CARE™ Perspectives

More Innovation Needed in Psoriatic Arthritis

Needs Assessment Results


10 Jun 2021


The aim of this publication is to provide a snapshot of:
Select response data from the recent CARE™ Needs assessment on the current state of care and access to innovative medicines in Canada
Data is augmented with additional context and insights by the CARE™ Rheumatology Faculty

The need for greater and more efficient access to approved innovative options in PsA is evident and is necessary to drive further improvement in patient outcomes.
Efforts moving forward will focus on highlighting inconsistencies and deficiencies in current processes for approval and funding of novel agents (and the potential downstream effect this has on the overall Canadian landscape) and explore the continued (and lasting) impact that the COVID-19 pandemic will have on rheumatology care.

The CARE™ Rheumatology Faculty plan to share their perspectives, informed by the insights gathered from this assessment during the upcoming multidisciplinary virtual CARE™ National Congress on Accessing Innovation in Canada slated for June 25, 2021. They will also be reporting on news and data from the EULAR 2021 Congress. Stay Tuned!

Key Takeaways


Responder feedback validates statements from faculty at ACR Convergence working group.

  • More innovation needed in psoriatic arthritis to address both unmet needs and gaps in therapy.
    • With current therapies, many patients experience residual pain and fail to achieve minimal disease activity (MDA).
    • Approval of innovative agents with different modes of action (MOA) is needed.
    • While multiple agents targeting TNF have been approved in Canada, fewer choices that target JAK inhibition, IL-17 and IL-23 are available to rheumatologists.
  • Unacceptable delays between notice of compliance from Health Canada and public formulary listing with 2/3 of responders indicating they have been unable to access an approved therapy due to delays in public payer funding.
Supporting Responder Feedback:
  • 85% of responders agree there are still unmet needs for PsA in terms of treatment options, with 90% indicating there is a need for innovative new medicines.
  • 85% of clinicians indicated they have concerns regarding delays in the approval of and access to innovative new treatment options, with 70% suggesting there is a need to ensure that PsA patients don’t have to wait longer than others for access to innovative new therapies.
  • 100% of respondents agree that a delay of 1 – 2 years between Health Canada approval (Notice of Compliance) and public formulary listing of new therapies for PsA is unacceptable.
  • 67% of clinicians indicated they have experienced situations where patients ask about starting a specific approved therapy for PsA but were unable to access it due to delays in formulary listing.
  • 79% of responders agree Canada is a laggard in approving new therapies for PsA.
  • 89% of clinicians agree that oral therapy options (as opposed to injected or infused therapies) would be preferable, particularly during the pandemic


Preview of Results
Do you have any concerns regarding delays in the approval of and
the access to innovative new treatment options?
Why? Please elaborate.

When asked to please elaborate, response included:

  • Burden of time delays systemically and on care team
  • Cost
  • Canadian- made innovation/Canada being overlooked by pharma
  • Limited options for patients with persistent disease or who have failed currently available therapies
  • Difficulties applying approval procedures used in RA to therapy approvals in other diseases such as PsA
  • Losing a window of opportunity with treatment/ patients
  • Inconsistencies in access to new drugs approved for reimbursement in Canada that are not always approved in individual provinces and territories
Have you experienced situations where patients ask about starting a specific approved therapy for PsA, but you are unable to access it due to delays in formulary listing?
Actions taken?

Response included:

  • Retrying other drugs from classes that patients have failed in the past
  • Contact ORA therapeutics committee
  • Trying to get off label approval if possible
  • Samples, compassionate through the company
  • Individual intervention by writing letters for “patient exception”. Takes time and causes delays in approval.
  • Nothing/wait
See the full results with insights from the CARE Rheumatology Faculty:
Click To View Full Results
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