japan had any sales of the drug. Read: 'High cost drugs, who have no competition': Medicaid plans to audit the prices of costliest drugs

How does Canada compare internationally on new drugs?

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