pan-Canadian Pharmaceutical Alliance (pCPA): July 2020 Trends and Insights
July 2020 Highlights:
- 6 products completed CADTH review
- 6 products initiated pCPA negotiations
- 7 negotiations were completed with an LOI
- 0 negotiations were closed without an LOI
- 0 files were closed without negotiation
Trends are beginning to emerge regarding impact of COVID19 on pCPA negotiations with 3 months of experience to consider. In general, negotiations are taking longer to start but those that start are being negotiated more quickly. There also appears to be a stabilization of activity across metrics as detailed below.
Files Under pCPA Consideration:
CADTH issued 6 new recommendations in July (24 files as of July 31).
| PRODUCT | INDICATION | SPONSOR | HTA | REC’N* DATE |
|---|---|---|---|---|
| Vascepa (icosapent ethyl) |
Ischemic events in statin-treated patients | HLS Theraputics | CDR | July 16 |
| Stelara/Stelara I.V. (ustekinumab) |
Ulcerative Colitis | Janssen | CDR | July 16 |
| Tecentriq & Avastin (atezolizumab & bevacizumab) |
Non-Squamous Non-Small Cell Lung Cancer | Hoffman-La Roche | pCODR | July 20 |
| Mayzent (siponimod) |
Secondary progressive multiple sclerosis | Novartis | CDR | July 21 |
| Aimovig (erenumab) |
Migraine | Novartis | CDR | July 22 |
| Vocabria and Cabenuva (cabotegravir sodium cabotegravir-rilpivirine) |
HIV-1 Infection | ViiV Heaalthcare | CDR | July 22 |
* REC’N DATE = Date of CDEC Final Recommendation (CDR), Date Notification to Implement Issued (pCODR)
Signals Decoded:
The Volume of files Under Consideration has stabilized over the last 3 months staying around the 23-24 mark. Pre-COVID, these numbers were consistently ≤ 11. The average time Under Consideration continues to climb, but still remains less than 3 months.
Negotiation Initiation:
The pCPA initiated 6 new negotiations in July (27 active negotiations as of July 31, 2020)
| PRODUCT | INDICATION | SPONSOR | CATEGORY | INITIATE DATE | TTI* |
|---|---|---|---|---|---|
| Darzalex SC (daratumumab) |
Multiple Myeloma | Janssen | Other | July 10 | N/A |
| Adcetris (Brentuximab vedotin) |
Peripheral T-Cell Lymphoma | Seattle Genetics | pCODR | July 3 | 14 |
| Lonsurf (trifluridine/tipiracil) |
Metastatic Gastric Cancer | Taiho | pCODR | July 7 | 90 |
| Dupixent (dupilumab) |
Atopic Dermatitis | Sanofi Genzyme | CDR | July 28 | 97 |
| Monoferric (iron (iii) isomaltoside 1000) |
Iron Deficiency Anemia | Pharmacosmos A/S | CDR | July 21 | 118 |
| Trintellix (vortioxetine) |
Major Depressive Disorder | Lundbeck | CDR | July 6 | 145 |
* TTI = Time to Initiate in calendar days
Signals Decoded:
The volume of active files continues to be lower than seen pre-COVID, corresponding with the higher number of files Under Consideration. However, we see a stabilization in the numbers from May – July 2020 perhaps signalling an equilibrium in activity.
Of the 6 files that initiated negotiations, they were evenly split between oncology and non-oncology files. Most were under consideration for 3-5 months before being initiated with the exception of Adcetris for Peripheral T-Cell lymphoma which was initiated within 2 weeks of the Notification to Implement date.
Completed/Closed Negotiations:
The pCPA completed 7 negotiations with a Letter of Intent (LOI) in July 2020.
| PRODUCT | INDICATION | SPONSOR | LOI DATE | TTN* |
|---|---|---|---|---|
| Kisqali (ribociclib) |
Advanced or metastatic breast cancer | Novartis | July 14 | 22 |
| Allerject (epinephrine) |
For the emergency treatment of severe acute allergic reactions (anaphylaxis) | Kaleo | July 22 | 61 |
| Kisqali with fulvestrant (ribociclib) |
Advanced or metastatic breast cancer | Novartis | July 14 | 64 |
| Ziextenzo (pegfilgrastim) |
Febrile neutropenia in non-myeloid malignancies | Sandoz | July 22 | 86 |
| Envarsus PA (tacrolimus) |
Prophylaxis of organ rejection in allogenic kidney or liver transplant adult patients | Paladin Labs | July 30 | 136 |
| Lutathera (lutetium 177 dotatate) |
Gastroenteropancreatic neuroendocrine tumors | Advanced Accelerator Applications | July 29 | 154 |
| Xeljanz (tofacitinib) |
Ulcerative Colitis | Pfizer | July 24 | 385 |
* TTN = Time to Negotiate in calendar days
Signals Decoded:
The average duration of negotiation for currently active files time has dropped since March, with the current average sitting at 4 months compared to 5.7 months in February.
Signals Decoded:
The number of protracted negotiations (active more than 12 months) has decreased and is very low (from 5 to only 1) while the opposite trend is occurring with the number of files Under Consideration for extended periods (greater than 6 months) which we see increasing (from 0 to 4).
Signals Decoded:
Total number of adjudicated files appears to be trending back towards numbers generally seen pre-COVID.
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