OBJECTIVES: Health Technology Assessments (HTAs) inform reimbursement decisions that directly impact patient care through access to new therapies. The COVID-19 pandemic has had a profound impact on all aspects of healthcare delivery, including the evaluation and access to therapeutic interventions. The aim of this study was to examine the time difference from submission to final HTA decision, to gain a comprehensive understanding of the impact of COVID-19 on the evaluation and access to therapies, thereby providing valuable insights for healthcare stakeholders and policymakers.

METHODS: Canadian Agency for Drugs and Technologies (CADTH) website was searched for final HTA recommendations published from April 2017 to March 2023, which were categorized into two periods: pre-COVID (01/Apr/2017 to 31/Mar/2020) and post-COVID (01/Apr/2020 to 31/Mar/2023). The start date was defined as manufacturer submission, whereas the end date was defined as issue of final recommendations for reimbursement decision. Resubmissions were excluded. Time duration calculated as the difference from submission to final recommendation for both pre-COVID and post-COVID period.

RESULTS: In total, 171 HTAs were included for analysis in pre-COVID and 216 HTAs in post-COVID period. The mean (95%CI) duration for reimbursement decision in post-COVID period was significantly longer versus pre-COVID period [253 (243,262) vs 220 (212,228) days; difference: 33 (20,46) days; P<0.05]. When analyzed by therapy types, the duration to therapy access was significantly longer in post-COVID period compared with pre-COVID for both oncology [243 (233,253) vs 223 (212,233) days; difference: 20 (6-35) days; P<0.05] and non-oncology [261 (245,277) vs 218 (206,230) days; difference: 43 days; P<0.05] therapies.

CONCLUSIONS: The results of this study clearly showed an increased time duration taken by CADTH to provide recommendations for therapy access due to COVID-19 in Canada. Due to the cross-sectional nature of this study, the factors contributing to this delay could not be ascertained and should be explored in further research.