Cadth Recommendations As Predictors For Drug Availability In British Columbia And Ontario


      The Canadian Agency for Drugs and Technologies in Health (CADTH) conducts health technology assessments and provides recommendations for drug listing and reimbursement. However, the health care providers of individual Canadian provinces are not obligated to follow CADTH recommendations. The aim of this analysis is to assess the value of CADTH recommendations as predictors for drug availability in British Columbia and Ontario.


      This study included 93 CADTH recommendations for 88 drugs across 30 disease conditions. The British Columbia and Ontario formularies and special access programs were searched for these 88 drugs (some drugs were included more than once as CADTH reviewed them for multiple indications). Agreement was defined as any case in which drugs received positive CADTH recommendations and were listed by a province’s health care system or in which they received negative recommendations and were not listed. A CADTH recommendation was only considered “negative” when CADTH specifically recommended that a drug not be listed.


      CADTH recommendations are significantly associated with both British Columbia’s drug listings (p<.01) and Ontario’s drug listings (p<.01). CADTH recommendations agreed with British Columbia listing decisions for 74% of the drugs reviewed by CADTH. Ontario agreed with CADTH for 76% of the drugs. Positive CADTH recommendations in particular often translated to availability in British Columbia and Ontario. Of the 57 drugs that received positive CADTH recommendations, 82% (47) are available in BC and 93% (53) are available in Ontario. Of the 36 drugs receiving negative CADTH recommendations, 61% (22) are unavailable in BC and 50% (18) are unavailable in Ontario.


      A positive CADTH recommendation is a good predictor of drug availability in British Columbia and Ontario. A drug that receives a negative CADTH recommendation, however, still has a significant probability of being listed by each province’s health care system, especially through their special access programs.