pan-Canadian Pharmaceutical Alliance (pCPA): October 2019 Trends and Insights
The pan-Canadian Pharmaceutical Alliance (pCPA) has issued the October 31, 2019 status of brand negotiations. Highlights since the last update include:
- 4 products completed CADTH review, for a total of 7 files under consideration;
- 2 products initiated pCPA negotiations, for a total of 42 active negotiations;
- 6 negotiations completed for a total of 282 completed negotiations;
- 2 negotiation closed, for a total of 47 closed negotiations; and
- 1 file closed without negotiations, for a total of 70 declined negotiations.
Files Under pCPA Consideration
4 new drug products received a CDEC recommendation or pERC notification to implement in October 2019, for a total of approximately 7 products under pCPA Consideration.
| Brand Name | Generic Name | Manufacturer | Indication | Recommendation |
|---|---|---|---|---|
| Pomalyst | Pomalidomide | Celgene | Multiple Myeloma (second-line or beyond) | Conditional |
| Keytruda | Pembrolizumab | Merck | Metastatic Urothelial Carcinoma (First Line) |
Do not reimburse
|
| Botox | OnabotulinumtoxinA | Allergan | Migraine, Chronic | Conditional |
| Xultophy | Insulin degludec + liraglutide | Novo Nordisk | Diabetes mellitus, type 2 | Conditional |
Note: The Request for Advice for Fibristal (ulipristal acetate) for uterine fibroids (signs and symptoms) has been removed from the under-consideration list as it has been addressed at the provincial level, as demonstrated by the listing in Ontario in October 2019.
Negotiation Initiation
The pCPA initiated 2 new negotiations since the last update, for a total of 42 active negotiations.
| Brand Name | Generic Name | Manufacturer | Indication | CADTH Date | Time to Initiate |
|---|---|---|---|---|---|
| Dovato | Dolutegravir
lamivudine |
ViiV Healthcare | HIV-1 infection | September 30, 2019 | 15 days |
| Mezera | Mesalazine | Avir Pharma | Ulcerative colitis | N/A | N/A |
*Negotiation initiation and completion/closed date assumed to be mid-month; approximate calendar days calculated.
Signals Decoded:
The average time under pCPA Consideration continues to remain below 30 days for the fourth consecutive month, meeting pCPA’s targeted completion time of ≤ 40 business days (from HTA recommendation). In addition, there have been no files under consideration for a period of longer than 6 months since May 2019.The number of active negotiations at 42 is at the lowest number since March 2018.
Completed
| Brand Name | Generic Name | Manufacturer | Indication | Initiated | Duration* |
|---|---|---|---|---|---|
| Delstrigo | Doravirine/
lamuvidine/ tenofovir disoproxil fumarate |
Merck | HIV Infection | June 2019 | 122 days |
| Pifeltro | Doravirine | Merck | HIV Infection | June 2019 | 122 days |
| Venclexta
Rituximab |
Venetoclax/
rituximab |
AbbVie | Chronic lymphocytic leukemia | June 2019 | 122 days |
| Ogivri | Trastuzumab | BGP Pharma | early breast cancer, metastatic breast cancer, and gastric cancer | May 2019 | 153 days |
| Trazimera | Trastuzumab | Pfizer | early breast cancer, metastatic breast cancer, and gastric cancer | May 2019 | 153 days |
| Opdivo | Nivolumab | Bristol Myers Squibb | Classic Hodgkin’s Lymphoma | October 2018 | 365 days |
*Negotiation initiation and completion/closed date assumed to be mid-month; approximate calendar days calculated.
Closed
| Brand Name | Generic Name | Manufacturer | Indication | Initiation | Duration* |
|---|---|---|---|---|---|
| Herceptin SC | Trastuzumab | Hoffman-LaRoche | Breast Cancer | January 2019 | 273 days |
| Praluent | Alirocumab | Sanofi-Aventis | prevention of cardiovascular events in patients with atherosclerotic cardiovascular disease (ASCVD) | August 2018 | 426 days |
Not Negotiated
| Brand Name | Generic Name | Manufacturer | Indication | CADTH Date | Time to Decision* |
|---|---|---|---|---|---|
| Lonsurf | Trifluridine and Tipiracil | Taiho Pharma | Metastatic Colorectal Cancer | September 16, 2019 | 29 days |
*Negotiation initiation and completion/closed date assumed to be mid-month; approximate calendar days calculated.
Signals Decoded:
The number of long-standing active negotiations (> 12 months) has decreased by 50% since early 2019, now down to only 3 files with the closing of Praluent which was active for over one year. This month shows some movement on trastuzumab biosimilars and Herceptin SC, with 2 of the 3 trastuzumab biosimilars reaching a LOI, and the negotiation for Herceptin SC closing without a LOI. Opdivo has completed its sixth successful pCPA negotiation. The workload at pCPA appears to have stabilized over 2019 with pCPA adjudicating between 5 and 10 files per month.
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