CADTH reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class.
The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada's federal, provincial, and territorial governments, with the exception of Quebec.
This review assesses avacopan (Tavneos), 30 mg (3 oral capsules of 10 mg each), twice daily.
Indication: For the adjunctive treatment of adult patients with severe antineutrophil cytoplasmic autoantibody–associated vasculitis (granulomatosis with polyangiitis and microscopic polyangiitis) in combination with standard background therapy including glucocorticoids. Avacopan does not eliminate glucocorticoid use.
{"title":"Avacopan (Tavneos)","authors":"None CADTH","doi":"10.51731/cjht.2023.762","DOIUrl":"https://doi.org/10.51731/cjht.2023.762","url":null,"abstract":"
 CADTH reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class.
 The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada's federal, provincial, and territorial governments, with the exception of Quebec.
 This review assesses avacopan (Tavneos), 30 mg (3 oral capsules of 10 mg each), twice daily.
 Indication: For the adjunctive treatment of adult patients with severe antineutrophil cytoplasmic autoantibody–associated vasculitis (granulomatosis with polyangiitis and microscopic polyangiitis) in combination with standard background therapy including glucocorticoids. Avacopan does not eliminate glucocorticoid use.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"67 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135617967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
During 3 multistakeholder dialogue sessions, patients, families, community members, emergency department (ED) staff and trainees told us that ED overcrowding results from a wider health care system dysfunction. They communicated that a major driving force is hospitals operating at or over capacity and large proportions of alternate level of care patients unable to be discharged due to lack of long-term care spaces.
We heard that an absence of health care resources available within communities could worsen the problem by filling the ED with patients who could be managed more appropriately elsewhere. Participants described how this creates frustration among patients and families and can contribute to staff burnout and moral distress.
Participants suggested that to effect change, solutions need to address accountability and incorporate integration across the health care systems. We heard that the specific health needs of patients and families should drive decision-making about solutions.
Participants described that currently available technologies and data are not being used to their full potential.
{"title":"Emergency Department Overcrowding in Canada: Multistakeholder Dialogue","authors":"Tamara Rader, Lindsay Ritchie","doi":"10.51731/cjht.2023.761","DOIUrl":"https://doi.org/10.51731/cjht.2023.761","url":null,"abstract":"
 During 3 multistakeholder dialogue sessions, patients, families, community members, emergency department (ED) staff and trainees told us that ED overcrowding results from a wider health care system dysfunction. They communicated that a major driving force is hospitals operating at or over capacity and large proportions of alternate level of care patients unable to be discharged due to lack of long-term care spaces.
 We heard that an absence of health care resources available within communities could worsen the problem by filling the ED with patients who could be managed more appropriately elsewhere. Participants described how this creates frustration among patients and families and can contribute to staff burnout and moral distress.
 Participants suggested that to effect change, solutions need to address accountability and incorporate integration across the health care systems. We heard that the specific health needs of patients and families should drive decision-making about solutions.
 Participants described that currently available technologies and data are not being used to their full potential.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135618074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CADTH recommends that Atriance should be reimbursed by public drug plans for the treatment of pediatric, adolescent, and young adult patients with intermediate- or high-risk T-cell acute lymphoblastic leukemia (T-ALL) in addition to front-line multiagent chemotherapy if certain conditions are met.
Atriance (nelarabine) should only be covered to treat patients with intermediate- and high-risk T-ALL who are aged 1 year to 30 years.
Atriance should only be reimbursed as an addition to front-line multiagent chemotherapy. Atriance should be prescribed by clinicians with expertise and experience in treating T-ALL.
{"title":"Nelarabine (Atriance)","authors":"None CADTH","doi":"10.51731/cjht.2023.759","DOIUrl":"https://doi.org/10.51731/cjht.2023.759","url":null,"abstract":"
 CADTH recommends that Atriance should be reimbursed by public drug plans for the treatment of pediatric, adolescent, and young adult patients with intermediate- or high-risk T-cell acute lymphoblastic leukemia (T-ALL) in addition to front-line multiagent chemotherapy if certain conditions are met.
 Atriance (nelarabine) should only be covered to treat patients with intermediate- and high-risk T-ALL who are aged 1 year to 30 years.
 Atriance should only be reimbursed as an addition to front-line multiagent chemotherapy. Atriance should be prescribed by clinicians with expertise and experience in treating T-ALL.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135779592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) provide guidance for health technology assessment bodies to use when reporting economic evaluations. The most recent edition, CHEERS 2022, is a 28-item reporting checklist that was developed in consultation with a broad range of stakeholders. CHEERS 2022 has been translated into French so it can be used more widely and improve consistency in economic evaluations among the international health technology assessment community.
{"title":"Consolidated Health Economic Evaluation Reporting Standards (CHEERS): French Translation","authors":"Karen Lee","doi":"10.51731/cjht.2023.755","DOIUrl":"https://doi.org/10.51731/cjht.2023.755","url":null,"abstract":"The Consolidated Health Economic Evaluation Reporting Standards (CHEERS) provide guidance for health technology assessment bodies to use when reporting economic evaluations. The most recent edition, CHEERS 2022, is a 28-item reporting checklist that was developed in consultation with a broad range of stakeholders. CHEERS 2022 has been translated into French so it can be used more widely and improve consistency in economic evaluations among the international health technology assessment community.","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135779593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ramon Brown, Sean Tiggelaar, Bernice Tsoi, Ian Cromwell
During CADTH’s search of the economic literature, 3 economic studies were identified that assessed the cost-effectiveness of a long-acting monoclonal antibody, nirsevimab, as an intervention to prevent respiratory syncytial virus in infants in high-income countries, including 1 study set in Nunavik.
The 3 studies were conducted for different geographical locations: Canada, the US, and England and Wales. While each study conducted an economic evaluation, their approaches differed: 1 was a cost-consequence analysis and the other 2 were cost-utility analyses.
The results from the 3 studies varied considerably, and the nirsevimab programs differed (e.g., in terms of patients eligible for immunization). In general, nirsevimab was generally more effective and associated with lower total costs than comparator programs. The results were sensitive to the modelled region, source of efficacy data, price of nirsevimab, and severity of the respiratory syncytial virus season.
The generalizability of the identified studies to Canadian policy-making may be limited given the population compositions and cost parameters included in the models. To understand the potential cost-effectiveness of nirsevimab, a de novo economic evaluation would be required that compared nirsevimab with the existing preventive strategies employed in Canada (which may include monoclonal antibodies for infants) and is conducted in a Canadian setting.
{"title":"Cost-Effectiveness of Nirsevimab for the Prevention of Respiratory Syncytial Virus Infection in Infants","authors":"Ramon Brown, Sean Tiggelaar, Bernice Tsoi, Ian Cromwell","doi":"10.51731/cjht.2023.760","DOIUrl":"https://doi.org/10.51731/cjht.2023.760","url":null,"abstract":"
 During CADTH’s search of the economic literature, 3 economic studies were identified that assessed the cost-effectiveness of a long-acting monoclonal antibody, nirsevimab, as an intervention to prevent respiratory syncytial virus in infants in high-income countries, including 1 study set in Nunavik.
 The 3 studies were conducted for different geographical locations: Canada, the US, and England and Wales. While each study conducted an economic evaluation, their approaches differed: 1 was a cost-consequence analysis and the other 2 were cost-utility analyses.
 The results from the 3 studies varied considerably, and the nirsevimab programs differed (e.g., in terms of patients eligible for immunization). In general, nirsevimab was generally more effective and associated with lower total costs than comparator programs. The results were sensitive to the modelled region, source of efficacy data, price of nirsevimab, and severity of the respiratory syncytial virus season.
 The generalizability of the identified studies to Canadian policy-making may be limited given the population compositions and cost parameters included in the models. To understand the potential cost-effectiveness of nirsevimab, a de novo economic evaluation would be required that compared nirsevimab with the existing preventive strategies employed in Canada (which may include monoclonal antibodies for infants) and is conducted in a Canadian setting.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"195 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135779591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The private, for-profit imaging landscape is expanding and is anticipated to continue expanding due to changes in some provincial government policies aimed at reducing wait lists.
The collection of data on private imaging can help to build a complete and comprehensive picture of overall procedural capacity across the country.
Estimates on the number of publicly funded exams conducted in private facilities can inform the extent to which wait times have been impacted by the shift in some provincial government policies.
The number of MRI and CT exams conducted at private facilities has increased over the past 4 fiscal years, with the exception of the first year of the COVID-19 pandemic (2020 to 2021).
Payment through private insurance and out-of-pocket payments were the main funding sources for MRI scans in 2021 to 2023 in the private setting. Provincial health care insurance was the main funding source for CT scans conducted at private facilities.
{"title":"Use of MRI and CT in Private Imaging Facilities in Canada (2021-2023)","authors":"None CADTH","doi":"10.51731/cjht.2023.758","DOIUrl":"https://doi.org/10.51731/cjht.2023.758","url":null,"abstract":"
 The private, for-profit imaging landscape is expanding and is anticipated to continue expanding due to changes in some provincial government policies aimed at reducing wait lists.
 The collection of data on private imaging can help to build a complete and comprehensive picture of overall procedural capacity across the country.
 Estimates on the number of publicly funded exams conducted in private facilities can inform the extent to which wait times have been impacted by the shift in some provincial government policies.
 The number of MRI and CT exams conducted at private facilities has increased over the past 4 fiscal years, with the exception of the first year of the COVID-19 pandemic (2020 to 2021).
 Payment through private insurance and out-of-pocket payments were the main funding sources for MRI scans in 2021 to 2023 in the private setting. Provincial health care insurance was the main funding source for CT scans conducted at private facilities.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135779545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
What was the question?
How can we work toward reconciliation by improving search methods for CADTH projects on Indigenous health topics?
What did we do?
We scanned the library and information science literature to find mention of searching for Indigenous topics.
We examined a list of key journals to determine their inclusion in bibliographic databases.
We analyzed a set of evidence reviews to assess their search methods.
We expanded the library collection to include Indigenous research methodologies.
What did we find?
Standard biomedical sources for literature searching do not include the full spectrum of Indigenous health information and Indigenous Knowledges.
Development of research and literature searching methodology for Indigenous health topics must ensure Indigenous Knowledges are respected and Indigenous communities are consulted.
What does this mean?
Current search methods may not adequately retrieve relevant sources of Indigenous health information.
CADTH is taking steps to expand literature search methods to retrieve sources of Indigenous information.
This work aligns with CADTH's commitment to reconciliation as outlined in our Strategic Plan and Statement of Reconciliation.
Further engagement with Indigenous communities is needed to help ensure respect is maintained in CADTH's reconciliation work moving forward.
{"title":"Searching for Indigenous Health Information and Knowledges","authors":"Melissa Walter, Caitlyn Ford, Murray Maracle","doi":"10.51731/cjht.2023.753","DOIUrl":"https://doi.org/10.51731/cjht.2023.753","url":null,"abstract":"What was the question?
 
 How can we work toward reconciliation by improving search methods for CADTH projects on Indigenous health topics?
 
 What did we do?
 
 We scanned the library and information science literature to find mention of searching for Indigenous topics.
 We examined a list of key journals to determine their inclusion in bibliographic databases.
 We analyzed a set of evidence reviews to assess their search methods.
 We expanded the library collection to include Indigenous research methodologies.
 
 What did we find?
 
 Standard biomedical sources for literature searching do not include the full spectrum of Indigenous health information and Indigenous Knowledges.
 Development of research and literature searching methodology for Indigenous health topics must ensure Indigenous Knowledges are respected and Indigenous communities are consulted.
 
 What does this mean?
 
 Current search methods may not adequately retrieve relevant sources of Indigenous health information.
 CADTH is taking steps to expand literature search methods to retrieve sources of Indigenous information.
 This work aligns with CADTH's commitment to reconciliation as outlined in our Strategic Plan and Statement of Reconciliation.
 Further engagement with Indigenous communities is needed to help ensure respect is maintained in CADTH's reconciliation work moving forward.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"126 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135889317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Equity-focused health technology assessment (HTA) can help ensure that health care interventions are evaluated and implemented fairly and that health systems are aware of and can take measures to redress inequities, where possible, to achieve the best health outcomes for everyone.
CADTH has made a commitment to apply a lens of equity and inclusiveness throughout the organization, to foster health systems that include diverse persons across Canada and that can better respond to their self-identified priorities and health needs.
{"title":"Equity in Health Technology Assessment","authors":"Farah Husein","doi":"10.51731/cjht.2023.756","DOIUrl":"https://doi.org/10.51731/cjht.2023.756","url":null,"abstract":"
 Equity-focused health technology assessment (HTA) can help ensure that health care interventions are evaluated and implemented fairly and that health systems are aware of and can take measures to redress inequities, where possible, to achieve the best health outcomes for everyone.
 CADTH has made a commitment to apply a lens of equity and inclusiveness throughout the organization, to foster health systems that include diverse persons across Canada and that can better respond to their self-identified priorities and health needs.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135942723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
For patients with type 2 diabetes mellitus, a single randomized controlled trial (SUSTAIN FORTE) suggested that once-weekly subcutaneous semaglutide 2.0 mg may achieve better glycemic control than once-weekly subcutaneous semaglutide 1.0 mg. However, it is unclear whether between-group differences are clinically meaningful.
Gastrointestinal disorders were the most common adverse event resulting in premature discontinuation in both groups. One participant in each study arm experienced a cardiovascular disorder serious enough for premature discontinuation.
As most trial patients were white, it is unclear if the results are generalizable to groups with higher prevalence of T2DM in Canada, such as Indigenous peoples or those of South Asian descent.
We did not find any studies on the cost-effectiveness of subcutaneous semaglutide 2.0 mg, compared to placebo or other doses of semaglutide.
{"title":"Semaglutide for Type 2 Diabetes (2 mg)","authors":"Deepa Jahagirdar, Quenby Mahood","doi":"10.51731/cjht.2023.752","DOIUrl":"https://doi.org/10.51731/cjht.2023.752","url":null,"abstract":"
 For patients with type 2 diabetes mellitus, a single randomized controlled trial (SUSTAIN FORTE) suggested that once-weekly subcutaneous semaglutide 2.0 mg may achieve better glycemic control than once-weekly subcutaneous semaglutide 1.0 mg. However, it is unclear whether between-group differences are clinically meaningful.
 Gastrointestinal disorders were the most common adverse event resulting in premature discontinuation in both groups. One participant in each study arm experienced a cardiovascular disorder serious enough for premature discontinuation.
 As most trial patients were white, it is unclear if the results are generalizable to groups with higher prevalence of T2DM in Canada, such as Indigenous peoples or those of South Asian descent.
 We did not find any studies on the cost-effectiveness of subcutaneous semaglutide 2.0 mg, compared to placebo or other doses of semaglutide.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135889582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The introduction of equity-focused methodologies into health technology assessment (HTA) can facilitate a systemic and comprehensive focus on health equity and enable the delivery of more equitable health outcomes.
CADTH has introduced several approaches and methodologies to centre equity considerations in its assessments of health technologies, including in topic identification and scoping, literature searches and information retrieval, health technology reviews, and the Early Scientific Advice program, supported by attention to equity in patient engagement, accessible publishing practices, and tracking outcomes.
CADTH’s initiatives to incorporate health equity considerations continue to evolve, and CADTH is involved in the ongoing trialling and adaptation of tools, methodologies, processes, and sources to address health inequities through the processes of HTA.
{"title":"Equity-Focused Health Technology Assessment at CADTH","authors":"Renata Axler, Amil Reddy, Farah Husein, Nicole Mittmann","doi":"10.51731/cjht.2023.757","DOIUrl":"https://doi.org/10.51731/cjht.2023.757","url":null,"abstract":"
 The introduction of equity-focused methodologies into health technology assessment (HTA) can facilitate a systemic and comprehensive focus on health equity and enable the delivery of more equitable health outcomes.
 CADTH has introduced several approaches and methodologies to centre equity considerations in its assessments of health technologies, including in topic identification and scoping, literature searches and information retrieval, health technology reviews, and the Early Scientific Advice program, supported by attention to equity in patient engagement, accessible publishing practices, and tracking outcomes.
 CADTH’s initiatives to incorporate health equity considerations continue to evolve, and CADTH is involved in the ongoing trialling and adaptation of tools, methodologies, processes, and sources to address health inequities through the processes of HTA.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"90 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135942724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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