How Important is a CADTH Recommendation for Reimbursement in Canada?

The Canadian Agency for Drugs and Technologies in Health (CADTH) conducts health technology assessments, and provides recommendations for drug listings and reimbursements. However, individual provincial healthcare providers are not bound to follow them. We wanted to assess the value and importance of CADTH endorsements as predictors for drug availability in Alberta, British Columbia, and Ontario.

We looked at the agency’s Common Drug Review between 2005 to March 2014 for 94 recommendations of 88 different drugs across 30 disease conditions. We defined as “positive” if the review recommended listing the drug, regardless of population restrictions (63%). A recommendation was only considered “negative” if the review explicitly stated that the drug should not be listed (37%).

Important But Not Essential

Although a positive CADTH recommendation is a strong predictor of drug availability in Alberta, British Columbia and Ontario, a negative CADTH review is comparatively a poor predictor. We also noted that negative CADTH recommendations do not preclude drug listing in any of these three provinces.

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