Alzheimer's Drug Therapy Review - Reports

The Ministry of Health (the Ministry) conducted  a review of cholinesterase inhibitor drugs for the treatment of mild to moderate Alzheimer’s disease using its usual drug review process, which included information from the Alzheimer’s Drug Therapy Initiative (ADTI).

Through its drug review process, the Ministry considered existing PharmaCare policies, programs, priorities and resources, and the evidence-informed recommendations of an independent advisory body called the Drug Benefit Council (DBC).

The following table includes the information that was provided to the DBC as part of its review, as well as the DBC Recommendation and Reasons for Recommendation. 

NAME OF DOCUMENT    

DESCRIPTION

Clinical Evidence Review Report

A meta-analysis and systematic review of the published literature on the efficacy and safety of the cholinesterase inhibitor drugs. This was commissioned by BC and completed in August 2014.

Clinical Evidence Review Report Update

An update of the meta-analysis and systematic review of the published literature on the efficacy and safety of the cholinesterase inhibitor drugs. This was commissioned by BC and completed in August 2015.

Ontario Clinical Evidence Review Reports

A drug class review of the published literature on cognitive enhancers (including the cholinesterase inhibitor drugs). This was completed by the Ontario Drug Policy Research Network, for the Ontario Public Drug Programs (Ontario Ministry of Health and Long-Term Care), in August 2015. 

Pharmacoeconomic Review Report

A review of the published literature on the cost-effectiveness of the cholinesterase inhibitor drugs. This was commissioned by BC and completed in November 2013.

ADTI Research Studies—University of Victoria

 

 

 

The final reports of the “coverage with evidence development” research studies conducted by researchers at the University of Victoria, involving primary data collected from BC patients and secondary analysis of BC administrative data. This work started in 2007 and the final report was completed in August 2015. The University of Victoria research studies include:

  1. The Seniors’ Medication Study
  2. The Clinical Epidemiology Project
  3. The Utilization and Cost Project
  4. The Caregiver Appraisal Study
Policy Questions The policy questions regarding PharmaCare coverage status of the cholinesterase inhibitors.
Jurisdictional Survey The survey of jurisdictional coverage status of the cholinesterase inhibitor drugs.

Patient Group Input

Summary of responses provided by a patient group. This update was completed in August 2015.

Manufacturer Comments—Janssen

Manufacturer Comments—Novartis

Manufacturer Comments—Pfizer

An assessment of the clinical evidence, pharmacoeconomic, and research reports as described above provided by the three brand manufacturers. These were completed in September 2015.

 

 

Alzheimer’s Drug Therapy Initiative (ADTI) Special Authority Forms

The former ADTI forms that were used to request temporary coverage through the Ministry’s Special Authority program. These include the ADTI coverage criteria and are provided as a reference.

ADTI Research Study – University of British Columbia

The final report of the “coverage with evidence development” research study conducted by researchers at the University of British Columbia, involving primary data collected from BC patients. This study was completed in 2015 and was named:

The Clinical Meaningfulness in Alzheimer Disease Treatment (CLIMAT) Study

Drug Benefit Council Recommendation

The Drug Benefit Council (DBC) reviewed the cholinesterase inhibitor drugs at their September 2015 meeting. The final recommendation from the Drug Benefit Council (DBC) for the cholinesterase inhibitor drugs was prepared in January 2016.