Cubic News

Update on the CADTH Biologics Review in Rheumatoid Arthritis

February 2011

In November 2010′s Cubic Health Monthly, we focused on findings from a study conducted by the Canadian Agency for Drugs and Technologies in Health (CADTH) comparing the efficacy, safety and cost between different specialty drugs (i.e. biologics) used in the treatment of Rheumatoid Arthritis (RA).

This study found that there were no significant differences between five of the most commonly prescribed biologic agents for RA. However, concerns from a number of stakeholders prompted CADTH to release a number of amendments to its original report.

Upon closer review of these amendments, it is clear that the primary objective of the revised report was to provide more insight into the data and methods used by CADTH and its Therapeutic Review Panel (TRP) to arrive at its final recommendations. These recommendations remain unchanged. As a result, these amendments do not influence the insight that these reports provide for initiating or restructuring existing PA programs for expensive specialty drugs.

Cubic Health continues to encourage plan sponsors to review their plan utilization and PA programs. Simply having a PA program in place is no longer sufficient in containing plan costs and ensuring optimal use of plan resources. Plan sponsors need to consider appropriate PA criteria for key specialty drugs, as well as a focus not just on initiation of therapy, but criteria around continuation of therapy. We recommend that plan sponsors request detailed information on their current PA plans, criteria being used for adjudication claims, and how long-term claims are handled.

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