Evidence map›Paper›PMID 33234584›Full record

ArticleCMAJ open

Use of real-world evidence in cancer drug funding decisions in Canada: a qualitative study of stakeholders' perspectives.

Marc Clausen, Chloe Mighton, Ruhi Kiflen, Agnes Sebastian, Wei Fang Dai, Rebecca E Mercer, Jaclyn M Beca, Wanrudee Isaranuwatchai, Kelvin K W Chan, Yvonne Bombard

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed.

  1. When should RWE studies be prioritized for reimbursement? Insights from the Canadian perspective.International journal of technology assessment in health care · 2026
    Article
  2. The use of real-world evidence among healthcare payers: a scoping review.International journal of technology assessment in health care · 2025
    Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Marc ClausenLi Ka Shing Knowledge Institute (Clausen, Mighton, Sebastian, Isaranuwatchai, Bombard), St. Michael's Hospital, Unity Health; Institute of Health Policy, Management and Evaluation (Mighton, Sebastian, Beca, Isaranuwatchai, Bombard), University of Toronto; Canadian Cancer Society (Kiflen); Cancer Care Ontario (Dai, Mercer, Beca, Chan), Ontario Health; Canadian Centre for Applied Research in Cancer Control (Dai, Mercer, Beca, Isaranuwatchai, Chan); Sunnybrook Health Sciences Centre (Chan), Toronto, Ont.
Chloe MightonLi Ka Shing Knowledge Institute (Clausen, Mighton, Sebastian, Isaranuwatchai, Bombard), St. Michael's Hospital, Unity Health; Institute of Health Policy, Management and Evaluation (Mighton, Sebastian, Beca, Isaranuwatchai, Bombard), University of Toronto; Canadian Cancer Society (Kiflen); Cancer Care Ontario (Dai, Mercer, Beca, Chan), Ontario Health; Canadian Centre for Applied Research in Cancer Control (Dai, Mercer, Beca, Isaranuwatchai, Chan); Sunnybrook Health Sciences Centre (Chan), Toronto, Ont.
Ruhi KiflenLi Ka Shing Knowledge Institute (Clausen, Mighton, Sebastian, Isaranuwatchai, Bombard), St. Michael's Hospital, Unity Health; Institute of Health Policy, Management and Evaluation (Mighton, Sebastian, Beca, Isaranuwatchai, Bombard), University of Toronto; Canadian Cancer Society (Kiflen); Cancer Care Ontario (Dai, Mercer, Beca, Chan), Ontario Health; Canadian Centre for Applied Research in Cancer Control (Dai, Mercer, Beca, Isaranuwatchai, Chan); Sunnybrook Health Sciences Centre (Chan), Toronto, Ont.
Agnes SebastianLi Ka Shing Knowledge Institute (Clausen, Mighton, Sebastian, Isaranuwatchai, Bombard), St. Michael's Hospital, Unity Health; Institute of Health Policy, Management and Evaluation (Mighton, Sebastian, Beca, Isaranuwatchai, Bombard), University of Toronto; Canadian Cancer Society (Kiflen); Cancer Care Ontario (Dai, Mercer, Beca, Chan), Ontario Health; Canadian Centre for Applied Research in Cancer Control (Dai, Mercer, Beca, Isaranuwatchai, Chan); Sunnybrook Health Sciences Centre (Chan), Toronto, Ont.
Wei Fang DaiLi Ka Shing Knowledge Institute (Clausen, Mighton, Sebastian, Isaranuwatchai, Bombard), St. Michael's Hospital, Unity Health; Institute of Health Policy, Management and Evaluation (Mighton, Sebastian, Beca, Isaranuwatchai, Bombard), University of Toronto; Canadian Cancer Society (Kiflen); Cancer Care Ontario (Dai, Mercer, Beca, Chan), Ontario Health; Canadian Centre for Applied Research in Cancer Control (Dai, Mercer, Beca, Isaranuwatchai, Chan); Sunnybrook Health Sciences Centre (Chan), Toronto, Ont.
Rebecca E MercerLi Ka Shing Knowledge Institute (Clausen, Mighton, Sebastian, Isaranuwatchai, Bombard), St. Michael's Hospital, Unity Health; Institute of Health Policy, Management and Evaluation (Mighton, Sebastian, Beca, Isaranuwatchai, Bombard), University of Toronto; Canadian Cancer Society (Kiflen); Cancer Care Ontario (Dai, Mercer, Beca, Chan), Ontario Health; Canadian Centre for Applied Research in Cancer Control (Dai, Mercer, Beca, Isaranuwatchai, Chan); Sunnybrook Health Sciences Centre (Chan), Toronto, Ont.
Jaclyn M BecaLi Ka Shing Knowledge Institute (Clausen, Mighton, Sebastian, Isaranuwatchai, Bombard), St. Michael's Hospital, Unity Health; Institute of Health Policy, Management and Evaluation (Mighton, Sebastian, Beca, Isaranuwatchai, Bombard), University of Toronto; Canadian Cancer Society (Kiflen); Cancer Care Ontario (Dai, Mercer, Beca, Chan), Ontario Health; Canadian Centre for Applied Research in Cancer Control (Dai, Mercer, Beca, Isaranuwatchai, Chan); Sunnybrook Health Sciences Centre (Chan), Toronto, Ont.
Wanrudee IsaranuwatchaiLi Ka Shing Knowledge Institute (Clausen, Mighton, Sebastian, Isaranuwatchai, Bombard), St. Michael's Hospital, Unity Health; Institute of Health Policy, Management and Evaluation (Mighton, Sebastian, Beca, Isaranuwatchai, Bombard), University of Toronto; Canadian Cancer Society (Kiflen); Cancer Care Ontario (Dai, Mercer, Beca, Chan), Ontario Health; Canadian Centre for Applied Research in Cancer Control (Dai, Mercer, Beca, Isaranuwatchai, Chan); Sunnybrook Health Sciences Centre (Chan), Toronto, Ont.
Kelvin K W ChanLi Ka Shing Knowledge Institute (Clausen, Mighton, Sebastian, Isaranuwatchai, Bombard), St. Michael's Hospital, Unity Health; Institute of Health Policy, Management and Evaluation (Mighton, Sebastian, Beca, Isaranuwatchai, Bombard), University of Toronto; Canadian Cancer Society (Kiflen); Cancer Care Ontario (Dai, Mercer, Beca, Chan), Ontario Health; Canadian Centre for Applied Research in Cancer Control (Dai, Mercer, Beca, Isaranuwatchai, Chan); Sunnybrook Health Sciences Centre (Chan), Toronto, Ont.
Yvonne BombardLi Ka Shing Knowledge Institute (Clausen, Mighton, Sebastian, Isaranuwatchai, Bombard), St. Michael's Hospital, Unity Health; Institute of Health Policy, Management and Evaluation (Mighton, Sebastian, Beca, Isaranuwatchai, Bombard), University of Toronto; Canadian Cancer Society (Kiflen); Cancer Care Ontario (Dai, Mercer, Beca, Chan), Ontario Health; Canadian Centre for Applied Research in Cancer Control (Dai, Mercer, Beca, Isaranuwatchai, Chan); Sunnybrook Health Sciences Centre (Chan), Toronto, Ont. yvonne.bombard@utoronto.ca.

Funding

CIHR
6 · The paper itself

Abstract

backgroundReal-world evidence (RWE) can provide postmarket data to inform whether funded cancer drugs yield expected outcomes and value for money, but it is unclear how to incorporate RWE into Canadian cancer drug funding decisions. As part of the Canadian Real-World Evidence Value for Cancer Drugs (CanREValue) Collaboration, this study aimed to explore stakeholder perspectives on the current state of RWE in Canada to inform a Canadian framework for use of RWE in cancer drug funding decisions.

methodsThis was a qualitative descriptive study. Qualitative semistructured interviews were conducted from April to July 2018. Participants were Canadian and international stakeholders who had experience with RWE and drug funding decision-making. Thematic analysis was used to analyze data.

resultsThirty stakeholders participated in the study. Five themes were identified. Stakeholders indicated that RWE had value in cancer drug funding decisions. However, a cultural shift is needed to adopt RWE in decision-making. Further, the Canadian infrastructure for real-world data is currently inadequate for decision-making, and there is a need for committed investment in building capacity to collect and analyze RWE. Finally, there is a need for increased collaboration among key stakeholders.

interpretationThe findings of this study suggest that if RWE is to be used in drug funding decisions, there is a need for a cultural shift, improved data infrastructure, committed investment in capacity building and increased stakeholder collaboration. Together with local stakeholder engagement, application of these findings may contribute to optimizing implementation of RWE.

Indexed as

Financing, GovernmentStakeholder ParticipationAntineoplastic AgentsCanadaDecision MakingDrug CostsEvidence-Based MedicineFemaleHumansInterviews as TopicMaleQualitative ResearchRandomized Controlled Trials as TopicAntineoplastic Agents

Identifiers

PMID33234584
PMCPMC7721249

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.