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Lessons learned from the Canadian Fabry Disease Initiative for future risk-sharing and managed access agreements for pharmaceutical and advanced therapies in Canada

Bibliographic Data

ID21467722
AuthorsConor Douglas (0000-0002-1303-9989, York University, corresponding author), Shir Grunebaum (0009-0001-9926-457X, York University)
Year2024
Volume143
Pages105044
Publication date2024-05-01
Open AccessYes
TypeARTICLE
VenueHealth Policy (JOURNAL)
Journal identifiersISSN: 0168-8510 • E-ISSN: 1872-6054
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.healthpol.2024.105044
PMID38508062
OpenAlexW4392740276
LanguageEN
Citations received4
References cited27

Risk sharing agreements (RSAs) and managed access agreements have emerged as tools to overcome evidentiary uncertainty and contain costs of pharmaceuticals; however, Canada has relatively little experience with these health policy instruments. This article describes one of the few examples of national RSAs. Enzyme replacement therapies (ERT) were introduced in Canada to treat Fabry disease in the early 2000s through an RSA. Based on qualitative interviews with key participating actors, this article explains how this RSA ensured continuity of treatment for patients already on ERT, and collected robust real-world evidence to secure treatment for future Fabry patients. We show the importance of partnerships, collaborations, and active patient communities in establishing RSAs, as well as the critical role of robust registries for the collection, storage, and use of that real-world data. In doing so, this paper points to reasons that explain the relative dearth of RSAs in Canada, which can be resource (both human and finance) intensive and are difficult to broker in a federalist health system. Through these findings, policy lessons are developed concerning the need for technological and governance platforms on how RSA in Canada can be more effectively supported going forward in a broader move towards "social pharmaceutical innovation"

Business · Corporate governance · Disease · Fabry disease · Inequality · Political science · Public relations · Health Systems, Economic Evaluations, Quality of Life · Lysosomal Storage Disorders Research · Medicine · Pharmaceutical Economics and Policy · Public Administration · Finance

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Citations per year4
Citation span2026 - 2026 (1)
Highly citedNo

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