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Record W4417523765 · doi:10.1093/jphsr/rmaf025

Is there another reason for the change in the rate of recommendations to reimburse from Canada’s drug agency?

2025· article· en· W4417523765 on OpenAlexaffabout
Nigel S. B. Rawson

Bibliographic record

VenueJournal of Pharmaceutical Health Services Research · 2025
Typearticle
Languageen
FieldEconomics, Econometrics and Finance
TopicHealth Systems, Economic Evaluations, Quality of Life
Canadian institutionsFraser InstituteInstitute of Health Services and Policy ResearchCanadian Institute for Health Information
Fundersnot available
KeywordsReimbursementDrugAgency (philosophy)Drug approvalMEDLINEAlliance

Abstract

fetched live from OpenAlex

Abstract Objective To assess whether the development of the pan-Canadian Pharmaceutical Alliance (pCPA) could be a reason for the change in the rate of recommendations to reimburse from Canada’s Drug Agency (CDA). Methods Data on submissions and recommendations were obtained from CDA’s reimbursement review reports. Only the first submission for each drug-indication combination between 2009 and 2023 was included. Recommendations to reimburse with or without clinical criteria and/or conditions were combined as positive recommendations, while do not reimburse recommendations were categorized as negative. Rates of positive and negative recommendations for submissions made in 2009 to 2013 (before and during the pCPA’s initial development), 2014 to 2018 (when the pCPA was formalized but not a standalone agency), and 2019 to 2023 (when pCPA transitioned into a standalone organization) were calculated for all drugs, oncology drugs, and non-oncology drugs. Key findings There has been a significant increase in the rate of positive recommendations for non-oncology medicines between 2009 and 2013 when the pCPA was not fully active and the rate in the following 10 years (P < .0001). Oncology drugs had a higher rate of positive recommendations than non-oncology drugs prior to the pCPA becoming fully active and the rate stayed approximately the same. Conclusion The creation of the pCPA has allowed CDA to step back from its role as price gatekeeper and pass it to the pCPA, permitting CDA to focus on its health technology assessment function. The pCPA’s establishment is an alternative reason for the significant increase in positive CDA recommendations.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.049
metaresearch head score (Gemma)0.001
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMetaresearch
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Commentary · Consensus signal: none
Teacher disagreement score0.695
Threshold uncertainty score0.979

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0490.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0010.000
Research integrity0.0000.001
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.593
GPT teacher head0.610
Teacher spread0.017 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreCommentary

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes2
Has abstractyes

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