Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-25T16:22:00.883Z Has data issue: false hasContentIssue false
  • English
  • Français

Comprehensive Drug-Class Review Framework for improved evidence-based drug policy and formulary modernization

Published online by Cambridge University Press:  03 December 2019

Mina Tadrous Open the ORCID record for Mina Tadrous [Opens in a new window] ,
Sandra Knowles ,
Brent Ruddock ,
Paul Oh ,
Muhammad M. Mamdani ,
David N. Juurlink  and
Tara Gomes
Mina Tadrous*
Affiliation:
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada ICES, Toronto, Canada Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
Sandra Knowles
Affiliation:
Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada Sunnybrook Research Institute, Toronto, Canada
Brent Ruddock
Affiliation:
Ontario Public Drug Programs, Ontario Ministry of Health and Long-Term Care, Toronto, Canada
Paul Oh
Affiliation:
Sunnybrook Research Institute, Toronto, Canada Cardiac Rehabilitation Program, University Health Network Toronto Rehabilitation Institute, Toronto, Canada
Muhammad M. Mamdani
Affiliation:
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada ICES, Toronto, Canada Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
David N. Juurlink
Affiliation:
ICES, Toronto, Canada Sunnybrook Research Institute, Toronto, Canada Department of Medicine, University of Toronto, Toronto, Canada
Tara Gomes
Affiliation:
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada ICES, Toronto, Canada Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
*
Author for correspondence: Mina Tadrous, E-mail: tadrousm@smh.ca
Get access Rights & Permissions [Opens in a new window]

Abstract

Formularies are used by payers to optimize access and ensure the appropriate use of medications. Lack of follow-up and re-evaluation can lead to outdated formularies that are not reflective of current evidence. Formulary modernization, an approach to re-align formularies with current evidence has proven successful. The Ontario Drug Policy Research Network (ODPRN) launched a framework for conducting comprehensive drug-class reviews. This commentary describes the individual components of this framework and lessons learned through completion of 12 reviews between 2013 and 2016. We present the ODPRN drug-class review of treatments for chronic hepatitis B as a case example to illustrate the components and impact. The incorporation of foundational health technology assessment components such as economic evaluations and knowledge synthesis with contextualizing evidence such as patient and clinician perspectives (through qualitative studies), real-world evidence (through data analytics), and cross-jurisdictional comparisons (through environmental scans and data analytics), successfully developed jurisdictionally specific policy recommendations grounded in up-to-date evidence. The ODPRN framework for conducting comprehensive drug-class reviews is a robust and feasible approach to conduct formulary modernization. This framework allows for actionable and specific policies which are likely to be considered by decision makers. Adoption of similar frameworks in other jurisdictions may improve uptake of evidence-informed policy recommendations.

Keywords

Technology assessmentBiomedicalDataEvidence generationHealthcare policyReal-world data
Type
Article Commentary
Information
International Journal of Technology Assessment in Health Care , Volume 36 , Issue 1 , 2020 , pp. 12 - 19
Copyright
Copyright © Cambridge University Press 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Canadian Institute for Health Information (2016) Prescribed drug spending in Canada, 2016: A focus on public drug programs. Available at: https://secure.cihi.ca/free_products/Prescribed%20Drug%20Spending%20in%20Canada_2016_EN_web.pdf. Accessed December 1, 2018.Google Scholar
2.Morgan, SG, McMahon, M, Mitton, C, et al. (2006) Centralized drug review processes in Australia, Canada, New Zealand, and the United Kingdom. Health Aff 25(2), 337–347.CrossRefGoogle ScholarPubMed
3.Pharmacopeia, U (2000) Principles of a sound drug formulary system. Rockville: US Pharmacopeia.Google Scholar
4.Tierney, M, Manns, B (2008) Optimizing the use of prescription drugs in Canada through the Common Drug Review. CMAJ 178(4), 432–435.CrossRefGoogle ScholarPubMed
5.McDonagh, MS, Jonas, DE, Gartlehner, G, et al. (2012) Methods for the drug effectiveness review project. BMC Med Res Methodol 12(1), 140.CrossRefGoogle ScholarPubMed
6.Khan, S, Moore, JE, Gomes, T, et al. (2014) The Ontario Drug Policy Research Network: Bridging the gap between research and drug policy. Health Policy 117(3), 392–398.CrossRefGoogle ScholarPubMed
7.Ontario Drug Policy Research Network (2015) Treatment of CHB in Ontario. Available at: http://odprn.ca/research/drug-class-review/chronic-hepatitis-b/. Accessed December 1, 2018.Google Scholar
8.Tricco, AC, Antony, J, Zarin, W, et al. (2015) A scoping review of rapid review methods. BMC Med 13(1), 224.CrossRefGoogle ScholarPubMed
9.Coyle, D, Lee, KM, Mamdani, M, et al. (2015) Reimbursement-based economics—what is it and how can we use it to inform drug policy reform? Headache 55(S4), 236–247.CrossRefGoogle ScholarPubMed
10.Kwong, J, Crowcroft, N, Campitelli, M, et al. (2010) Ontario Burden of Infectious Disease Study Advisory Group; Ontario Burden of Infectious Disease Study (ONBOIDS): An OAHPP/ICES Report. Toronto: Ontario Agency for Health Protection and Promotion. Institute for Clinical Evaluative Sciences, 28–33.Google Scholar
11.Minuk, G, Uhanova, J (2001) CHB in Canada. Can J Infect Dis Med Microbiol 12(6), 351–356.Google Scholar
12.Schweitzer, A, Horn, J, Mikolajczyk, RT, et al. (2015) Estimations of worldwide prevalence of CHB virus infection: A systematic review of data published between 1965 and 2013. Lancet 386(10003), 1546–55.CrossRefGoogle Scholar
13.Zhang, J, Zou, S, Giulivi, A (2001) Epidemiology of hepatitis B in Canada. Can J Infect Dis Med Microbiol 12(6), 345–350.Google ScholarPubMed
14.Sherman, M, Bain, V, Villeneuve, J-P, et al. (2004) The management of chronic viral hepatitis: A Canadian consensus conference. Can J Gastroenterol Hepatol 18(12), 715–728.Google ScholarPubMed
15.Liaw, Y-F, Kao, J-H, Piratvisuth, T, et al. (2012) Asian-Pacific consensus statement on the management of CHB: A 2012 update. Hepatol Int 6(3), 531–561.CrossRefGoogle Scholar
16.Liver EAFTSOT (2012) EASL clinical practice guidelines: Management of CHB virus infection. J Hepatol 57(1), 167–185.CrossRefGoogle Scholar
17.Terrault, NA, Bzowej, NH, Chang, KM, et al. (2016) AASLD guidelines for treatment of CHB. Hepatology 63(1), 261–283.CrossRefGoogle Scholar
18.Leber, A, Sherman, M (2009) Estimation of immigration related CHB infection and hepatocellular carcinoma development in Canada from 1981–2006. Can J Gastroenterol (Suppl A), A22.Google Scholar
19.Tadrous, M, Brahmania, M, Martins, D, et al. (2018) Publicly funded oral CHB treatment patterns in Ontario over 16 years: An ecologic study. J Manag Care Spec Pharm 24(5), 464–468.Google Scholar
20.Ministry of Health and Long-Term Care Ontario Public Drug Programs (2018) Notice from the executive officer: Funding of hepatitis B drugs under the Ontario Drug Benefit Program. Available at: http://www.health.gov.on.ca/en/pro/programs/drugs/opdp_eo/notices/exec_office_20180221.pdf. Accessed December 1, 2018.Google Scholar