Case Study: Overturning a negative HTA recommendation

The challenge

The client faced a significant obstacle when Canada’s Drug Agency (CDA, formerly CADTH) issued a negative reimbursement recommendation for their new drug submission. They were seeking opportunities for reconsideration, ultimately aiming to secure a positive final recommendation.

The approach

Our primary objective was to file a compelling request for reconsideration. We focused on understanding and addressing the key drivers in the reconsideration process, as well as the factors assessed by the CDA expert committee.

 

The outcome

Our collaborative efforts ultimately led to a positive reimbursement recommendation with conditions from CDA. With this positive Health Technology Assessment (HTA) decision, the client was able to advance to the next phase of the process, negotiation with the pan-Canadian Pharmaceutical Alliance (pCPA) for formulary listing.

From April 2021 to May 2024, only 7 of the 44 files that initially received negative recommendations from CDA were overturned to a final positive recommendation.