Hurry up! Report highlights long wait times between Health Canada approval of new drugs and when they appear in provincial drug coverage

Canadians must wait on average two years before having access to new drugs approved by Health Canada through provincial public drug insurance plans—a delay “twice as long as that observed in most other OECD countries [Organization for Economic Co-operation and Development, Editor's note]”, indicates a new report from the Conference Board of Canada.The report invites pharmaceutical laboratories, organizations regulators and public payers to collaborate in order to streamline processes.In keeping with its economic vocation, the think tank emphasizes these delays are “not only detrimental to the lives of Canadians, but they also have a negative impact on Canada’s economic growth. . . . Canadians who could work or contribute to the economy cannot do so while waiting for new drugs that could significantly improve their quality of life.”The Conference Board's findings are not surprising in themselves. Several reports and studies have in the past highlighted the delays in availability of new drugs in the country. The organization Innovative Medicines Canada (IMC), which represents the interests of pharmaceutical companies in the country, reported in 2020 that Canada ranked 18th out of 20 among OECD countries in terms of time between the first global approval of a medicine until its public reimbursement. This delay was then estimated at 926 days while the median for developed countries was 519 days.This time, the Conference Board was particularly interested in the time between the green light given by Health Canada (this taking 180 to 300 days) and the inclusion of the new treatment on the lists of public health plans, which goes through several stages.After the notice of conformity obtained from Health Canada, the National Institute of Excellence in Health and Social Services (INESSS) in Quebec, or the Canadian Agency for Drugs and Technologies in Health (CADTH) in the rest of the Canada, come into play to evaluate the clinical effectiveness and cost-utility ratio of the drug. Following the opinions of the two evaluation agencies, the Pan-Canadian Pharmaceutical Alliance (PPA) takes over to negotiate its price with the manufacturer. Once its price is set, each participating province then decides if, and when, the treatment will be reimbursed by its public drug insurance plan.In 2022, an average of 736 days elapsed, or a little over two years, between Health Canada's notice of compliance and the inclusion of a new drug on the lists of provincial public plans. In 2021, this deadline was 827 days, or approximately two years and three months.Quebec stands out favorablyThe Conference Board report details the delays between the completion of negotiations between the APP and the manufacturer (which took an average of 189 days in 2022) and the inclusion of the drug on the lists of public plans in the different provinces. In this regard, Quebec stands out with the shortest delay, i.e. 44 days, well below the Canadian average (250 days). Conversely, Prince Edward Island takes the longest, with a delay of 662 days.“The number of drugs added to the list does not seem to have an impact on registration times in the provinces. For example, while Prince Edward Island and Manitoba had 44 and 46 drugs listed, respectively, the wait time for Prince Edward Island patients was more than three times longer,” the report further notes. .In conclusion, the Conference Board indicates that Ottawa, provincial governments and pharmaceutical manufacturers should work together to streamline the approval, evaluation and registration processes for new drugs. The report invites them in particular to shorten the time between approval from Health Canada and the conclusion of negotiations with the APP and to aim for a goal of 30 days between this conclusion and the inclusion of the drug on the provincial lists.This article was translated from its original French and first appeared on our sister site Profession Santé.

Hurry up! Report highlights long wait times between Health Canada approval of new drugs and when they appear in provincial drug coverage

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