Developing a framework to incorporate real-world evidence in cancer drug funding decisions: the Canadian Real-world Evidence for Value of Cancer Drugs (CanREValue) collaboration
- Oncology therapy is becoming more expensive, challenging the affordability and sustainability of drug programs globally.
- Health technology assessment organizations use clinical trials for drug funding decisions, which may not reflect real-world outcomes.
- The Canadian Real-world Evidence for Value of Cancer Drugs (CanREValue) collaboration is creating a framework for generating and using real-world evidence (RWE) for cancer drug funding in Canada.
- CanREValue consists of multiple stakeholders, including researchers, decision-makers, payers, patients, and caregivers.
- Five working groups focus on specific processes for RWE: Planning and Drug Selection, Methods, Data, Reassessment and Uptake, and Engagement.
- The framework aims to reassess cancer drugs, refine funding recommendations, and implement novel funding mechanisms for better clinical and economic outcomes.
New therapies for cancer are becoming increasingly more expensive, challenging the affordability and sustainability of public drug programs in Canada and around the world. While the cost increases of new cancer therapies are evident, the benefits are not always clear. In the Canadian cancer drug funding process, after receiving regulatory approval from Health Canada, organizations such as the pan-Canadian Oncology Drug Review (pCODR) at the Canadian Agency of Drugs and Technologies in Health (CADTH) and the Institute national d"excellence en santé et services sociaux (INESSS) in Quebec evaluate new cancer drugs and make funding recommendations to federal and provincial public payers. However, there is no policy infrastructure or framework in place for post funding reassessment of cancer drugs, leaving payers and policy decision-makers with limited opportunity to incorporate more mature evidence into funding decisions or to renegotiate prices with manufacturers based on evolving evidence and expanded use.
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