Impact of COVID-19 on the Biopsychosocial Model of Health

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Dr. Tarry Ahuja, Manager of Program Development in Pharmaceutical Reviews and Senior RWE Advisor at CADTH, joined me for a thought-provoking discussion around the impact of COVID-19 on the biopsychosocial model of health, key opportunities and barriers to RWE throughout the drug lifecycle, and much more!

Here is a sneak peek of our conversation:

Q: Can you explain a little bit about the timing and how private versus public players play out with the final decisions or recommendations that the CADTH makes for their particular product?

A: You raise a really good question, Natalie. I can say right off the top that private runs slightly differently. This is a great example of how one stream can be a disrupter or embrace innovation a little bit more than others. Private tends to provide access to more medicine sooner, more broadly speaking, versus public. For those who are unaware of the difference, private refers to groups that either your employer or you are paying for directly to get enhanced access to services like medicines or physiotherapy or a dentist and doctor. All those kinds of things that are not coming out of your pocket and that they’re covering are private.

The private playground, I like to call, is actually a really great area for innovation because they’re willing to say “Well, you know this employer wants the latest and greatest medicines and as a result, they’re paying a higher premium and so we want to offer them access to medicines that are groundbreaking or more innovative.” Manufacturers want this because it gets their medicine out in the real world, it gets them early access to data in the real world and allows them to validate their clinical trial program and to allow others around the globe to see what their medicine looks like in the hands of clinicians and patients, so that happens.

If things look really great, all of a sudden they have leverage and they have the proxy to say, “Listen, we’ve applied this in the private insurance program and all these patients have had it, and look at how well it’s doing. This is something you’re going to want.” That’s why you can see that’s the catalyst for them to try and work their program.

In the public program, they go through the Health Canada CADTH process and you were asking about timing and how that looks in terms of market access; it does take a little bit more time and there is more red tape and it’s usually because of the associated costs. Now, when you’re opening something to the public, as the name implies, it’s public, it’s for everyone whose allowed to fit within that mold of being a public patient. That’s millions and millions of people. There’s a lot of work and effort that goes into ensuring that the decisions being made at the public level are based on evidence. It is a more conservative approach for a reason.

I think that it’s really challenging to review a drug, bring it to market and then pull it off the market in a large public environment if there’s either a problem or we feel that if the drug is not working. Whereas, private can make those decisions quite nimbly and they have their own rules that they follow. Overall, public or private, we follow the same overall process that still needs to go through Health Canada for compliance, and that it goes to review by CADTH…

For more of our discussion, you can watch the whole Fireside Chat with Dr. Tarry Ahuja, or listen to the podcast version, below.

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