Comparison of drug coverage in Canada before and after the establishment of the pan-Canadian Pharmaceutical Alliance.
OBJECTIVE
This study was conducted to determine whether establishment of the pan-Canadian Pharmaceutical Alliance (pCPA) was associated with significant changes in drug listing decisions across Canada.


RESULTS
This study included drug indications that received a Common Drug Review or pan-Canadian Oncology Drug Review listing recommendation within 3 years before ('pre-PCPA era' group; n=79) and 3 years after ('PCPA era' group; n=91) the pCPA was established in August 2010. At the time of this study (30 April 2014), nine pCPA-participating jurisdictions had listed 35-59% of drug indications in the pre-pCPA era group and a nearly identical range, 36-59%, in the pCPA era group. Within the pCPA-era group, 31 drug indications (34%) had completed pCPA negotiations ('pCPA negotiation' subgroup); the jurisdictions had listed 39-77% of these drug indications. Comparison of the pCPA era group to the pre-pCPA era group indicated that the proportion listed did not change significantly in any jurisdiction, and time-to-listing increased significantly in New Brunswick and decreased significantly in Alberta, Manitoba, and Ontario. When the pCPA negotiation subgroup was compared to the pre-pCPA era group, the proportion listed increased significantly in British Columbia, Saskatchewan, Manitoba and Newfoundland and Labrador, and time-to-listing increased significantly in New Brunswick and Nova Scotia and decreased significantly in Manitoba and Ontario. A sensitivity analysis suggested more favourable results regarding the pCPA's impact.


CONCLUSIONS
While the pCPA might have had a varied effect on time-to-listing, this study's primary analysis did not observe a significant impact on the overall proportion of new drug indications listed across jurisdictions. This may be due to the fact that, at the time of this study, only a limited number of drug indications had completed pCPA negotiations. This study provides a framework for future evaluations of the pCPA's impact as it continues to evolve.
MILLREED Enterprises Ltd, Toronto, Ontario, Canada.
Debbie
D
Milliken
J.Venkatesh Healthcare Consulting Inc, Surrey, British Columbia, Canada.
Jaya
J
Venkatesh
Janssen Inc, Toronto, Ontario, Canada.
Rebecca
R
Yu
Cornerstone Research Group Inc, Burlington, Ontario, Canada.
Zhuo
Z
Su
Cornerstone Research Group Inc, Burlington, Ontario, Canada.
Melissa
M
Thompson
School of Public Health, University of Alberta, Edmonton, Alberta, Canada.
Dean
D
Eurich
D002170:Canada; D003299:Cooperative Behavior; D017277:Drug Approval / Q000706:statistics & numerical data*; D017723:Drug Utilization Review / Q000379:methods*; D005500:Follow-Up Studies; D006284:Health Plan Implementation; D006801:Humans; D012189:Retrospective Studies; D013997:Time Factors