Skip to main content Accessibility help
×
Home

Comprehensive Drug-Class Review Framework for improved evidence-based drug policy and formulary modernization

  • Mina Tadrous (a1) (a2) (a3), Sandra Knowles (a3) (a4), Brent Ruddock (a5), Paul Oh (a4) (a6), Muhammad M. Mamdani (a1) (a2) (a3) (a7), David N. Juurlink (a2) (a4) (a8) and Tara Gomes (a1) (a2) (a3) (a7)...

Abstract

Formularies are used by payers to optimize access and ensure the appropriate use of medications. Lack of follow-up and re-evaluation can lead to outdated formularies that are not reflective of current evidence. Formulary modernization, an approach to re-align formularies with current evidence has proven successful. The Ontario Drug Policy Research Network (ODPRN) launched a framework for conducting comprehensive drug-class reviews. This commentary describes the individual components of this framework and lessons learned through completion of 12 reviews between 2013 and 2016. We present the ODPRN drug-class review of treatments for chronic hepatitis B as a case example to illustrate the components and impact. The incorporation of foundational health technology assessment components such as economic evaluations and knowledge synthesis with contextualizing evidence such as patient and clinician perspectives (through qualitative studies), real-world evidence (through data analytics), and cross-jurisdictional comparisons (through environmental scans and data analytics), successfully developed jurisdictionally specific policy recommendations grounded in up-to-date evidence. The ODPRN framework for conducting comprehensive drug-class reviews is a robust and feasible approach to conduct formulary modernization. This framework allows for actionable and specific policies which are likely to be considered by decision makers. Adoption of similar frameworks in other jurisdictions may improve uptake of evidence-informed policy recommendations.

Copyright

Corresponding author

Author for correspondence: Mina Tadrous, E-mail: tadrousm@smh.ca

References

Hide All
1.Canadian Institute for Health Information (2016) Prescribed drug spending in Canada, 2016: A focus on public drug programs. Available at: https://secure.cihi.ca/free_products/Prescribed%20Drug%20Spending%20in%20Canada_2016_EN_web.pdf. Accessed December 1, 2018.
2.Morgan, SG, McMahon, M, Mitton, C, et al. (2006) Centralized drug review processes in Australia, Canada, New Zealand, and the United Kingdom. Health Aff 25(2), 337347.
3.Pharmacopeia, U (2000) Principles of a sound drug formulary system. Rockville: US Pharmacopeia.
4.Tierney, M, Manns, B (2008) Optimizing the use of prescription drugs in Canada through the Common Drug Review. CMAJ 178(4), 432435.
5.McDonagh, MS, Jonas, DE, Gartlehner, G, et al. (2012) Methods for the drug effectiveness review project. BMC Med Res Methodol 12(1), 140.
6.Khan, S, Moore, JE, Gomes, T, et al. (2014) The Ontario Drug Policy Research Network: Bridging the gap between research and drug policy. Health Policy 117(3), 392398.
7.Ontario Drug Policy Research Network (2015) Treatment of CHB in Ontario. Available at: http://odprn.ca/research/drug-class-review/chronic-hepatitis-b/. Accessed December 1, 2018.
8.Tricco, AC, Antony, J, Zarin, W, et al. (2015) A scoping review of rapid review methods. BMC Med 13(1), 224.
9.Coyle, D, Lee, KM, Mamdani, M, et al. (2015) Reimbursement-based economics—what is it and how can we use it to inform drug policy reform? Headache 55(S4), 236247.
10.Kwong, J, Crowcroft, N, Campitelli, M, et al. (2010) Ontario Burden of Infectious Disease Study Advisory Group; Ontario Burden of Infectious Disease Study (ONBOIDS): An OAHPP/ICES Report. Toronto: Ontario Agency for Health Protection and Promotion. Institute for Clinical Evaluative Sciences, 2833.
11.Minuk, G, Uhanova, J (2001) CHB in Canada. Can J Infect Dis Med Microbiol 12(6), 351356.
12.Schweitzer, A, Horn, J, Mikolajczyk, RT, et al. (2015) Estimations of worldwide prevalence of CHB virus infection: A systematic review of data published between 1965 and 2013. Lancet 386(10003), 1546–55.
13.Zhang, J, Zou, S, Giulivi, A (2001) Epidemiology of hepatitis B in Canada. Can J Infect Dis Med Microbiol 12(6), 345350.
14.Sherman, M, Bain, V, Villeneuve, J-P, et al. (2004) The management of chronic viral hepatitis: A Canadian consensus conference. Can J Gastroenterol Hepatol 18(12), 715728.
15.Liaw, Y-F, Kao, J-H, Piratvisuth, T, et al. (2012) Asian-Pacific consensus statement on the management of CHB: A 2012 update. Hepatol Int 6(3), 531561.
16.Liver EAFTSOT (2012) EASL clinical practice guidelines: Management of CHB virus infection. J Hepatol 57(1), 167185.
17.Terrault, NA, Bzowej, NH, Chang, KM, et al. (2016) AASLD guidelines for treatment of CHB. Hepatology 63(1), 261283.
18.Leber, A, Sherman, M (2009) Estimation of immigration related CHB infection and hepatocellular carcinoma development in Canada from 1981–2006. Can J Gastroenterol (Suppl A), A22.
19.Tadrous, M, Brahmania, M, Martins, D, et al. (2018) Publicly funded oral CHB treatment patterns in Ontario over 16 years: An ecologic study. J Manag Care Spec Pharm 24(5), 464468.
20.Ministry of Health and Long-Term Care Ontario Public Drug Programs (2018) Notice from the executive officer: Funding of hepatitis B drugs under the Ontario Drug Benefit Program. Available at: http://www.health.gov.on.ca/en/pro/programs/drugs/opdp_eo/notices/exec_office_20180221.pdf. Accessed December 1, 2018.

Keywords

Comprehensive Drug-Class Review Framework for improved evidence-based drug policy and formulary modernization

  • Mina Tadrous (a1) (a2) (a3), Sandra Knowles (a3) (a4), Brent Ruddock (a5), Paul Oh (a4) (a6), Muhammad M. Mamdani (a1) (a2) (a3) (a7), David N. Juurlink (a2) (a4) (a8) and Tara Gomes (a1) (a2) (a3) (a7)...

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed