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Patient Engagement in HTA Drug Review Process
Helen Mai, CADTH
Adam Waiser, HTAPEN, Canadian Cancer Action Network
Canadian Expert Patients in Health Technology Conference
November 7-8, 2016
Patient Engagement in HTA Drug Review Process
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• Understanding Health Technology
Assessment (HTA)
• Value of Patient Input and Feedback in HTA
process
• Collaborative Projects - Capacity Building
of Patient Engagement & Involvement in
Cancer Drug Reviews
Objectives
Patient Engagement in HTA Drug Review Process
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Drug Access—Who Does What
Health Canada
Regulator (Effect & safety)
CDR (CADTH)
pCODR (CADTH)
Quebec (INESSS)
HTA (Assess value)
Pan Canadian Pharmaceutical Alliance (pCPA)
Price negotiator
F/P/T Ministries of Health and Cancer Agencies
Decision maker/funder
Patient Engagement in HTA Drug Review Process
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• Regulator: How confident can we be that
results are real?
• HTA: How confident can we be in the
magnitude of that benefit and what is its
value?
Understanding evidence for regulatory review
vs health technology assessment
Patient Engagement in HTA Drug Review Process
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Provincial Advisory Group
Submitter
Patient Advocacy Group
Registered Clinician
Review Team
Registered ClinicianProvincial Advisory
GroupPatient Advocacy
Group
pERC
Submitter
INPUT
SUBMISSION
REVIEW
DELIBERATIONS
FEEDBACK
Initial Recommendation
Final Recommendation
CADTH’s pan-Canadian Oncology Drug Review
Expert Committees (CDEC, pERC)
Presented, used in deliberations & reflected
in recommendations
Who Uses Patient Input?
CADTH Review Team
Used to inform protocol & report
Public Drug Plans
Shared with plans and shared at www.cadth.ca
Patient Engagement in HTA Drug Review Process
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pCODR Expert Review Committee’s (pERC) Deliberative
Framework
Clinical Benefit• Effectiveness• Safety• Burden of Illness• Need
Patient Values• Alignment with values
Economic Evaluation
• Cost effectiveness
Adoption and Feasibility
• Economic feasibility (BIA)• Organizational feasibility
Patient Engagement in HTA Drug Review Process
Patient input to CDR & pCODR
Single44%
2 to 431%
5 to 1015%
11+ 10%
137 patient groups submitted to
CDR & pCODR 532 patient input
submissions
June 2010 – June 2016
Many groups responded to multiple calls for patient
input
Patient Engagement in HTA Drug Review Process
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• HTA recommendations will ultimately affect patients for whom the technology is intended
• Only patients and their family/caregivers have:
day-to-day lived experience with the disease or condition
direct experience with currently available treatments (if applicable) and possibly experience with the technology being reviewed
• Patients and their caregivers can provide their perspectives on the most important considerations and outcomes for a new technology
Why Does Patient Input Matter in HTA?
Health Technology Assessment
Patient Engagement Navigator:
A New Resource
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Patient Engagement in HTA Drug Review Process
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• The Health Technology Assessment Patient Engagement Navigator (HTAPEN) project is a collaboration of the Canadian Cancer Action Network (CCAN) and CADTH
• The HTAPEN project is funded by the Canadian Partnership Against Cancer, with in-kind funding provided by CADTH and CCAN, to develop, identify and support opportunities for patient and caregiver involvement with the pCODR program
How Can We Promote Patient Participation in
Canadian HTA Drug Reviews?
Patient Engagement in HTA Drug Review Process
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A live resource to support and further enhance cancer patient community involvement in the assessment of new cancer drugs.
Key activities of the HTAPEN project:
• Promote patient awareness of pCODR and their role in the HTA process.
• Work directly with patient groups to identify and collect data as well as to prepare the submissions.
• Expand the breadth and improve the quality of resources available to patients.
What is a HTA Patient Engagement Navigator?
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• Targeted outreach to patient groups after a call for patient input has been announced
• Presentations to organizations and events about the HTAPEN project
• Workshop for Patient Groups: Role of Health Technology Assessment in Cancer Drug Funding Decisions
• Act as a go-between for patient groups to help them connect with the pCODR process
HTAPEN Key Activities
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HTAPEN Key Activities
Health Technology Assessment E-Bulletin
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• Provide support that is geared to the specific needs of a patient group
• Provide advice to help groups find patients with relevant experience
• Help patient groups develop survey questions and strategies
• Review previous submissions for ways to improve in the future
• Provide opportunity for feedback and dialogue on patient evidence submission
HTAPEN Key Activities
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Online Resources for Patient Groups
www.ccanceraction.ca
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• A Guide for Patient Advocacy Groups:
How to provide patient and caregiver input for
a pCODR drug review
• Online CCAN/pCODR narrated presentations
Online Resources for Patient Groups
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Guidelines, Procedures and Templates
https://www.cadth.ca/pcodr
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Adam Waiser
HTA Patient Engagement Navigator
(416) 418-5035
HTAPEN Contact Information
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Thank You and Questions?
