Processes and new advancements in atopic dermatitis treatments
There have been many advancements in research and treatments for atopic dermatitis (AD) in recent years, and there are currently more than 80 new treatments in development for AD. These advancements don’t happen overnight, and it can take years for new medications to be made available in Canada.
The process begins with approval by Health Canada. After a careful review, Health Canada may approve a medication if they deem it is safe and effective. The new treatment then moves to health technology assessment (HTA) bodies who recommend if it should be reimbursed by public drug plans.
The two main HTA bodies in Canda are the Canadian Agency for Drugs and Technologies in Health (CADTH) and for Quebec, l’Institut national d’excellence en santé et en services sociaux (INESSS).
But it doesn’t stop there. These are just a few of the steps involved in this complex process.
To help navigate how new drugs are developed and made accessible in Canada, ESC created a new resource that helps explain the drug development process in Canada. We also invite you to read on for a summary on some new AD therapies, and a snapshot of their current reimbursement status in Canada (as of May 2022).
ABROCITINIB
Brand Name: Cibinqo
Class: Orak JAK Inhibitor
Delivery method: Oral pill, once daily
Indication: For the treatment of patients 12 years and older with refractory moderate to severe atopic dermatitis, including the relief of pruritus, who have had an inadequate response to other systemic drugs (e.g. steroid or biologic), or for whom these treatments are not advisable.
Health Canada approval status: Approved
Private payer reimbursement: Pending review
Public payer reimbursement: Pending review
CRISABOROLE
Brand Name: Eucrisa
Class: Phosphodiesterase-4 (PDE4) Inhibitor
Delivery Method: Ointment, 2% for topical use
Indication: For topical treatment of mild to moderate atopic dermatitis adults and pediatric patients 3 months and older.
Health Canada approval status: Approved
Private payer reimbursement: Insurance plans may be reimbursing this medication – check with your insurer
Public payer reimbursement: CADTH and INESSS have both made recommendations not to reimburse this medication
DUPILUMAB
Brand Name: Dupixent
Class: Biologic Drug
Delivery Method: Subcutaneous injection
Indication: For the treatment of patients aged 6 years and older with moderate-to-severe AD whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable.
Health Canada approval status: Approved
Private payer reimbursement: Insurance plans are reimbursing this medication – check with your insurer
Public payer reimbursement: CADTH and INESSS made a recommendation to reimburse this medication with certain criteria for patients aged 12 and older. Reimbursement is available, with certain criteria in Alberta, Manitoba, New Brunswick, Newfoundland and Labrador, Northwest Territories, Nova Scotia, Nunavut, Ontario, Prince Edward Island, Quebec, Saskatchewan, and through NIHB.
TRALOKINUMAB
Brand Name: Adtralza
Class: Biologic Drug
Delivery Method: Subcutaneous injection
Indication: Treatment of moderate-to-severe atopic dermatitis (AD) in adult patients whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable. Adtralza can be used with or without topical corticosteroids.
Health Canada approval status: Approved
Private payer reimbursement: Insurance plans may be reimbursing this medication – check with your insurer
Public payer reimbursement: At time of publication, CADTH and INESSS have both made recommendations not to reimburse this medication
UPADACITINIB
Brand Name: Rinvoq
Class: Oral JAK Inhibitor
Delivery Method: Oral once-daily pill
Indication: Treatment of adults and adolescents 12 years of age and older with refractory moderate to severe atopic dermatitis (AD) who are not adequately controlled with a systemic treatment (e.g., steroid or biologic) or when use of those therapies is inadvisable.
Health Canada approval status: Approved
Private payer reimbursement: Insurance plans are reimbursing this medication – check with your insurer
Public payer reimbursement: In negotiation (accurate at time of publication)- both CADTH and INESSS made a recommendation to reimburse this medication with certain criteria.