OBJECTIVE: The integration of the Common Drug Review (CDR) was a substantial change for Canada's public drug plans. Detailed comparisons of time-to-listing and proportion of medications covered by the province of Alberta's drug plans within the context of the CDR process have not been rigorously conducted. METHODS: New drugs approved by Health Canada were identified five years prior to the CDR's first recommendation (May 2004) and five years after. The time-to-listing and proportion of new drugs covered on the Alberta Health and Wellness Drug Benefit List (AHWDBL) was compared between these periods. The level of agreement between CDR recommendations and coverage in Alberta was calculated using a kappa score. RESULTS: Two hundred and twenty new drugs were identified and met the study eligibility criteria (118 pre-CDR, 102 post-CDR). The median time-to-listing was 312 vs. 524 days in the pre-CDR and post-CDR periods, respectively, with the difference largely driven by time from notice of compliance (NOC) to the CDR recommendation. The level of agreement between 73 drugs with CDR recommendations and coverage in Alberta was fair (kappa 0.55). CONCLUSION: Following the implementation of the CDR, the proportion of drugs covered has decreased and overall median time-to-listing of new drugs has increased in the province of Alberta. For drugs listed on the AHWDBL, the proportion of time attributable to the CDR process (NOC to CDR recommendation) was 63% of the overall time-to-listing.
OBJECTIVE: The integration of the Common Drug Review (CDR) was a substantial change for Canada's public drug plans. Detailed comparisons of time-to-listing and proportion of medications covered by the province of Alberta's drug plans within the context of the CDR process have not been rigorously conducted. METHODS: New drugs approved by Health Canada were identified five years prior to the CDR's first recommendation (May 2004) and five years after. The time-to-listing and proportion of new drugs covered on the Alberta Health and Wellness Drug Benefit List (AHWDBL) was compared between these periods. The level of agreement between CDR recommendations and coverage in Alberta was calculated using a kappa score. RESULTS: Two hundred and twenty new drugs were identified and met the study eligibility criteria (118 pre-CDR, 102 post-CDR). The median time-to-listing was 312 vs. 524 days in the pre-CDR and post-CDR periods, respectively, with the difference largely driven by time from notice of compliance (NOC) to the CDR recommendation. The level of agreement between 73 drugs with CDR recommendations and coverage in Alberta was fair (kappa 0.55). CONCLUSION: Following the implementation of the CDR, the proportion of drugs covered has decreased and overall median time-to-listing of new drugs has increased in the province of Alberta. For drugs listed on the AHWDBL, the proportion of time attributable to the CDR process (NOC to CDR recommendation) was 63% of the overall time-to-listing.
Authors: Muhammad Mamdani; Leanne Warren; Alex Kopp; J Michael Paterson; Andreas Laupacis; Ken Bassett; Geoffrey M Anderson Journal: CMAJ Date: 2006-12-05 Impact factor: 8.262
Authors: Cynthia A Jackevicius; Jack V Tu; Virginie Demers; Magda Melo; Jafna Cox; Stephane Rinfret; Dimitri Kalavrouziotis; Helen Johansen; Hassan Behlouli; Alice Newman; Louise Pilote Journal: N Engl J Med Date: 2008-10-23 Impact factor: 91.245
Authors: Virginie Demers; Magda Melo; Cynthia Jackevicius; Jafna Cox; Dimitri Kalavrouziotis; Stéphane Rinfret; Karin H Humphries; Helen Johansen; Jack V Tu; Louise Pilote Journal: CMAJ Date: 2008-02-12 Impact factor: 8.262