CADTH Recommendation to Not Reimburse New Treatment a Failure for People Living with Schizophrenia
STEINBACH, MB, Sept. 21, 2022 /CNW/ - The Schizophrenia Society of Canada (SSC) is joined by the schizophrenia community across Canada in its disappointment with the final recommendation by the Canadian Agency for Drugs and Technologies in Health (CADTH), the agency responsible for provincial reimbursement recommendations, that Vraylar (cariprazine) should not be publicly reimbursed for the treatment of schizophrenia in adults1. Vraylar is the only approved treatment for adults with schizophrenia that has also been shown to improve predominant negative symptoms and functioning – which clinical experts consulted by CADTH confirmed as an area of unmet need2.
"Health Canada's approval of Vraylar gave new hope to thousands of Canadian patients and their families dealing with schizophrenia by providing a new, convenient, and safe treatment option to minimize the burdens associated with not only the positive symptoms but also the negative symptoms of the condition," said Chris Summerville, CEO of the Schizophrenia Society of Canada. "CADTH's recommendation is a failure to those living with negative symptoms of schizophrenia and runs completely contrary to the patient input provided by several mental health organizations and two clinician groups."
Characterized by issues like the inability to enjoy pleasure, social withdrawal, difficulty in concentrating or displaying emotions and challenges in communicating3, negative symptoms significantly impede critical pursuits like education and employment4 for patients living with these symptoms and can lead to their social exclusion. Currently, there is no publicly funded antipsychotic medication that targets these debilitating symptoms and reliably improves psychosocial functioning to support recovery and reintegration into society.
"While antipsychotic medications have first-line evidence in treating schizophrenia, the current options primarily target only the positive symptoms of the condition, such as hallucinations and delusions," said Dr. Ruth Baruch, MD, FRCP(C) a community psychiatrist from Toronto who has extensive experience in treating patients with schizophrenia and their loved ones. "It is important to have additional treatment options available for people, since one size does not fit all when it comes to therapies for people living with negative symptoms of schizophrenia. Regardless of how well positive symptoms are controlled, negative symptoms will continue to challenge in recovery efforts."
In April 2022, Vraylar was approved by Health Canada for the treatment of schizophrenia, based on controlled clinical trials where it was found to improve both positive and negative symptoms5. In their input to CADTH, two clinician groups "advocated for Vraylar (cariprazine) as a first-line antipsychotic for patients with schizophrenia, including those with an early phase of psychosis or negative symptoms." Notably, the final CADTH recommendation acknowledges that in clinical trials Vraylar has shown "statistically significant" improvement in patients with acute schizophrenia, relapse prevention, and predominant negative symptoms and functioning. CADTH also acknowledged that "patients expressed a need for treatments which minimize the negative and cognitive symptoms of schizophrenia" and "provide an additional option for those who do not respond to existing treatments."
"By all accounts, access to Vraylar would fill an expressed unmet need for people living with schizophrenia, their family members, and physicians as a therapeutic option to address negative symptoms and reliably improve psychosocial functioning to support recovery and reintegration into the community," said Hazel Meredith, President of the SSC Board of Directors. "As such, SSC and the schizophrenia community will continue to urge all provinces to make Vraylar accessible across Canada through public funding without further delay."
Schizophrenia is often a severe and chronic mental disorder that is associated with higher rates of health service use, hospitalization6, homelessness7, unemployment8, and mortality9. In a 2005 analysis, it was found that the health and non-healthcare costs of schizophrenia in Canada accounted for a loss of about 6.85 billion dollars per annum. People with schizophrenia can benefit from a range of biological and psychosocial treatments - accessible through public funding - with antipsychotic medication being a mainstay of treatment.
The SSC is a national mental health organization with over 42 years of experience advocating for the unique needs of those individuals living with early psychosis or schizophrenia and their family members. SSC's mission is to build a Canada where those living with early psychosis and schizophrenia achieve their potential.
The SSC represents the more than 380,000 Canadians who have some form of schizophrenia, as well as three percent of the population that will experience early psychosis at some time in their lives. All these people have family members, significant others, and friends who are affected by their mental illness. Consequently, to conversations around mental health and mental illness, we bring the value of lived/living voices and expertise of those living with early psychosis and schizophrenia, and their recovery experiences.
SSC is a member of the Canadian Alliance on Mental Illness and Mental Health, and a strong advocate for early intervention and recovery-oriented mental health services.
1 CADTH. (2022, August 10). Cariprazine (Vraylar). cadth.ca. Retrieved Sept 7, 2022, from https://www.cadth.ca/cariprazine |
2 CADTH. (n.d.). CADTH Reimbursement Recommendation (Draft) - Cariprazine (Vraylar). Retrieved Sept 7, 2022 |
3 Mitra, S., Mahintamani, T., Kavoor, A. R., & Nizamie, S. H. (2016). Negative symptoms in schizophrenia. Retrieved Sept 7, 2022, from Industrial psychiatry journal, 25(2), 135–144. https://doi.org/10.4103/ipj.ipj_30_15 |
4 Gard, D. E., Kring, A. M., Gard, M. G., Horan, W. P., & Green, M. F. (2007). Anhedonia in schizophrenia: distinctions between anticipatory and consummatory pleasure. Schizophrenia research, Retrieved Sept 7, 2022, from 93(1-3), 253–260. https://doi.org/10.1016/j.schres.2007.03.008 |
5 Product monograph including Patient Medication Information. (n.d.). Retrieved Sept 7, 2022, from https://allergan-web-cdn-prod.azureedge.net/allergancanadaspecialty/allergancanadaspecialty/media/actavis-canada-specialty/en/products/pms/vraylar-pm-eng-22apr2022.pdf |
6 Schizophrenia in Canada - Public Policy Forum. (2014, February). Retrieved Aug 26, 2022, from https://ppforum.ca/wp-content/uploads/2018/03/Schizophrenia-in-Canada-Final-report.pdf |
7Ayano, G., Tesfaw, G., & Shumet, S. (2019, November 27). The prevalence of schizophrenia and other psychotic disorders among homeless people: A systematic review and meta-analysis - BMC Psychiatry. BioMed Central. Retrieved August 26, 2022, from https://bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-019-2361-7#citeas |
8Schizophrenia Society of Canada. (2020, August 4). Schizophrenia Society of Canada - Education. Retrieved August 26, 2022, from https://schizophrenia.ca/learn-more-about-schizophrenia/#learn6 |
9Public Health Agency of CANADA. (2017). Schizophrenia in Canada. Retrieved August 26, 2022, from https://www.canada.ca/content/dam/phac-aspc/documents/ |
SOURCE Schizophrenia Society of Canada
Chris Summerville, Chief Executive Officer, Schizophrenia Society of Canada, [email protected]
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