Canada

CADTH, pCODR, INESSS: Canada's three tracks.

Q: CADTH vs pCODR vs INESSS?

CADTH runs the common drug review (CDR) for non-oncology medicines. The pan-Canadian Oncology Drug Review (pCODR), part of CADTH, evaluates cancer drugs. INESSS runs Québec's independent provincial review. Most pharmaceuticals require all three tracks. We coordinate across them.

Q: What discount rate does CADTH use?

CADTH's CADTH Guidelines for the Economic Evaluation of Health Technologies use 1.5% per year on costs and outcomes in the base case (revised from 5% in 2017). Sensitivity at 0% and 3% is conventional. The lower discount rate is a meaningful structural difference from PBAC/MSAC and Pharmac.

Q: Do you submit to INESSS separately?

Yes. INESSS's evaluation framework is independent of CADTH and uses French-language dossiers. We re-cut the model and translate the dossier, working with translation specialists for the language layer.

Canadian Health Technology Assessment splits across CADTH for medicines, pCODR for oncology, and INESSS for Québec. We coordinate the modelling and dossier work across all three, plus the pCPA price negotiation that follows recommendation.

The Canadian pathway, in one paragraph.

For most pharmaceuticals: CADTH runs a common drug review (CDR) producing a federal-level reimbursement recommendation. Oncology drugs go through the pan-Canadian Oncology Drug Review (pCODR), an oncology-specialised CADTH process. INESSS (Institut national d'excellence en santé et en services sociaux) runs the Québec provincial review independently. After a positive CADTH or pCODR recommendation, the pan-Canadian Pharmaceutical Alliance (pCPA) coordinates a price negotiation across provinces. Provincial / territorial drug plans then make their own listing decisions, anchored on the federal recommendation and the negotiated price.

Where HEC fits in the pathway.

CADTH / pCODR pre-submission

Comparator selection from the relevant Canadian formulary, evidence-gap analysis, CADTH 1.5% discount re-cut from international source models.

CDR or pCODR submission

Full economic model + clinical evidence + budget impact at the federal level. Submitted in the agency's templates, with PSA scenario tables ready for the committee.

INESSS dossier

Québec-specific economic evaluation in French, INESSS evaluation framework. We re-cut the model and coordinate translation.

pCPA preparation

Confidential price scenarios pre-modelled so the pCPA negotiation runs on the same coherent economic basis as the federal recommendation.

Response cycle

CADTH committee questions, INESSS review questions, and post-recommendation follow-ups answered within the agency's timelines.

Provincial follow-up

Where province-specific economic evidence is requested post-pCPA, we provide it without rebuilding the model.

Common questions on Canada.

CADTH vs pCODR vs INESSS?

CADTH runs the federal common drug review for non-oncology medicines. pCODR (within CADTH) handles oncology. INESSS runs the Québec provincial review independently. Most products go through all three.

What discount rate does CADTH use?

1.5% per year on costs and outcomes in the base case (revised from 5% in 2017). Sensitivity at 0% and 3%. This is meaningfully different from PBAC, MSAC, and Pharmac.

What about the pCPA stage?

After CADTH or pCODR recommends, the pan-Canadian Pharmaceutical Alliance negotiates price across participating provinces. The same economic model anchors the negotiation.

Do you submit to INESSS separately?

Yes. INESSS uses an independent evaluation framework and French-language dossiers. We re-cut the model and coordinate translation specialists for the language layer.

Planning a CADTH or pCODR submission?

30 minutes to scope the three-track work across federal, Québec, and pCPA, and decide if an agreement fits.

Book a 30-minute call