Medlior’s Founder and President Tara Cowling was delighted to attend the CADTH Symposium 2023 in Ottawa last week. The event brought together our Canadian HEOR and HTA community.
On the heels of the ISPOR 2023 conference, CADTH also tackled some key issues surrounding the use of RWE to inform decision-making. The demand to include RWE in HTA decision-making in Canada stems largely from our prolonged timelines to access novel therapies, particularly for populations with high unmet needs such as rare disease populations. Some highlights and key takeaways from the discussions were as follows:
- CADTH RWE guidance
CADTH released the final version of their RWE guidance at the start of the symposium. An emphasis was placed on this guidance being iterative, and future versions addressing areas such as how RWE will be reviewed and incorporated into committee decision-making. The current guidance is somewhat limited, an “epi 101” in terms of best practices for reporting observational studies. Still, it does offer a useful checklist to ensure researchers and manufacturers have considered key areas for reporting their studies with transparency in terms of the data source, methods, and results presentation. The takeaway message: “Transparency is key for RWE in HTA.”
- Managed access in Canada
Timelines for Canadians to access innovative therapies was a key theme at the symposium. Citing international examples of managed access agreements, a panel of patients, payers, and HTA representatives agreed that Canada’s multi-payer health system can learn from other countries to facilitate faster access in Canada. In fact, one avenue may be a “coverage with evidence” recommendation, expected from CADTH. This recommendation would allow patient access to new therapies while evidence is still being collected. A coverage with evidence recommendation would follow the example of HTA bodies from other publicly funded health systems, including NICE in the UK. The takeaway message: “Managed access in Canada is feasible.”
- Surrogate outcomes
An illustrious group of Canadians—including Bill Dempster, Kristian Thorland, Cal Shephard, Robert Bick, and Lisa Machado—have been on a roadshow since 2022 discussing opportunities for surrogate outcomes to facilitate access to new therapies. At the symposium this panel was joined by Farah Hussein, Director of Science and Methods at CADTH, to discuss the potential for surrogate outcomes and the importance of patients’ voices for driving access to therapies for early-stage cancers. The takeaway message: “Surrogate outcomes may facilitate access for patients with early-stage cancer”.
How can Medlior help?
We are delighted to see opportunities emerging to leverage world-class provincial health system data in Canada to inform and expedite decision-making. There is tremendous potential in health system data for informing managed access agreements and determining surrogate endpoints for those agreements.
Compared to other datasets, Canadian health system data has the advantage of data provenance and quality (i.e., robust data collected by the health system). The data is population-based with long-term follow-up and can be linked to lab data, vital statistics, inpatient, outpatient, and drug claims datasets.
We are grateful for our opportunity to participate in such an energized and innovation-focused agenda at the CADTH Symposium and look forward to participating again next year!