Forum on
PATHWAYS TO ACCESS & REIMBURSEMENT
March 26–27, 2025 • One King West, Toronto, ON
Your 2025 Co-Chairs
Andrea Masters Strategic Access & Pricing Director Hoffmann-La Roche Limited
Strengthen Your Market Access Strategy with Timely Insights from:
• Canada’s Drug Agency
• INESSS
• PMPRB
• Bayer
• Roche
• Biogen
Rebecca Vieira Head of Access and Pricing Vertex Pharmaceuticals
Program Highlights
CHEVRON-RIGHT Pharmaceutical Policy Power Panel: Hear reflections and projections on the evolution of Canada’s pharmaceutical access environment so that you can plan for 2025 and beyond
CHEVRON-RIGHT Technology Use Cases for Pharma: Examine practical applications for managing market access and drug negotiations
CHEVRON-RIGHT Hypothetical Case Study and Breakout Discussion: Identify opportunities to improve the drug to market process through patient inclusivity
CHEVRON-RIGHT Working Group on how to advance the use of value-based agreements in Canada
Associate Sponsors Networking Breaks Sponsor
In the 10-year history of the Canadian Institute’s Forum on Pathways to Access and Reimbursement the past year stands out among the rest.
Celebrating a Decade of Collaborative Conversations on Market Access and Reimbursement
A period of intense change is unfolding. CADTH has transformed into the CDA, the pCPA has transitioned into a standalone organization, and at the federal policy level there is finally movement on funding for drugs for rare disease and the pharmacare file. In addition, the PMPRB has resumed consultations on final guidelines for drug pricing reviews.
These changes make for an interesting and complex policy and regulatory environment for pharmaceutical manufacturers to navigate.
CI is proud to continue to offer a platform for government, manufacturers, patients, and payers to come together for critically important conversations about how to ensure patients gain access to the right drug at the right time.
Join us in Toronto on March 26–27, 2025, as we celebrate the 10th anniversary of CI’s Forum on Pathways to Access & Reimbursement. As in years prior, the program is curated to ensure that you start the new year with a clear view of Canada’s pharmaceutical landscape.
The 2025 program will put a strong focus on evidence generation, value-based decision making, expedited pathways to access, and patient perspectives.
Join us this January, to:
CHEVRON-RIGHT BUILD a market access and drug pricing plan based on insights from CDA, INESSS, patients, and industry leaders
CHEVRON-RIGHT PREPARE for PMPRB’s impending draft guidelines for drug pricing review
CHEVRON-RIGHT ALIGN drugs submissions with payer priorities
CHEVRON-RIGHT DEVELOP an understanding of how to use AI and digital tools to support market access and drug negotiations
CHEVRON-RIGHT COLLABORATE with the life sciences community on strategies to improve the collection and use of RWE for drug access decisions
WHO YOU WILL MEET
Practitioners at every level with experience in:
• Pricing
• Reimbursement
• Market access
• Patient access
• Government and regulatory affairs
• Health economics
• Research and development
• Policy and compliance
• Pharmacy services
• Marketing
• National trade
• Formularies
• Business development
• Sales
From brand generic and manufacturing companies involved in:
• Product development
• Public drug programs
• Pharmaceutical benefits
• Pharmaceutical strategy
• Drug submissions
• Formulary management
• Policy and economic analysis
• Provider services and
• relations
• Pharmacy
And representatives from:
• Associations
• Patient Advocacy Groups
Speaker Faculty
Co-Chairs
Speakers
Andrea Masters Strategic Access & Pricing Director Hoffmann-La Roche Limited
Rebecca Vieira Head of Access and Pricing Vertex Pharmaceuticals
Saad Ahmed Lecturer, Department of Family & Community Medicine University of Toronto
Gail Attara President Gastrointestinal Society
Stephane Barakat Head, Market Access & HEOR – Oncology AbbVie
Mélanie Caron Director, Evaluation of Medicines and Technologies for Reimbursement Purposes INESSS
Alex Chambers Senior Market Access Manager Bayer
Rosemarie Childerhose Head of Market Access & Pricing Biocon Biologics
Guillaume Couillard Executive Director PMPRB
Tara Cowling President Medlior
Ed Dybka General Manager Ipsen Canada
Jason Field President and CEO Life Sciences Ontario
Julie Frappier President & Founder TOWWERS Program, Data4Actions
Bettina Hamelin President Innovative Medicines Canada (IMC)
Gerry Jeffcott Senior Associate 3Sixty Public Affairs
Dara Jospé Partner Fasken
Farah Jivraj Head of Market Access, Policy and Stakeholder Relations Biogen
Sudha Kutty Executive Vice-President, Evidence, Products, and Services Canada Drug Agency
Philippe Laplante, FICA,FSA Principal Eckler
Global Sponsorship Opportunities
Suzanne Lepage Private Health Plan Strategist Suzanne Lepage Consulting
Sang Mi Lee Executive Director Morse Consulting Inc.
Ursula Mann Principal and Chief Patient Office PatientVoicePartners
Farah Meghji Co-Founder Unum co.
Michael Nashat, PharmD, RPh Director OnPharm-United
Mark Omoto General Manager IQVIA
Ned Pojskic Vice President, Pharmacy Benefits Management GreenShield
Nathan Sigworth President and Founder CCX
Mina Tadrous Assistant Professor, Leslie Dan Faculty of Pharmacy University
Durhane Wong-Rieger President & CEO CORD
Media Partner
DAY ONE
Wednesday, March 26, 2025
7:45 Registration and Continental Breakfast Served
8:45 Co-Chairs’ Opening Remarks
10 YEAR ANNIVERSARY PANEL
Great overview, gave me a different perspective. Got me thinking differently. Team Lead, Pricing and Contracts, GSK
9:00 Reflecting on 10 Years in Canada’s Pharmaceutical Landscape: A Progress Report on Promoting Innovation and Improving Patient Access
This special power panel of key stakeholders from across Canada’s pharmaceutical and health care sector will provide reflections and perspectives on the polices and initiatives that have shaped the innovation ecosystem and impacted patient access in Canada. Each panelist will highlight significant strides and persistent barriers to timely access and reimbursement before turning their attention to what’s ahead, with a federal election looming. Key themes to be explore include:
• Innovation vs. system sustainability
• Unmet patient needs through expedited pathways to access
• Progress on pharmacare and anticipating the impact of political shifts
Jason Field President and CEO Life Sciences Ontario
Mark Omoto General Manager IQVIA
Bettina Hamelin President Innovative Medicines Canada (IMC)
10:00 From CADTH to Canada Drug Agency: How the Transformation will Expand the Scope of Work and Support Next Steps on the Pharmacare File
CADTH has officially become the Canada Drug Agency. In January of 2024, the Government of Canada announced the change. CADTH’s role and expertise in HTA and post market drug evaluations will continue under a new name and with expanded mandate. In addition to evidence evaluations in the pharmaceutical sector, the CDA is tasked with advancing other key initiatives, including pharmacare.
This session will explore how the scope of work has changed and what it means for how stakeholders within the pharmaceutical sector.
• Identifying how the CDA’s scope of work differs and builds off CADTH’s principals, expertise and mandate
» Assessing opportunities to reduce drug system duplication leading to costly inefficiencies
» Increasing and improving pan-Canadian data collection, including RWD for future decision making
• Introducing a phased approach to pharmacare in Canada for improved accessibility and affordability of drugs
• Analyzing the impact of the rolling review pilot process on the time it takes for a patient to access a new drug
10:45 Morning Coffee & Networking Break Sponsored by
Ed Dybka General Manager Ipsen Canada Sudha Kutty Executive VicePresident, Evidence, Products, and Services Canada Drug Agency
11:00 Examining Canada’s First Time-Limited Recommendation:
Canada’s Drug Agency has granted the first ever time limited reimbursement recommendation to AbbVie for an injectable Lymphoma treatment. The TLR pathway was created by the CDA in collaboration with the pCPA to address unmet patient needs, faster. A temporary recommendation is given based on Phase II clinical data while more evidence collected for future evaluation.
• Navigating the TLR and pTAP process
» Outlining the type of drugs that are eligible for the TLR
» Identifying potential opportunities to expedite access to drugs in your pipeline with insights on the TLR process in practice
• Exploring regulatory and manufacturer perspectives on what worked well and future considerations for the process
• Anticipating future expansion of the recommendation category
• Examining how RWE will be used to support decision making as part of this pathway
Sudha Kutty Executive VicePresident, Evidence, Products, and Services Canada Drug Agency
Stephane Barakat Head, Market Access & HEOR – Oncology AbbVie
11:30 Barriers to Access in the Biosimilars Market: How to Navigate the Maze of Public and Private Payer Policies in Canada
• Analyzing the policies in Europe that improved biosimilars uptake
• Assessing trends in private payers policies on biosimilars
• Navigating the different provincial switch policies
12:15
Rosemarie Childerhose
Head of Market Access & Pricing Biocon Biologics
Ned Pojskic
Vice President, Pharmacy
Benefits Management GreenShield
1:30 Shaping the Future of Market Access: Exploring the Role of Technology in Supporting Access and Catalyzing Pharma-Payer Collaboration
Artificial Intelligence holds great potential for the life sciences and pharmaceutical industry in terms of driving innovation and the business.
In market access there is an opportunity to extract insights that will help you stay competitive; however, key processes and platforms need to be in place. This session will explore keys steps in preparing your organization to leverage AI while also providing insights on use cases in market access and drug negotiations.
• Organizing data and implementing processes
» Tracking current negotiations
» Extract insights from key data points and outcomes for improved negotiations in the future
• Identifying opportunities to improve drug pricing negotiation preparation using AI
• Assessing the market and establishing the value proposition for innovative new drugs
Sang Mi Lee
Executive Director
Morse Consulting Inc.
Nathan Sigworth
President and Founder CCX
IMPLEMENTING THE NATIONAL STRATEGY FOR DRUGS FOR RARE DISEASE
2:30 Assessing Future Funding Opportunities through the Common List of Drugs for Rare Disease
In March of 2023, the Government of Canada announced up to $1.5 billion in funding over three years to support the National Strategy for Drugs for Rare Disease. The hope is that this will help lower drug costs and improve patient access. Part of the investment will go to the provinces through bilateral agreement, the first of which, has been made with British Columbia. This session will examine how the strategy is being rolled out and what it means for both patients and the manufacturers who are bringing these innovative therapies to market.
• Detailing how drugs are being evaluated and ultimately selected for the common list
• Analyzing how bilateral agreements between the Government of Canada and the provinces will improve access and reduce the funding challenges for DRD
• Assessing the role of manufacturers and key stakeholders in RWE collection as part of this process
3:15
MODERATOR:
Farah Jivraj
Head of Market Access, Policy and Stakeholder Relations Biogen
Durhane Wong-Rieger President & CEO CORD
Gerry Jeffcott
Senior Associate
3Sixty Public Affairs
3:30 Pinpointing Missed
Opportunities to Engage Patients and Enhance Decisions Making about Drugs
This interactive session will use a hypothetical product launch case study as the basis for discussions about data gaps and how patient experiences and insights can support and solve challenges along the pathways to access.
4:45 Cheers to 10 Years!
Farah Meghji
Co-Founder
Unum co.
Join us for a special prosecco pour to cap off day one of the conference. Together we will raise a glass to 10 years of collaborative conversations at CI's Forum Pathways to Access and Reimbursement.
DAY TWO
Thursday, March 27, 2025
7:45 Registration Opens and Continental Breakfast Served
8:45 Co-Chairs' Opening Remarks
Andrea Masters Strategic Access & Pricing Director
Overall excellent topics and speakers. Truly enjoyed the selection of speakers and the panels. Manager, Pricing and Contracts, Astellas
Rebecca Vieira Head of Access and Pricing Vertex Pharmaceuticals
9:00 The Value Based Drug Pricing Showcase in Quebec: A Collaborative Data Project to Expedite Drug Access in Canada
Creating equitable access to innovative new medicines is critical. Breakthrough treatments can be life changing, and even lifesaving for patients but without sufficient data and the necessary infrastructure it can be difficult for payers to make reimbursement decisions.
To tackle this challenge, a multi-stakeholder group has come together to advance the implementation of value-based pricing in Canada through a series of demonstration projects. The initiative, led by patients, physicians, payers, policymakers and manufacturers, will collect data on and evaluate the value of a drug at a patient and health system level.
This session will provide insights on the project and future deliverables aimed at supporting drug decisions.
Alex Chambers Senior Market Access Manager Bayer Tara Cowling President Medlior
Ursula Mann Principal and Chief Patient Office PatientVoicePartners
10:15 Anticipating PMPRB Draft Guidelines: How to Prepare for Future Drug Pricing Reviews in Canada
PMPRB recently invited stakeholders to comment on a discussion guide outlining the proposed framework for drug price reviews that will make up new guidelines.
• Overview of the proposed framework including international price comparison (IPC) options:
» Median International Price (MIP)
» Highest International Price (HIP)
» The midpoint between MIP and HIP
• Demonstrating how different pricing options will be applied in reviews using case study examples
• Anticipating the impact of different pricing options on innovator drug companies and patient access
• Assessing how grandfathered patented medicines will be impacted under the new framework
Guillaume Couillard Executive Director
11:45
What happens when you are not successful in negotiating an LOI with the pCPA? Can individual jurisdictions negotiate independently? And what happens when they refuse to do so? A judicial review is currently being brought in Quebec to explore these issues.This session will detail that judicial review and the pseudo-administrative framework which led to the court action.
Caron
Dara Jospé Partner Fasken
1:15
Pharmacy Network: Assessing the Pros, Cons, and Projected Impact of Patient Access
Ontario’s Ministry of Finance is consulting on the role of preferred pharmacy networks (PPN) in Ontario’s employer-sponsored drug insurance industry following push back from patient groups and industry associations.
For the insurance companies entering into these contractual agreements that allow only specific pharmacies to provide services to members, the argument is that it will lower costs. However, there are concerns that PPNs disrupt care and jeopardize patient access. This session will focus on:
• Defining the role of preferred pharmacy networks
» Understanding the different network designs
• Weighing the pros and cons of PPNs
» Assessing the impact on patient access and the overall health system
» Addressing concerns that PPNs are anticompetitive
• Examining current regulations for PPNs in Ontario and the rest of Canada
2:00
Suzanne Lepage
Private Health Plan Strategist Suzanne Lepage Consulting
Michael Nashat, PharmD, RPh Director OnPharm-United
» Anticipating how the regulatory environment could evolve because of Ontario’s consultation process
Next Steps in Addressing Supply Chain Disruptions and Drug Shortages in Canada
Since the pandemic, disruptions to the pharmaceutical supply chain have been exacerbated. A multi-stakeholder group in Canada is working diligently to mitigate the
Saad Ahmed Lecturer, Department of Family & Community Medicine University of Toronto
• Examining the newly established national drug shortage list and how it will be used to communication and act on potential shortages in the future
• Assessing current supply chain challenges impacting drug supply in Canada
• Identifying how stakeholders across the pharmaceutical supply chain and in the health care system can assist with the prevention and mitigation of drug shortages
• Exploring how artificial intelligence can assist with real time monitoring
Mina Tadrous Assistant Professor, Leslie Dan Faculty of Pharmacy University of Toronto
analysis, British Columbia is not keeping up with drug other drug budgets and has denied coverage of critical medications approved by other provinces. This session will take a deep dive into gaps in spending and the patient impact.
3:45 Drug Pooling: Examining the Ins and Outs of the Private Payer Framework to Manage High-Cost Claims
• Understanding how drug insurance pooling is used in Canada to manage offset the impact of high-cost drug claims
» Understanding the finer actuarial considerations for measuring risk
• Identifying the provincial differences in the implementation of pooling
• Assessing the ability of pooling to manage multiple or recurring high-cost drug claims
• Understanding plan sponsor perspectives on pooling
• Forecasting the future of pooling frameworks
4:30 Conference Concludes
Gail Attara President Gastrointestinal Society Philippe Laplante, FICA,FSA Principal Eckler
A report developed by the Gastrointestinal Society reveals inequities in drug access across Canada. According to the
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