Market access: Navigating the Canadian reimbursement landscape
By Innomar Strategies
Despite perceptions of a universal healthcare system, Canada’s medication reimbursement relies on both public and private payers, impacting market access for new therapies. In this video, Beth Koster, Director, Health Economics & Outcomes Research (HEOR), shares considerations for market access, including the need for early strategic planning and comprehensive evidence collection.
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Transcript of ‘Market access: Navigating the Canadian reimbursement landscape’
What is the medication reimbursement landscape like in Canada?
Canada is usually thought of as having a universal healthcare system. However, many companies entering the market are surprised to learn that when it comes to medication reimbursement, we actually don't. We've got a network of both public and private insurance. Well, the public plans do cover some of the population. Private insurance has evolved to fill in the gaps, and now they do cover a lot of the working population. Private insurance was historically thought to be a quick win or a low barrier to entry into the Canadian market. However, more recently, with more expensive technology entering, they've become more cautious, sophisticated, and rigorous in their approach to evaluating medications to add to their drug plans. So, this may include a rigorous health technology assessment, which looks at the clinical and economic evidence. It could include price negotiation or product listing agreement development. And increasingly, we see that private payers are waiting for CADTH*, or the Canadian Agency for Drugs and Technologies in Health, recommendation to come out before they make their decision. These additional steps have added time and complexity, and that's why it's really important for companies coming to Canada to start early and make sure they're bringing solid evidence to the table.
*CADTH is now CDA (Canada’s Drug Agency)
