How do HTA decisions affect access to mental health drugs in Canada?
Posted on April 12, 2017
By Brett J Skinner, Ph.D. | Founder and CEO, Canadian Health Policy Institute
Speaking at the Canada 2020 health summit in September of last year, the federal Health Minister Jane Philpott remarked on the importance of improving access to medicines for Canadians and emphasized the need to invest more in mental health treatment. Her comments are supported by the facts.
Mental health should be a priority public policy concern. An estimated 7.2 million Canadians experienced some type of mental illness in 2015. Clinical evidence confirms that patients' responses to treatments vary significantly from person-to-person. It is important to have a wide choice of therapy options to find the best fit for each patient when treating mental illnesses.
Yet, Canada’s public drug plans offer limited and delayed coverage of new medicines (generally) compared not only to private sector plans, but also compared to public drug plans in comparable countries. Canada’s relative lack of access to new medicines in public drug plans has serious consequences. Nearly 12 million Canadians depend on public drug plans operated by the federal, provincial and territorial governments; and research has shown that there are significant health and economic costs associated with waits to accessing new medicines.
Health Technology Assessment (HTA) is one part of a multi-stage process which determines which new medicines are eventually deemed eligible for public drug coverage in Canada. HTA evaluates the cost-effectiveness of new medicines that have already been certified by Health Canada as clinically safe and effective for patients to use.
The Canadian Agency for Drugs and Technologies in Health (CADTH) provides HTA recommendations through the Common Drug Review (CDR) to the public drug plans of the federal government, and 9 of 10 provincial governments.
HTA decisions have the potential to act as a barrier to access. How do HTA decisions affect access to mental health drugs in Canada?
A recent study published by the Canadian Health Policy Institute (CHPI) examined the evidence. It compared the experience of mental health drugs versus other types of drugs. The data included all of the drugs reviewed by the CDR from 2004 to 2015. The main findings are shown in the bullet points and charts below.
• The CDR issued a positive (with or without conditions) recommendation for a smaller percentage of mental health drugs compared to other drugs.
• The CDR took longer to issue decisions for mental health drugs compared to other drugs.
• Public drug plans took almost 10 months longer to cover mental health drugs compared to other drugs.