Year in Review

Partnering With Government: Introducing Guidance on RWE 

Globally, RWE plays an increasingly important role in health care decision-making, and this year we made important strides in advancing the use of RWE in Canada.

In partnership with Health Canada and the Institut national d’excellence en santé et en services sociaux (INESSS), we published Guidance for Reporting Real-World Evidence. The document is unique in Canada and globally because it outlines a consistent approach, aligned with international principles, for reporting RWE studies to both regulatory and HTA agencies. The guidance was launched at the 2023 Symposium and Health Canada subsequently published its position, noting the emphasis on transparent and comprehensive reporting of RWE studies to assess reliability and reproducibility.

To develop the guidance, we worked with health system partners spanning government, patient organizations, industry, academia, and data holders who brought important perspectives to the project. We also established an Expert Methods Panel that included members from across Canada, the US, and the UK.

As we work to expand our use of RWE, collaboration will remain a hallmark of our approach, helping us address data challenges and harness the potential of RWE in the value assessment of new and existing drugs. 

Partnering With Industry: Launching the Ambitious Target Zero Initiative

Canada is home to dynamic pharmaceutical and life sciences industries that make important contributions to pan-Canadian health systems. The Target Zero initiative, launched in March 2024, is part of our commitment to a new level of cooperation with industry and partner organizations to help improve access to approved new drugs.

The initiative’s ambitious goal is to achieve zero days between Health Canada’s regulatory approval of a new drug and our draft reimbursement recommendation to participating public drug plans. The collective effort involves working closely with pharmaceutical companies to identify barriers and opportunities to increase the number of drugs that are filed with us prior to Health Canada’s approval. It also includes collaborating with Health Canada, the pan-Canadian Pharmaceutical Alliance, and patient organizations to enable and support these efforts. By achieving earlier drug submissions, we can deliver more timely reimbursement recommendations.

It is only through dialogue and collaboration that we can better understand the distinct perspectives and objectives of our partners, continue to build trust, and help make the pan-Canadian drug reimbursement pathway more efficient, seamless, and transparent. The response to Target Zero and our ambitious goal has been strong and enthusiastic. 

Partnering With Clinicians: Bringing Diverse Perspectives to the Issue of Emergency Department Overcrowding

In November 2023, we published new evidence and expert guidance from our Health Technology Expert Review Panel on emergency department (ED) overcrowding. The guidance was released as ED staff across Canada were coping with persistently high patient volumes and staffing shortages.

Engaging with ED clinicians and trainees, as well as patients, caregivers, and community members, was central to this project. We recruited additional members with significant lived and clinical experience in emergency care to serve on the panel. We also engaged with clinical associations to hear the voices of nurses, physicians, and paramedics, as well as patient organizations, among others. 

Our final guidance report underscored that ED overcrowding is a complex, system-wide issue, and that accountability and transparency should be key principles in how it is addressed. Having clinician, patient, and caregiver voices around our table brought essential and authentic perspectives to deliberations that directly affect their lives.

Uptake of the evidence and guidance among provinces and territories has been strong, and decision-makers have noted its rigour and comprehensiveness. Several provinces are incorporating the guidance into their planning and using it to analyze gaps and consider interventions appropriate for their local context. 

Partnering With Patients: Centring Caregiver Experience to Develop a Watch List

In March we released our Watch List, an annual must-read forecast of emerging technologies and issues that have the potential to transform the delivery of health care. The list identified new models of care and genetic testing among the technologies to watch. It also highlighted issues that affect the implementation of these advancements, such as disparities in access and health system interoperability.

With a focus on children and youth with medical complexities, engaging with caregivers was essential to understanding their experiences in the health system and the potential impact of technologies on their day-to-day lives.

We used a modified James Lind Alliance priority-setting partnerships approach to bring diverse groups together on equal footing and to facilitate a consensus-based decision-making process. Our panel brought together 5 parent caregivers, plus policy and legal experts, researchers, industry representatives, and clinicians.

Notably, the report underscored that the need for additional support for caregivers, and specifically mental health support, is worthy of greater attention. This reflects the profound impact that caring for a child with medical complexity can have on individuals and families. 

Collaborating With Indigenous Leaders and Organizations

In March 2023, we met with Indigenous health leaders who shared important guidance on reconciliation and how we can include diverse Indigenous perspectives and voices.  

Since that meeting, our Strategic Partners for Indigenous Engagement and Partnerships and IDEA have been working alongside teams to build internal organizational capacity by reviewing and strengthening internal systems, and taking steps to integrate equity into our products and services based on priorities identified by Indigenous leaders. pipikwan pêhtâkwan, an Indigenous-owned and led organization, helped us understand how to humbly and respectfully approach Indigenous organizations as part of our own knowledge building. We’ve started outreach and engagement by attending Indigenous forums and conferences and by aligning with other PCHOs doing similar work. 

We’ve further built upon our understanding of national Indigenous organizations and their priorities through attending the First Nations Health Managers Association Annual National Conference, as well as sponsoring and attending the Métis Nation Health Policy Forum. These events gave us the opportunity to learn about health priorities identified by these organizations and enabled us to listen and be present as discussions unfold. In March 2024, we collaborated with pCHO partners to gather with national Indigenous organizations to learn about their priorities and mandates, as well as how to align to work together with Indigenous organizations. 

This year, we also explored how to advance reconciliation across the organization and spanning all of our programs, products, and services. We published new insights on how to search for Indigenous health information and Knowledge, in collaboration with the Strategic Partner for Indigenous Engagement and Partnerships. We redeveloped our internal recruitment process and expanded external programs like our Symposium travel awards to be more inclusive and reflective of the diversity found in Canada. 
 

Partnering With International Organizations: Global Partnerships Help Advance HTA in Canada

Over the course of the past year, we continued to play a leading role in the global HTA community and found new ways to work better together, with more agility and efficiency. The international collaboration between HTA bodies in the UK, Australia, and Canada welcomed INESSS (Québec) and Pharmac (New Zealand). Priorities for the collaboration include work sharing, horizon scanning, and science and methods development.

In a separate collaboration, we issued a joint position statement on redacting clinical data awaiting publication with the National Institute of Health and Care Excellence (NICE) in the UK, and the Institute for Clinical and Economic Research (ICER) in the US. The statement describes how our 3 organizations are changing how we handle some confidential clinical evidence submitted through our respective review processes to increase transparency and consistency across borders.

Members of our team also made important contributions at the annual meetings of Health Technology Assessment International and the International Network of Agencies for Health Technology Assessment. We presented on topics ranging from making HTA more efficient to meet changing expectations and advancing alignment with regulators. A throughline across all of our partnerships is the imperative for collaboration on a global scale so the HTA community can collectively respond to emerging opportunities and challenges in health care.