This webinar was hosted by Gerry Jeffcott from 3Sixty Public Affairs. He summarized some important changes that the Canadian Agency for Drugs and Technologies in Health (CADTH) has proposed to the way pCODR reviews new cancer medications and outline the current consultation process. Following the CADTH summary, patient representatives Louise Binder (Save Your Skin Foundation) and Martine Elias (Myeloma Canada) offered their perspective on the proposals and helped frame the patient feedback. After hearing from CADTH and the patients, there was time for an interactive question and answer session. In particular, the presentation covered the following topics: - A summary of the Cancer Drug Implementation Advisory Committee (CDIAC) role and function in the cancer medication evaluation process - A review of how CADTH proposes to embed the CDIAC’s work into its pCODR process - Patient perspectives on the proposed changes

1. CDIAC Transition to CADTH
CCSN Webinar | March 14, 2019
Cancer Drug
Implementation
Advisory Committee
(CDIAC)

2. Guest Panelists
Louise Binder
Health Policy Consultant
Save Your Skin Foundation
Martine Elias
Executive Director
Myeloma Canada
2

3. Overview
• Where does CDIAC fit in the Canadian medication
reimbursement review and approval process
• Summary of the CADTH proposal
• Panel discussion
• Q & A
3

4. Overview of
the Canadian
Medication
Review
Process
4

5. pCODR Process
• The pan-Canadian Oncology Drug Review
(pCODR) is a national review program that
conducts evidence-informed comparative clinical
and cost-effectiveness evaluations of new cancer
treatments
• As part of a pCODR evaluation, CADTH
undertakes a systematic review, engages clinical
and economic panels to conduct assessments of
submitted evidence, considers public drug plan,
patient and clinician input and submits its
findings to the pCODR Expert Review Committee
(pERC)
• pERC makes funding recommendations based on
a four-part deliberative framework to support
public reimbursement decision-making
5

6. pCPA
• The pan-Canadian Pharmaceutical Alliance
(pCPA) is a national framework that facilitates
product listing agreement negotiations related
to innovative medications under consideration
by public payers for reimbursement
• The pCPA negotiates with innovators on behalf
of all public payers in Canada. The terms
negotiated in the context of successful
agreements are used to facilitate public
reimbursement deals between the
manufacturer and each individual public plan
• The pCPA terms are considered in the context
of each jurisdictions particular circumstances
(i.e., formulary design, reimbursed
competitors, system considerations)
6

7. How CDIAC currently operates
Initiate
Implementation issues
highlighted and prioritized
Confirm
Discussion of provincial
funding intentions
Consult
Survey tumour group leads
Consolidate
Review funding options, provincial
intentions, clinical input and funding
recos incl. sequencing
Share
Final recos shared with
CAPCA board
3 - 4
months
“in parallel
with
pCODR /
pCPA”
CDIAC• Cancer Drug Funding
Implementation Advisory
Committee (CDIAC) is a multi-
stakeholder advisory body
• Operates under the auspices of
the Canadian Association of
Provincial Cancer Agencies
(CAPCA)
• Provides advice about funding
options and sequencing
• In place since 2016 – formed as
part of CAPCA’s Cancer Drug
Funding Sustainability initiative
• Now consulting on a potential
transfer of CDIAC responsibilities
to CADTH
7

8. CADTH Consultation
Proposal to Integrate Key Functions of the Cancer
Drug Implementation Advisory Committee into
CADTH’s pan-Canadian Oncology Drug Review
Process
• Consultation document
https://www.cadth.ca/sites/default/files/pcodr/cdiac-consultation-
doc-backgrounder.pdf
• March 4th webinar recording
https://register.gotowebinar.com/recording/135518503898294540
8

9. 9
Current pCODR and CDIAC Coordination
1. Pre-Submission
Before a submission
received: 4 months
4. CDIAC Work: ~4 months
Initiate CDIAC
process
~ 1 month before
initial rec is issued
CAPCA Board
consideration
(after notification
to implement)
2. Assessment
Submission received to posting
initial recommendation: 6 months
3. Feedback and Completion
Stakeholder input

10. Summary of CADTH proposals
Proposed changes:
1. Pre-submission requirements
(incl. proposed treatment
algorithm)
2. Enhanced clinician engagement
3. Revisions to the mandates of the
Provincial Advisory Group (PAG),
clinical guidance panels and pERC
4. Expansion of PAG membership
5. CAPCA Board review
10
CDIAC tasks to be
embedded in the
pCODR process
1. Consider how to
integrate new
oncology treatments
into a given
therapeutic area
2. Examine how a new
product would
affect existing
treatment patterns

11. Proposed pCODR Process
11
4-month timeline
unchanged
CAPCA
Board of
Directors
180-day timeline
unchanged

12. 2019 Timeline
12
Consultation announced: February 21
Consultation background and survey released: February 28
Webinar: March 4
Consultation closes: March 28
Internal (staff, advisory, and expert committee) plus external discussion:
April
Proposal modification/process documentation revisions: May to June
Launch: July 1

13. Panel discussion
13

14. 14

15. 15
Canadian Cancer Survivor Network
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Ottawa, ON K2C 2B5
Telephone: 613-898-1871
E-mail jmanthorne@survivornet.ca or mforrest@survivornet.ca
Website www.survivornet.ca
Blog: http://jackiemanthornescancerblog.blogspot.com/
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