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CMAJ Open. 2016 Nov 3;4(4):E674-E678. doi: 10.9778/cmajo.20160006. eCollection 2016 Oct-Dec.

Evaluating alignment between Canadian Common Drug Review reimbursement recommendations and provincial drug plan listing decisions: an exploratory study.

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School of Pharmacy and Pharmaceutical Sciences (Allen, Walker), Cardiff University, Cardiff, UK; Centre for Innovation in Regulatory Science (Allen, Walker), London, UK; Centre for Innovation in Regulatory Science (Liberti), Hatton Garden, London, UK; Canadian Agency for Drugs and Technologies in Health (Sehgal), Ottawa, Ont.; Department of Pharmacy, Pharmacology and Postgraduate Medicine (Salek), School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Institute for Medicines Development (Salek), Cardiff, UK.



The CADTH Common Drug Review was established in 2002 to prepare national health technology assessment reports to guide listing decisions for 18 participating drug plans. The aim of this study was to compare the nonmandatory recommendations from the Common Drug Review in Canada with the listing decisions of provincial payers to determine alignment.


We identified the recommendations issued by the Common Drug Review from Jan. 1, 2009, to Jan. 1, 2015, and compared these with the listing decisions of 3 provincial public payers (Alberta, British Columbia and Ontario) that participate in the Common Drug Review and the recommendations from Quebec.


We identified 174 medicine-indication pairs in CADTH Common Drug Review reports issued from Jan. 1, 2009, to Jan. 1, 2015; 110 of these met the inclusion criterion. Among the 110 medicine-indication pairs, listing decisions were available for 95 in Alberta, 102 in Quebec, 104 in Ontario and 106 in BC. There was moderate to substantial agreement between provincial listing decisions and Common Drug Review recommendations: 74.5% (κ = 0.47, 95% confidence interval [CI] 0.31-0.64) for Quebec, 78.8% (κ = 0.56, 95% CI 0.41-0.72) for Ontario, 78.9% (κ = 0.58, 95% CI 0.42-0.74) for Alberta and 81.1% (κ = 0.62, 95% CI 0.47-0.77) for BC.


Our study showed moderate to substantial agreement between Common Drug Review recommendations and provincial listing decisions. Future studies can build on this research by evaluating the concordance between Common Drug Review recommendations and listing decisions of all participating federal, provincial and territorial drug plans.

Conflict of interest statement

Since this manuscript was written, Nicola Allen has become employed by ICON plc, Global Pricing and Market Access, London, UK. Chander Sehgal was a director of CADTH Common Drug Review from April 2011 to July 2016. No other competing interests were declared.

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