scholarly journals Impact of the pan-Canadian Oncology Drug Review on provincial concordance with respect to cancer drug funding decisions and time to funding

2017 ◽  
Vol 24 (5) ◽  
pp. 295 ◽  
Author(s):  
A. Srikanthan ◽  
H. Mai ◽  
N. Penner ◽  
E. Amir ◽  
A. Laupacis ◽  
...  
Keyword(s):  
Linear Models ◽  
Drug Product ◽  
Median Number ◽  
Cancer Drug ◽  
Cancer Drugs ◽  
Oncology Drug ◽  
Before And After ◽  
Canadian Provinces ◽  
The Impact ◽  
Drug Review

Background The pan-Canadian Oncology Drug Review (pcodr) was implemented in 2011 to address uneven drug coverage and lack of transparency with respect to the various provincial cancer drug review processes in Canada. We evaluated the impact of the pcodr on provincial decision concordance and time from Notice of Compliance (noc) to drug funding.Methods In a retrospective review, Health Canada’s Drug Product Database was used to identify new indications for cancer drugs between January 2003 and May 2014, and provincial formulary listings for drug-funding dates and decisions between 1 January 2003 and 31 December 2014 were retrieved. Multiple linear models and quantile regressions were used to evaluate changes in time to decision-making before and after the implementation of the pcodr. Agreement of decisions between provinces was evaluated using kappa statistics.Results Data were available from 9 provinces (all Canadian provinces except Quebec), identifying 88 indications that represented 51 unique cancer drugs. Two provinces lacked available data for all 88 indications at the time of data collection. Interprovincial concordance in drug funding decisions significantly increased after the pcodr’s implementation (Brennan-Prediger coefficient: 0.54 pre-pcodr vs. 0.78 post-pcodr; p = 0.002). Nationwide, the median number of days from Health Canada’s noc date to the date of funding significantly declined (to 393 days from 522 days, p < 0.001). Exploratory analyses excluding provinces with incomplete data did not change the results.Conclusions After the implementation of the pcodr, greater concordance in cancer drug funding decisions between provinces and decreased time to funding decisions were observed.

scholarly journals Telehealth to support referral management in a universal health system: a before-and-after study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sabrina Dalbosco Gadenz ◽  
Josué Basso ◽  
Patrícia Roberta Berithe Pedrosa de Oliviera ◽  
Stephan Sperling ◽  
Marcus Vinicius Dutra Zuanazzi ◽  
...  
Keyword(s):  
Linear Models ◽  
Patient Flow ◽  
Waiting Times ◽  
Median Number ◽  
Waiting Lists ◽  
Referral Management ◽  
Before And After ◽  
The Impact ◽  
Universal Health ◽  
Before And After Study

Abstract Background Management of patient flow within a healthcare network, allowing equitable and qualified access to healthcare, is a major challenge for universal health systems. Implementation of telehealth strategies to support referral management has been shown to increase primary care resolution and to promote coordination of care. The objective of this study was to assess the impact of telehealth strategies on waiting lists and waiting times for specialized care in Brazil. Methods Before-and-after study with measures obtained between January 2019 and February 2020. Baseline measurements of waiting lists were obtained immediately before the implementation of a remotely operated referral management system. Post-interventional measurements were obtained monthly, up to six months after the beginning of operation. Data was extracted from the database of the project. General linear models were applied to assess interaction of locality and time over number of cases on waiting lists and waiting times. Results At baseline, the median number of cases on waiting lists ranged from 2961 to 12,305 cases. Reductions of the number of cases on waiting lists after six months of operation were observed in all localities. The magnitude of the reduction ranged from 54.67 to 88.97 %. Interaction of time measurements was statistically significant from the second month onward. Median waiting times ranged from 159 to 241 days at baseline. After six months, there was a decrease of 100 and 114 waiting days in two localities, respectively, with reduction of waiting times only for high-risk cases in the third locality. Conclusions Adoption of telehealth strategies resulted in the reduction of number of cases on waiting lists. Results were consistent across localities, suggesting that telehealth interventions are viable in diverse settings.

PP134 The Impact Of Pan-Canadian Oncology Drug Review Coming Under The Remit Of The Canadian Agency For Drugs And Technologies In Health – Three Year Update

2018 ◽  
Vol 34 (S1) ◽  
pp. 118-119
Author(s):  
Richard Macaulay ◽  
Erika Turkstra ◽  
Elizabeth Griffiths
Keyword(s):  
Evaluation Criteria ◽  
Oncology Drug ◽  
Canadian Provinces ◽  
The Government ◽  
Two Phases ◽  
Student’S T ◽  
The Impact ◽  
Drug Review ◽  
Positive Recommendation ◽  
Student’S T Test

Introduction:The pan-Canadian Oncology Drug Review (pCODR) was established in 2010 to bring consistent oncology drug assessments across Canadian provinces/territories. In April 2014, pCODR was transferred to the Canadian Agency for Drugs and Technologies in Health (CADTH). This transfer comprised two phases. In phase one, pCODR staff, processes, funding, and expertise remained intact as a program but under the government of CADTH. In phase two, beginning April 2015, better alignment of pCODR and CADTH evaluation criteria and review processes were explored. This research aims to see what effect the CADTH transfer has had on the number of appraisals conducted by pCODR and their recommendation rates.Methods:All publically available pCODR reports were extracted up to 22nd November 2017. The drug, indication, date and outcome were extracted. Statistical comparisons were made using Student's t-test.Results:Ninety-six appraisals have been conducted by pCODR, reflecting an average of 16 per year (10 in 2012, 18 in 2013, 9 in 2014, 24 in 2015, 19 in 2016, and 20 in 2017). The rate of appraisals was similar pre-CADTH transfer (14.2 per year [32 from January 2012 to March 2014]) versus post-CADTH transfer (13.7 per year [56 from April 2014 to November 2017]). Seventy-eight percent of pCODR outcomes were positive recommendations (defined as full recommendations [10 percent] or restricted/conditional recommendations [68 percent]) with 22 percent not recommended. Annually, positive recommendation rates were 70 percent in 2012, 89 percent in 2013, 78 percent in 2014, 79 percent in 2015, 74 percent in 2016, and 75 percent in 2017. There were no significant differences in recommendation rates since pCODR was transferred to CADTH irrespective if the phase one or phase two cut-off dates were used (p = 0.434 and 0.307, respectively).Conclusions:The number of appraisals and likelihood of a positive recommendation for oncology drugs has not been affected by the pCODR transfer to CADTH.

scholarly journals mHealth App Prescription in Australian General Practice: Pre-Post Study

10.2196/16497 ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. e16497 ◽  
Author(s):  
Oyungerel Byambasuren ◽  
Elaine Beller ◽  
Tammy Hoffmann ◽  
Paul Glasziou
Keyword(s):  
General Practice ◽  
Median Number ◽  
Implementation Intervention ◽  
Electronic Reporting ◽  
Before And After ◽  
Australian General Practice ◽  
Prescription Rates ◽  
Drug Interventions ◽  
The Impact ◽  
Mhealth Apps

Background Evidence of effectiveness of mobile health (mHealth) apps as well as their usability as non-drug interventions in primary care are emerging around the globe. Objective This study aimed to explore the feasibility of mHealth app prescription by general practitioners (GPs) and to evaluate the effectiveness of an implementation intervention to increase app prescription. Methods A single-group, before-and-after study was conducted in Australian general practice. GPs were given prescription pads for 6 mHealth apps and reported the number of prescriptions dispensed for 4 months. After the reporting of month 2, a 2-minute video of one of the apps was randomly selected and sent to each GP. Data were collected through a prestudy questionnaire, monthly electronic reporting, and end-of-study interviews. The primary outcome was the number of app prescriptions (total, monthly, per GP, and per GP per fortnight). Secondary outcomes included confidence in prescribing apps (0-5 scale), the impact of the intervention video on subsequent prescription numbers, and acceptability of the interventions. Results Of 40 GPs recruited, 39 commenced, and 36 completed the study. In total, 1324 app prescriptions were dispensed over 4 months. The median number of apps prescribed per GP was 30 (range 6-111 apps). The median number of apps prescribed per GP per fortnight increased from the pre-study level of 1.7 to 4.1. Confidence about prescribing apps doubled from a mean of 2 (not so confident) to 4 (very confident). App videos did not affect subsequent prescription rates substantially. Post-study interviews revealed that the intervention was highly acceptable. Conclusions mHealth app prescription in general practice is feasible, and our implementation intervention was effective in increasing app prescription. GPs need more tailored education and training on the value of mHealth apps and knowledge of prescribable apps to be able to successfully change their prescribing habits to include apps. The future of sustainable and scalable app prescription requires a trustworthy electronic app repository of prescribable mHealth apps for GPs.

scholarly journals Clinician participation in CADTH’s pan-Canadian Oncology Drug Review: contribution and impact on cancer drug funding recommendations

2017 ◽  
Vol 24 (2) ◽  
pp. 71
Author(s):  
M. Trudeau ◽  
P. Hoskins ◽  
T. Reiman ◽  
A. Chambers ◽  
H. Mai ◽  
...  
Keyword(s):  
Cancer Drug ◽  
Oncology Drug ◽  
Drug Review

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Pan-Canadian Oncology Drug Review (pCODR): A unique model to support harmonization of cancer drug funding decisions in Canada.

2018 ◽  
Vol 36 (30_suppl) ◽  
pp. 41-41 ◽  
Author(s):  
Maureen E. Trudeau ◽  
Alexandra Chambers ◽  
Kendra Christiansen ◽  
Helen Mai
Keyword(s):  
Cancer Drug ◽  
Equitable Access ◽  
Review Committee ◽  
Expert Review ◽  
Unique Model ◽  
Consistent Manner ◽  
Local Funding ◽  
Canadian Provinces ◽  
The Cost ◽  
Drug Review

41 Background: Unlike most other countries, Canada has a dedicated HTA process to review cancer drugs. pCODR, a program of CADTH, conducts thorough and objective evaluations of clinical and economic evidence; as well as considering clinician and patient perspectives, and using this information to make recommendations to the participating jurisdictions to guide their drug funding decisions. Previously, Canadian provinces had separate regional drug review processes to inform their local funding decisions. The pCODR process reduces duplication of effort by individual funders and ensures that reviews are done in a timely and consistent manner. Methods: In a retrospective review, we identified all anticancer drugs reviewed by pCODR from July 2011 to March 2018. Results: As of March 31, 2018, pCODR has issued 103 notifications to implement a final recommendation. Of note, 96% of the submissions include patient group input and 88% of the submissions include clinician input. The median time to complete a review is 146 business days. The pCODR Expert Review Committee has issued 21 negative recommendations, while the remainder were either positive recommendations (n = 10), or conditional recommendations (n = 72). The “condition” that must be addressed most frequently in the conditional recommendations is the cost-effectiveness of the drug. Over 75% of the 82 positive and conditional recommendations have received uptake from one or more participating jurisdictions. The concordance rates are as follows: Conclusions: With the implementation of the pCODR process, there is greater harmonization in cancer drug funding decisions and supports equitable access across Canada.[Table: see text]

Association between oncology drug review times and public funding recommendations.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 99-99
Author(s):  
Richard Gagnon ◽  
Chelsea Wong ◽  
Eddy Taguedong ◽  
Parthiv Maneesh ◽  
Safiya Karim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Public Funding ◽  
Study Data ◽  
Clinical Indication ◽  
Cancer Drug ◽  
P Value ◽  
Tumour Type ◽  
Oncology Drug ◽  
To Receive ◽  
Drug Review

99 Background: New oncology drugs undergo detailed review of clinical, economic, and patient data. Thoroughly assessing these data can require lengthy review processes, in the absence of accelerated approval pathways. The aim of this study was to assess how cancer drug review times impact public funding recommendations. Methods: Drugs reviewed by Canada’s health technology assessment body, the pan-Canadian Oncology Drug Review (pCODR), from April 2012 to November 2020 were included in this study. Data was collected including Health Canada approval date, initial and final funding recommendations, treatment intent, drug class, clinical indication (tumour type) and incremental cost-effectiveness ratios (ICER). Univariable and multivariable analyses were used to determine the association between funding recommendations and review times. Results: Of the 227 applications submitted to pCODR, 168 had received positive funding recommendations. Amongst the total drug applications, 24 (14.3%) drugs were intended for the treatment of thoracic cancers, 19 (11.3%) for gastrointestinal cancers, 17 (10.1%) for genitourinary cancers, 17 (10.1%) for breast cancer, and 91 (54.2%) for other tumour sites. Median time from pCODR submission to final recommendation was longer for drugs indicated for the treatment of lung and breast cancer compared to those indicated for treatment of other tumours (223 vs. 212 vs. 203 days, respectively; Kruskal-Wallis p = 0.0322). Drugs with longer review times were more likely to receive a negative pCODR recommendation, even when adjusting for ICER (157 vs 298 days, Wilcoxon p-value = 0.0003). There was no association between positive or negative funding recommendation and tumour type. Conclusions: Oncology drugs with longer review times are less likely to receive recommendation for public funding in Canada. Addressing factors contributing to variance in review times and standardizing the review process can ensure equitable access to cancer drugs.

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