Appraising Canada's Joint/pan-Canadian Oncology Drug Review (JODR/pCODR) Using an Economic Perspective

Abstract

<p>BACKGROUND AND OBJECTIVES: In 2007, the Joint Oncology Drug Review (JODR) (which ultimately evolved into a permanent body called the pan-Canadian Oncology Drug Review (pCODR)) was established to make recommendations to Canada’s provincial and territorial public drug plans regarding the funding (i.e. reimbursement) of new cancer drugs. The JODR/pCODR exists alongside Canada’s Common Drug Review, which provides reimbursement recommendations to Canada’s provincial and territorial public drug plans for drugs in all other disease areas. Using an economic perspective, this thesis (composed of three separate papers) appraised: the rationale for the JODR/pCODR’s establishment, the JODR/pCODR’s resource allocation goals, and the JODR/pCODR’s decision-making criteria and decision rules. The overarching theme linking the three thesis papers is whether the JODR/pCODR facilitates Canada’s provincial drug plans’ ability to achieve a goal of maximizing health benefits with available resources.</p> <p>METHODS: For the first two papers, a series of questions regarding the JODR’s establishment, resource allocation goals, decision-making criteria and decision rules were posed. The questions were answered by reviewing peer-reviewed literature and/or JODR/pCODR-published materials and by applying fundamental principles underlying an economic perspective. By again applying these same principles, the third paper in this thesis addressed the challenges associated with striving to simultaneously achieve the pCODR’s resource allocation goals of maximizing health benefits with available resources and striving to improve access to a more consistent standard of care across Canada.</p> <p>FINDINGS AND CONCLUSION: The various issues identified in this thesis suggest that the JODR/pCODR is unlikely to facilitate Canada’s provincial drug plans’ ability to achieve a goal of maximizing health benefits with available resources for several reasons (which are described in detail in the thesis papers). It is my hope that this thesis will encourage further debate regarding the strengths and limitations of the pCODR and regarding other possible approaches for managing the public reimbursement of cancer drugs.</p>