The pan-Canadian Cancer Drug Funding Sustainability Ini9a9ve

JULY 13 2017

THE CANADIAN ASSOCIATION OF PROVINCIAL CANCER AGENCIES (CAPCA)

Agenda

4. Real World Evidence

BackgroundandContext

SummaryofStakeholderConsulta5on

Q&A

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MembersandPartners

OurPartners•  CADTH/pCODR•  pan-CanadianPharmaceu5calAlliance(pCPA)•  CanadianPartnershipAgainstCancer(CPAC) 3

  Direc5ongénéraledecancérologie,MinistryofHealthandSocialServicesDr.JeanLatreille

  NewBrunswickCancerNetworkDr.EshwarKumar

  EasternHealthCancerCareProgramElaineWarren

  NovaSco5aHealthAuthorityDr.DrewBethune

  PEICancerTreatmentCentreDr.PhilipChampion

BCCancerAgencyDr.MalcolmMoore

AlbertaHealthServicesNancyGuebert

SaskatchewanCancerAgencyJonTonita/ScoQLivingstone

CancerCareManitobaDr.SriNavratnam

CancerCareOntarioDr.MichaelSherar

The opportunity and the challenge

Growingincidenceofcancer

Growthinthecancerdrug

pipeline

Increasingsurvival

FiQerbeQer

informedpa5ents

Highcostofdrugs

Increasingcosts(drugsbiggest

%)

The opportunity and the challenge

Growingincidenceofcancer

Growthinthecancerdrug

pipeline

Increasingsurvival

FiQerbeQer

informedpa5ents

Highcostofdrugs

Increasingcosts(drugsbiggest

%)

The opportunity and the challenge

Growingincidenceofcancer

Growthinthecancerdrug

pipeline

Increasingsurvival

FiQerbeQer

informedpa5ents

Highcostofdrugs

Increasingcosts(drugsbiggest

%)

The opportunity and the challenge

Growingincidenceofcancer

Growthinthecancerdrug

pipeline

Increasingsurvival

FiQerbeQer

informedpa5ents

Highcostofdrugs

Increasingcosts(drugsbiggest

%)

Price/mo(list)

Letrozole(generic) $39

Palbociclib $6250

Bortezomib(generic) $4723

Lenalidomide $8904

Carfilzomib $6133-$7666

Triplettherapy(len,dex+carfilzomib) $15,307

DrugFundingSustainabilityIni5a5ve

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Tocreateaprocesstogather,analyze,andapplyREAL

WORLDEVIDENCE(RWE)ofadrug’seffec5venessinthe

generalpopula5on

Todevelopcriteriaandaprocesstoassess

AFFORDABILITYofacancerdrug

ToOPTIMIZEhowcancerdrugsareselectedandused

ToHARMONIZEhownewcancerdrugsareintegratedintoclinicalpathwaysand

implemented

The pan-Canadian Oncology Drug System TODAY

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HealthCanada

pCODR/CADTH/INESSS

pCPA

F/P/Ts

•  Safety/Efficacy/Quality/ProposedPrac55onerandConsumerInforma5on

•  CostEffec5veness/ClinicalEffec5veness/Pa5entValues/Implementa5onFeasibilty

•  ValueandPrice

•  Implementa5on

CAPCA STAKEHOLDER ENGAGEMENT

TheCancerDrugImplementa5onAdvisoryCommiQee(CDIAC)

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AsanadvisorymechanismtoMinistriesofHealththroughtheCAPCABoardofDirectors,CDIACprovidesanopportunitytoinformhow–andnotjustwhether–newcancerdrugsshouldbeimplemented.Ithelpsbuildondiscussionsthatarealreadytakingplaceandbringspeopletogetherwhoarealreadydoingthisworkwithineachprovincetosharebestprac5cesandinforma5on,discussandwherefeasiblealignfundingintentandcriteria.

CDIAC’sProcess

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Ini5ate

•  Highlightimplemen-ta5onissues

Confirm

•  Discussprovincialfundinginten5ons

Consult

•  Gatherinputfromprovincialdiseasesiteclinicalleadsordesignates

Consolidate

•  Reviewclinicalinput,provincialfundinginten5ons,andconfirmop5ons

Share

•  Presentrecommen-da5onstoCAPCABoardofDirectors

pCPAleadnego5a5ons

CDIAC’s work occurs in parallel / concurrent with pCODR/pCPA processes, building on discussions that were already taking place in each province.

pERC

Agenda

4. Real World Evidence

BackgroundandContext

SummaryofStakeholderConsulta5on

Q&A

12

FourStepStakeholderConsulta5onProcess

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1 2 3 4

1.  Introductorywebinarsforclinicians,andpa5entgroup/pharmaceu5calindustryrepresenta5ves(JanuaryandFebruary)Purpose:Commonunderstandingofini5a5vepurposeandgoals

3.In-PersonRoundtables(FebruarytoApril)Purpose:Convenesmaller,in-persondiscussionsfordeeperinput

2.OngoingOnlineFeedback(JanuarytoApril)Purpose:Enablestakeholderstoprovideinputandraiseques5ons

4.On-lineSurvey(MarchandApril)Purpose:Gathermoredetailedfeedbackfrombroadergroup

Consulta5onThemes1.  Effortstoensurecon5nued5melyaccesstoinnova5ve,

evidence-basedcancertreatmentsisvital.Focusonpreservingaccessnotcostcontainment.

2.  Stakeholdersexpectmeaningful,ongoingopportuni5esfortheirvoicestobeheard.

3.  Betransparent,anddoubleuponeffortsimproveefficiencyandreduceorideallyeliminateduplica5onofwork.

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Consulta5onThemes

4.  Exploreintegra5onofCDIAC’sworkintootherexis5ngmechanisms,whererelevantandpossible

5.  Enhanceworktoaddressuseofrealworldevidence.

6.  Workloadisanareaofsignificantconcernforeveryone.Maximizeopportuni5esforinputandminimizethenumberof5mesit’srequested.

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CAPCA’sResponse1.  Ensureworkdoesnotslowprocessdownbydevelopingand

assessingkeyperformanceindicators.

2.  Exploreaddi5onofpa5ent,familyandpublicrepresenta5ononCDIAC.

3.  MakeCDIACmembership,mandateandprocesspublic.

4.  Exploreop5onstoenhancecollec5onanduseofrealworldevidence.

5.  Con5nuetofocusonrightconversa5onattheright5mewiththerightgroupofpeople.

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CurrentStatus1.  Keyperformanceindicatorsbeingdeveloped.Inten5onto

monitorimpactofCDIAConfunding5melines.

2.  Workingwithexis5ngPa5entandFamilyAdvisoryCouncilstoiden5fyapa5entandfamilyrepresenta5ve.

3.  Exploringop5onsforpublicrepresenta5on.

4.  CDIACmembership,mandateandprocesspostedoncapca.ca•  Implementa5onrecommenda5onsoneofseveralinputsthatMinistriesconsidersowillnotbemadepublic.

5.  OngoingdiscussionofCADTH,pCPA,andCAPCAleadershipandstafftoaligneffortandtoimproveefficiency.

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ClosingThoughts•  CAPCA’sgoalistoimproveaccesstohighquality,evidence-basedcancerdrugsforallpa5entsandcontributetothesustainabilityofthecancerdrugsystemforallCanadians.

•  CAPCA’sworkisinearlystages–andfeedbackandadvicefromstakeholdersacrossthecountryisessen5al.

•  Welookforwardtohearingfromthepar5cipantsontoday’swebinaraboutourworkondrugfundingsustainability.Thankyouforthisopportunity.

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Agenda

4. Real World Evidence

ContextandBackground

SummaryofStakeholderConsulta5on

Q&A

19

Q&A

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