TELUS Health has implemented the Enhanced Drug Review (EDR) process into their formulary listing decision-making. The EDR leverages TELUS Health's expert team of Health Economists, Pharmacists, and Health Technology Assessment (HTA) partners to create customized drug reports and recommendations to help carrier clients make evidence-informed listing decisions. Also, TELUS Health uses the results of this EDR process to develop managed formularies.
While leveraging evidence of treatment efficacy and cost-effectiveness to determine eligibility for coverage is not a new concept, what is unique here is that TELUS Health conducts the drug review from a private payer perspective. In particular, the cost-effectiveness analysis and budget impact analysis consider factors like productivity improvements, reduced disability and relevant working population. This approach allows for the design of private payer-relevant value-based drug plans and allows employers to change the trajectory of their drug spending while providing access to effective therapies for employees.
The Enhanced Drug Review Process answers YOUR questions:
The ability to make such distinctions is one of the key advantages of the process. The Enhanced Drug Review process can help carriers leverage TELUS Health resources and minimize bias in how clinical information and economic outcomes are interpreted. A more holistic approach to reviewing drugs is becoming the norm for the growing number of higher-cost, specialty drugs coming to market. In the long run, plan sponsors and their benefits providers can feel more confident knowing that they are better able to protect their drug plan’s sustainability, while also supporting the health and productivity of their employees.
All submissions can be electronically sent through drug.submissions@telus.com. A gateway file share site has been created to facilitate the submission of larger files.
To gain access to the gateway site, please request a username through drug.submissions@telus.com. Instructions for use of the site will be sent via email with an assigned username for access.
All submissions should include the following documents:
Please note: A requirements document containing a more detailed list of components for various types of submissions and template files is available upon request through drug.submissions@telus.com or on the gateway site.
Once all required components are received, an email communication will either confirm that the submission is complete and include an outline of review timelines, or request any missing components.
Please note: The review process will only begin when a submission is deemed complete. You can expect to receive a confirmation response within 2-3 weeks.
Typically, new drug submissions are provided from manufacturers at the time of the Notice of Compliance from Health Canada. The complete submission takes between 6-9 months from the time the complete drug submission is received to when formulary listing decisions are made on TELUS-managed formularies.
Please note: TELUS Health does accept pre-NOC submissions, as long as the following criteria are met:
If unexpected changes to indication and price occur, review timelines will be affected and TELUS Health reserves the right to restart the review timelines.
Click to view the Drug Submission Requirements
Download the presentation (PDF)
All submissions should be electronically submitted through drug.submissions@telus.com. A gateway file share site has been created to facilitate the submission of larger files.
The central inbox, drug.submissions@telus.com, has limited file size capacity. The gateway file share site facilitates the transfer of files larger than 10MB. To gain access to the gateway site, please request a username through drug.submissions@telus.com. Instructions for use of the site will be sent via email with the assigned username for access.
Requirements for a new drug submission include the following components:
A requirements document containing a more detailed list of components for various types of submissions and template files is available upon request through the drug.submissions@telus.com inbox or on the gateway site.
Once a submission is deemed complete, an email confirmation will be sent. If components are missing, an email will be sent requesting missing components. The review process will only begin when a submission is deemed complete. The complete review process and final decision for TELUS Health managed formularies takes 6-9 months from time of complete submission receipt. Please ensure to also submit to all insurers to facilitate insurer internal processes.
Please direct any inquires for meetings to drug.submissions@telus.com.