At a glance
between January 1st and October 13th, 2026
What the data shows
The proportion of files closing without a Letter of Intent (LOI) has fluctuated between 8% and 22% over the past decade. Rates were relatively low in 2024 and 2025 (8% and 9%, respectively), compared with a record high of 22% in 2019. While negotiation timelines in the first half of 2026 remained consistent with 2025 levels (MORSE CRaFT Subscription), the proportion of files closing without an LOI has climbed to 22%, as of October 13th, 2026, matching the 2019 peak. Of the 78 negotiations concluded to date in 2026, 17 have closed without an agreement.
The proportion of closed files has risen in both Non-Oncology and Oncology files, currently 32% in Non-Oncology and 16% in Oncology, with the larger percentage-point increase occurring in Non-Oncology.
Why it matters
After two years of historically low rates of files closing without an LOI, 2026 marks a notable shift, with more than 1 in 5 concluded negotiations ending without an agreement as of October 13th, 2026, suggesting that more challenges are emerging at the point of reaching final alignment.
This trend may reflect a more complex and demanding negotiation environment, where payers and manufacturers appear less likely to converge on acceptable pricing and reimbursement terms, given many uncertainties arising such as impacts of MFN (Most Favored Nation). For manufacturers planning submissions, these findings underscore the importance of early market access planning, pressure-testing pricing and value propositions, and anticipating areas of potential contention before negotiations begin. Negotiation success may increasingly depend on entering discussions with a well-defined negotiation strategy, clear evidence-based justifications, and contingency plans for addressing key payer concerns.
Methodology and sources
Data Sources
pCPA Negotiations Database; MORSE CRaFT Subscription; MORSE Consulting Data Intelligence Tool.
Note
- Data accurate as of October 13th, 2026.
- 2026 data only includes files concluded between January 1st and October 13th, 2026.
- Oncology files are defined as files negotiated with a CDA-AMC recommendation by pERC, and Non-Oncology files are defined as files negotiated with a CDA-AMC recommendation by CDEC. Files without a CDA-AMC recommendation are not included in the Oncology/Non-Oncology analysis but included in the total analysis.
- Analysis based on negotiation conclusion year.
What’s next
For the full picture of Canadian reimbursement timelines as well as insights on files that closed without LOI in 2025 and 2026, subscribe to MORSE CRaFT Reports.
For a comprehensive overview of MFN and expert insights on impact on Canadian market access, our Most-Favored Nation (MFN) Report 2026 is available to order now.
MORSE's Canadian market access data supports evidence-based insights for complex questions. If your team is facing a market access challenge, we would welcome the opportunity to connect.
For more information about this analysis or MORSE’s data analytics services, please contact Lana Duan, Senior Manager, Market Access & Data Analytics.