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Economic Evaluations in the Canadian Common Drug Review

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Abstract

The Canadian Common Drug Review (CDR) was established in 2003 to provide a single process for making formulary recommendations to most Canadian publicly funded drug plans. This paper considers the most common challenges faced by the CDR: (a) determining the effectiveness of a drug (particularly interpreting the importance of surrogate markers and changes in QOL measures); (b) the massive rise in the cost of new drugs, which, in general, does not seem to accompanied by a massive increase in effectiveness; (c) interpreting complex pharmacoeconomic evaluations which often do not provide straightforward answers about the cost effectiveness of a drug; (d) prescription creep (the tendency for drugs in the real world to be used in patients who were not studied in clinical trials, thus raising concerns about a drug’s real-world cost effectiveness; and (e) ethical and societal issues, particularly the reimbursement of expensive drugs for rare diseases.

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Notes

  1. The use of trade names is for product identification purposes only and does not imply endorsement.

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Acknowledgements

Dr Laupacis was Chair of the Canadian Expert Drug Advisory Committee (CEDAC) during its first 3 years. The views expressed in this article are those of Dr Laupacis, and do not represent the views of CEDAC, the Common Drug Review, the Institute for Clinical Evaluative Sciences or St Michael’s Hospital.

No sources of funding were used to assist in the preparation of this article. The author has no conflicts of interest that are directly relevant to the content of this article.

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Authors and Affiliations

  1. Li Ka Shing Knowledge Institute, 30 Bond Street (80 Bond Street, 1st Floor), Toronto, Ontario, M5B 1X2, Canada

    Andreas Laupacis

  2. Departments of Medicine and Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

    Andreas Laupacis

  3. Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada

    Andreas Laupacis

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  1. Andreas Laupacis
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Correspondence to Andreas Laupacis.

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Laupacis, A. Economic Evaluations in the Canadian Common Drug Review. Pharmacoeconomics 24, 1157–1162 (2006). https://doi.org/10.2165/00019053-200624110-00011

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