Our webinar, Exploring Real World Data in Canada, part of the global Health Data Passport webinar series, highlighted Canada’s many Real World Data (RWD) assets and their usage in medical and pharmaceutical research.

The session provided a comprehensive overview of the Canadian healthcare data ecosystem, methods to locate data assets, deep dives into specific assets, including pharmacy data, claims data, and EMR data, and several case studies demonstrating the practical applications of Canadian RWD.

Understanding the Canadian Healthcare Data Ecosystem

Canada's Real World Data environment is robust, with the country having used ICD-10 in hospital and emergency care setting for over 15 years. Canada benefits from having a diverse patient population, with 30% of Canadians coming from non-European backgrounds. This makes Canada an attractive location for Real World Evidence (RWE) studies as it delivers a broad representation of real-world outcomes, which is crucial for comprehensive research.

A Top 10 Global Pharmaceutical Market

In the webinar, Brad Millson, General Manager of Real World Solutions for Canada highlighted the significance of Canada in the global pharmaceutical market. With a population of approximately 40 million, Canada is one of the top ten markets for pharmaceuticals worldwide.

The healthcare system in Canada is managed at the provincial level and is predominantly publicly funded, covering a wide range of services from outpatient care to long-term care. Pharmaceuticals are covered through a blend of private and public insurance making the landscape diverse as well as complex.

The Strengths of Canadian Data Sources

The webinar outlined several of the many Real World Data sources available in Canada and their applications. The primary patient data sources include pharmacy and claims data, administrative data, registries, electronic medical records (EMR), and patient support programs:

• Pharmacy and Claims Data: These data sets capture a majority of patient lives across Canada, providing insights into drug usage, persistence, adherence, and lines of therapy.
• Administrative Data: These data sets offer a broader and deeper understanding of healthcare services, capturing information on hospitalizations, physician visits, and lab results, ideal for large population epidemiological studies as well as burden of illness and healthcare resource utilization.
• Registries and EMR: These RWD sources provide detailed information on specific conditions and patient demographics, helping to answer complex, clinically focused research questions.
• Patient Support Programs: Unique to Canada, these programs generate valuable insights and information. With appropriate consent, they can be used for drug utilization and clinical outcomes assessments; they also can be linked to other data sets for additional outcomes research.

Finding Data Assets with IQVIA’s Health Data Catalogue

Speaker Amy Roach introduced the IQVIA Health Data Catalogue, a comprehensive tool designed to simplify the process of accessing Real World Data. The catalogue contains over 4000 global data sets, each with hundreds of searchable attributes. This tool helps researchers quickly find relevant and high-quality patient data for their projects.

During the demonstration, Amy showed how to filter data sets by country and disease area, highlighting the power of the tool to quickly find RWD datasets according to your specific needs and criteria. For example, by selecting Canada and respiratory diseases, the tool quickly narrowed down the options from over 4000 to just 53 relevant data sets. This capability significantly reduces the time and effort required to find suitable Real World Data for research.

Data Sets Deep Dives and Sample Case Studies

Calum Neish, a Senior Principal with the Real World Solutions team at IQVIA Canada, provided an in-depth look at various data sets and their applications through case studies including the following:

IQVIA Claims Information Dataset

The IQVIA Claims data set captures longitudinal transactional level data from the largest private drug plan insurers and the Ontario Public program (Ontario is Canada’s largest province). This data set includes information on prescription dates, drug quantities, costs, and patient demographics, making it useful for drug utilization studies.

Longitudinal Prescription Data

Canada’s LPD data set captures information from retail pharmacies, covering about 75% of all prescriptions across Canada. It includes data on public, private, and cash-paying prescriptions, providing a comprehensive view of drug usage and includes patient demographics and prescriber details in six provinces.

Electronic Medical Records (EMR)

IQVIA's EMR data comes from a network of physicians in Ontario, covering over 1 million patient lives. This data set includes detailed clinical information such as diagnoses, lab results, and patient demographics, making it invaluable for real-world evidence studies.

Real World Data in Action: Case Studies

Impact of COVID-19 on Type 2 Diabetes Treatment

The webinar showed several Real World Data client case studies conducted by the IQVIA Canada team using local data assets and IQVIA RWD analytics tools. One of these examined the impact of the COVID-19 pandemic on treatment patterns for type 2 diabetes in Canada. Using EMR data, the study found a shift from in-person visits to remote consultations. Despite the pandemic, the overall number of healthcare touchpoints remained stable, ensuring that patients continued to receive necessary care. This study highlighted the adaptability of healthcare delivery methods and the resilience of the healthcare system in maintaining patient care during a global crisis.

Burden of Disease and Productivity Loss in Migraine Patients

Another RWD study focused on the burden of disease and productivity loss among migraine patients. By combining EMR data with patient-reported outcomes, the study quantified the significant productivity loss due to migraines. The findings revealed that migraine patients experienced substantial disruptions in their daily activities and work productivity. These results were presented at a migraine conference, emphasizing the real-world impact of migraines on patients' lives and the importance of effective management strategies.

Treatment Patterns in Dry Eye Disease

A third case study explored treatment patterns in dry eye disease using IQVIA claims data. The study analyzed medication history and time to events, providing insights into how patients progress through different stages of treatment. The findings showed that many patients tried multiple treatments before finding an effective solution, highlighting the need for personalized treatment approaches and better patient education on managing dry eye disease.

Prescription Abandonment Rates

The webinar’s final case study investigated prescription abandonment rates in relation to out-of-pocket costs. The study found a linear relationship between higher out-of-pocket costs and increased abandonment rates. This emphasized the importance of cost considerations in patient adherence to medication. The study results suggest that reducing out-of-pocket costs could improve medication adherence and health outcomes, underscoring the need for policies that address financial barriers to medication access.

Advantages of Canadian Patient Data Sources

The webinar concluded with a discussion on the advantages of using Canadian Real World Data sources for research. The diverse population and comprehensive data capture make Canada an ideal location for real-world evidence studies. Additionally, the local relevance of Canadian patient data is crucial for successful Health Technology Assessment (HTA) submissions.

Accessing and Using Provincial Patient Databases

Accessing provincial RWD databases involves a process that varies by province. Typically, studies require a protocol and local ethics board approval. IQVIA assists clients in navigating these processes, ensuring compliance and efficient access to data. The timelines for accessing data also vary, with Ontario offering a rapid approach for standard burden of illness information.

Linking data sets can be done deterministically with patient consent or probabilistically using quasi-identifiers. This allows researchers to create comprehensive, research-ready data sets that fill gaps in existing data.

Benefits and Effective Usage of Real World Data

Real World Data (RWD) offers numerous benefits for medical and pharmaceutical research. It provides insights into how treatments perform in routine clinical practice, beyond the controlled environment of clinical trials. This can lead to a better understanding of treatment effectiveness, safety, and patient outcomes. RWD can also help identify unmet medical needs, inform clinical guidelines, and support health technology assessments (HTA).

In Canada, the effective usage of RWD is facilitated by the availability of diverse and comprehensive data sets. Researchers can leverage these data sets to conduct robust and meaningful studies that reflect the real-world experiences of patients. The ability to link different data sources further enhances the richness of the data, allowing for more detailed and nuanced analyses.

Conclusion

The webinar Exploring Real World Data in Canada, highlighted the richness and utility of Canadian RWD assets for medical and pharmaceutical research.

Canada's strengths as a source for Real World Data include its diverse population, which ensures broad representation of real-world outcomes, and its comprehensive data capture, which minimizes missing information and enhances the reliability of research findings. Additionally, the local relevance of Canadian data is essential for successful Health Technology Assessment (HTA) submissions, making it a critical resource for researchers and policymakers alike. By leveraging these data assets, researchers can generate evidence that supports better healthcare decision-making and ultimately improves patient outcomes.

The diverse and comprehensive data sets available in Canada provide valuable insights for researchers, making Canada a key player in the global Real World Data landscape. To get a clearer picture of Canada’s Real World Data strengths, watch the webinar Exploring Real World Data in Canada on demand.