pan-Canadian Pharmaceutical Alliance (pCPA): October 2020 Trends and Insights
October 2020 Highlights:
- 5 products completed CADTH review
- 7 products initiated pCPA negotiations
- 5 negotiations were completed with an LOI
- 0 negotiations were closed without an LOI
- 2 files were closed without negotiation
Files Under pCPA Consideration:
CADTH issued 5 new recommendations in October (22 files as of October 31).
| PRODUCT | INDICATION | SPONSOR | Type | REC’N* DATE |
|---|---|---|---|---|
| Xtandi** (enzalutamide) |
Metastatic Castration Sensitive Prostate Cancer | Astellas | Oncology | October 8 |
| Soliris (eculizumab) |
Myasthenia Gravis (gMG) | Alexion | Non-Oncology | October 19 |
| Nexplanon (etonogestrel) |
Prevention of Pregnancy | Merck | Non-Oncology | October 20 |
| Duobrii (Halobetasol propionate and tazarotene) |
Psoriasis, moderate to severe plaque | Bausch | Non-Oncology | October 28 |
| Jorveza (budesonide) |
Eosinophilic esophagitis, adults | AVIR Pharma | Non-Oncology | October 29 |
* REC’N DATE = Date of CDEC Final Recommendation (non-oncology), Date Notification to Implement Issued (oncology). Note: October marks the first month that CADTH has implemented their aligned review reports, so terminology going forward in these updates will reflect this (changing from CDR to non-oncology and pCODR to non-oncology).
**File received a notification to implement and was initiated in the same month and is therefore, not included in the under-consideration count
Signals Decoded:
CADTH issued five new recommendations/notification to implement in October for a total of 22 files Under Consideration. This is the lowest Under Consideration count since April 2020 (n=20). The average time these 22 files have been under consideration continues to increase, currently at an average of 157 calendar days. This average is largely being driven by the increasing number of files that have been under consideration for more than six months, which is at 10 as of October 31, 2020.
Negotiation Initiation:
The pCPA initiated 7 new negotiations in October (28 active negotiations as of October 31, 2020)
| PRODUCT | INDICATION | SPONSOR | CATEGORY | INITIATE DATE | TTI* |
|---|---|---|---|---|---|
| Aermony Respiclick (fluticasone propionate) |
Asthma | Teva Canada | Other | October 7 | N/A |
| Crysvita (burosumab) |
X-Linked Hypophosphatemia | Ultragenyx | Non-Oncology | October 9 | 135 |
| Erleada (apalutamide) |
Metastatic Castration Sensitive Prostate Cancer | Janssen | Oncology | October 9 | 155 |
| Nubeqa (darolutamide) |
Non-metastatic castrate resistant prostate cancer | Bayer | Oncology | October 23 | 169 |
| Entyvio SC (vedolizumab) |
Ulcerative Colitis | Takeda | Non-Oncology | October 19 | 153 |
| Vocabria and Cabenuva (cabotegravir and rilpivirine) |
HIV Infection | VIIV Healthcare | Non-Oncology | October 22 | 92 |
| Xtandi (enzalutamide) |
Metastatic Castration Sensitive Prostate Cancer | Astellas | Oncology | October 30 | 22 |
Signals Decoded:
The pCPA initiated 7 negotiations in the month of October, including one re-activation for Aermony Respiclick which was previously closed in 2019. This is a significant increase to September where no files-initiated negotiations. The volume of active files has remained relatively consistent since May with numbers between 25 and 28. This is in contrast to the trends prior to February 2020 where active negotiations were in the 32-34 range.
Completed/Closed Negotiations:
The pCPA completed 5 negotiations with a Letter of Intent (LOI) in October 2020.
| PRODUCT | INDICATION | SPONSOR | LOI DATE | TTN* |
|---|---|---|---|---|
| Rituxan SC (rituximab) |
Chronic Lymphocytic Leukemia | Hoffmann-La Roche | October 14 | 64 |
| Lynparza (olaparib) |
Ovarian Cancer | AstraZeneca | October 21 | 125 |
| Kanuma (sebelipase alfa) |
Lysosomal acid lipase deficiency | Alexion Pharma | October 21 | 691 |
| Revestive (teduglutide) |
Short Bowel Syndrome | Shire Pharma | October 28 | 250 |
| Takhyzro (lanadelumab) |
Hereditary Angioedema | Shire Pharma | October 30 | 252 |
* TTN = Time to Negotiate in calendar days
Signals Decoded:
5 negotiations were completed during the month of October including a re-negotiation for Rituxan SC (for the treatment of CLL) which was completed relatively quickly (64 days) and Kanuma for the treatment of lysosomal acid lipase deficiency, which was the longest outstanding negotiation (691 days). The completion of Kanuma drives the average time under negotiation for currently active files down from 190 days in September to an average of 158 days as of October 31, 2020.
Not Negotiated:
The pCPA declined to negotiate 2 files in October 2020.
| PRODUCT | INDICATION | SPONSOR | DECLINE DATE | TTD* |
|---|---|---|---|---|
| Contravenaltrexone hydrochloride and bupropion hydrochloride) | Chronic Weight Management | Bausch Health | October 13 | 139 |
| Cablivi (caplacizumab) |
Acquired thrombotic thrombocytopenic purpura | Sanofi-Aventis | October 23 | 58 |
* TTD = Time to Decline in calendar days
Signals Decoded:
The 2 declined negotiations, Contrave and Cablivi, both received Do Not Reimburse recommendations from CADTH. The pCPA adjudicated a total of 7 files in October, up from the previous 2 months.
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