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Use of Real-World Data Sources for Canadian Drug Pricing and Reimbursement Decisions: Stakeholder Views and Lessons for Other Countries

Published online by Cambridge University Press:  28 May 2019

Don Husereau ,
Edward Nason ,
Tarun Ahuja ,
Enkeleida Nikaï ,
Eva Tsakonas  and
Philip Jacobs
Don Husereau*
Affiliation:
School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
Edward Nason
Affiliation:
Ontario SPOR Support Unit, Toronto, Canada
Tarun Ahuja
Affiliation:
Canadian Agency for Drugs and Technologies in Health, Ottawa, Canada
Enkeleida Nikaï
Affiliation:
Eli Lilly Benelux S.A., Brussels, Belgium
Eva Tsakonas
Affiliation:
Independent consultant, Montreal, Canada
Philip Jacobs
Affiliation:
University of Alberta, Edmonton, Canada
*
Author for correspondence: Don Husereau, E-mail: donh@donhusereau.com
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Abstract

Background

Canada has a long history of the use of clinical evidence to support healthcare decision making. Given improvements in data holdings and analytic capacity in Canada and stakeholder interest, the purpose of this study is to reflect on perceptions of the value of real-world evidence in pricing and reimbursement decisions, barriers to its optimal use in pricing and reimbursement, current initiatives that may lead to its increased use, and what role the pharmaceutical industry may play in this.

Methods/Results

To capture stakeholder perceptions, ninety-one participants identified as key stakeholders were identified according to background roles and geography and invited to participate in four round table discussions conducted under Chatham House rule. Important themes emerging from these discussions included: (i) the need to understand what “real world” evidence means; (ii) barriers to using real world evidence from differences in access, governance, inter-operability, system structures, expertise, and quality across Canadian health systems; (iii) differing views on industry's role.

Conclusions

The use of real-world data in Canada to inform pricing and reimbursement decisions is far from routine but nascent and slowly increasing. Barriers, including interoperability concerns, may also apply to other federated health systems that need to focus on the networking of healthcare administrative data across provincial jurisdictional boundaries. There also appears to be a desire to see better use of pragmatic trials linked to these administrative data sets. Emerging initiatives are under way to use real world evidence more broadly, and include identification of common data elements and approaches to networking data.

Keywords

DataHealthcare policyReal-world dataEvidence generation
Type
Policy
Information
International Journal of Technology Assessment in Health Care , Volume 35 , Issue 3 , 2019 , pp. 181 - 188
Copyright
Copyright © Cambridge University Press 2019 

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