Reimbursement Recommendation

Upadacitinib (Rinvoq)

Indication: For the treatment of adult patients with giant cell arteritis. Upadacitinib is used in combination with a tapering course of corticosteroids and as monotherapy following discontinuation of corticosteroids.

Sponsor: AbbVie Corporation

Recommendation: Reimburse with conditions

What Is the Reimbursement Recommendation for Rinvoq?

Canada’s Drug Agency (CDA-AMC) recommends that Rinvoq be reimbursed by public drug plans for the treatment of adult patients with giant cell arteritis (GCA) if certain conditions are met. Rinvoq is used in combination with a tapering course of corticosteroids and as monotherapy following discontinuation of corticosteroids.

Which Patients Are Eligible for Coverage?

Rinvoq should only be covered to treat adult patients with active and clinically stable, new-onset, or relapsing GCA who are currently on corticosteroids with the intention to taper.

What Are the Conditions for Reimbursement?

Rinvoq should only be reimbursed if prescribed by, or in consultation with, a rheumatologist or other physician experienced in the management of GCA. It should not be combined with other advanced therapies for GCA, and the total treatment cost of Rinvoq should be negotiated so that it does not exceed that of tocilizumab for the treatment of adult patients with GCA.

Why Did CDA-AMC Make This Recommendation?

• Evidence from 1 clinical trial demonstrated that more patients treated with Rinvoq entered remission and stayed free from disease flares, while needing less corticosteroid therapy, compared with those treated with placebo.

• Evidence from 1 long-term extension study demonstrated that patients who continued treatment with Rinvoq were more likely to remain in remission, stay free from disease flares, and receive less corticosteroids compared to patients who stopped taking Rinvoq.

• Based on evidence from 1 indirect treatment comparison, the committee found that Rinvoq and tocilizumab, the current standard of care for GCA, have similar efficacy in helping people reach remission and avoid disease flares. However, the evidence was very uncertain.

• Based on the CDA-AMC assessment of the health economic evidence, Rinvoq does not represent good value to the health care system at the public list price. The committee determined that there is not enough evidence to justify a greater cost for Rinvoq compared with tocilizumab.

• Based on public list prices, Rinvoq is estimated to cost the public drug plans approximately $36.2 million to $50.4 million for the combined incident and prevalent populations over the next 3 years. However, the actual budget impact is uncertain.

Additional Information

What Is GCA?

GCA is a life-threatening medical emergency in which the blood vessels in the head and neck become inflamed. This inflammation can cause severe headaches, jaw pain, and vision problems including permanent blindness. The estimated standardized prevalence rate of GCA in Ontario between 2000 and 2018 was approximately 235 per 100,000 people older than 50 years of age.

Unmet Needs in GCA

There remains a need for alternative treatments that are effective at inducing clinical remission with an improved toxicity profile and ease of administration. This need is particularly important for patients who cannot be treated with tocilizumab either due to clinical reasons or access barriers.

How Much Does Rinvoq Cost?

Treatment with Rinvoq is expected to cost approximately $18,876 per patient per year.

Review Background

• Giant cell arteritis (GCA) is a type of vasculitis, a group of diseases whose main feature is inflammation of blood vessels. GCA most often affects arteries that carry blood to the head and typically occurs in adults older than 50 years of age.

• The estimated standardized prevalence rate of GCA in Ontario between 2000 and 2018 was 235 (95% confidence interval [CI], 231 to 239) per 100,000 people older than 50 years of age.

• Upadacitinib (Rinvoq) has been approved by Health Canada for the treatment of adult patients with GCA. Upadacitinib is used in combination with a tapering course of corticosteroids (CSs) and as monotherapy following discontinuation of CSs. The sponsor is seeking reimbursement for this patient population.

• Upadacitinib is a Janus kinase (JAK) inhibitor that preferentially inhibits JAK1 signalling, thereby modulating the signalling of cytokines interleukin-6 and interferon gamma, the main proinflammatory drivers of GCA. It is available as an extended-release oral tablet, and the dosage recommended in the product monograph is 15 mg daily.

• Treatment costs: At the submitted price of $51.68 per 15 mg extended-release tablet, the annual cost of upadacitinib is expected to be $18,876 per patient, based on the Health Canada–recommended dosage.

Highlights of Input From Interested Parties

The patient groups (Arthritis Consumer Experts [ACE], Arthritis Society Canada, the Canadian Arthritis Patient Alliance, Vasculitis Foundation Canada, and Vision Health Initiatives) noted the following regarding impacts of the disease, unmet needs, and important outcomes:

• Patients described a variety of impacts from GCA including blurry or flashing vision, double vision, scalp pain, persistent headaches, fatigue, and pain or discomfort or fatigue when chewing.

• Patients indicated that current treatment options have negative impacts on quality of life (e.g., insomnia, mood swings, time burden associated with travel to clinics for infusions) and typically include a heavy reliance on CSs, prolonged uncertainty during tapering, and challenges accessing newer, potentially safer alternatives.

The clinician groups (CanVasc, the Canadian Rheumatology Association, and Rheumatologists of Newfoundland and Labrador and Prince Edward Island) and the clinical experts consulted by CDA-AMC noted the following regarding unmet needs arising from the disease and the place in therapy for the drug under review:

• The clinical experts consulted for this review and the clinician groups noted that there remains an unmet need for GCA treatments that are effective at inducing clinical remission and have an improved toxicity profile. An additional treatment option was noted as being particularly important for patients who have disease that is refractory to the current standard of care, or have contraindications to or have experienced prohibitive adverse effects with the current standard of care.

• The experts noted that tocilizumab, a relevant comparator for this patient population, is administered via subcutaneous injection that may be difficult for some patients to use or access due to storage temperature requirements, possibly disproportionately affecting patients who live in remote or rural communities. Clinician groups indicated that these difficulties sometimes lead to poor adherence and, consequently, suboptimal clinical outcomes.

• The experts agreed that the appropriate patient population for treatment with upadacitinib includes all patients with GCA.

The participating public drug programs raised potential implementation issues related to considerations for initiation, renewal, discontinuation, and prescribing of therapy.

Recommendation

With a vote of 12 in favour to 1 against, the Canadian Drug Expert Committee (CDEC) recommends that upadacitinib be reimbursed for GCA, only if the conditions listed in Table 1 are met.

Table 1: Reimbursement Conditions and Reasons

CDA-AMC = Canada’s Drug Agency; CS = corticosteroid; GCA = giant cell arteritis.

Rationale for the Recommendation

Clinical Value

Based on the totality of the clinical evidence, CDEC concluded that upadacitinib demonstrates acceptable clinical value in adult patients with GCA. Given that upadacitinib is expected to be an alternative treatment to CS therapy alone or tocilizumab, acceptable clinical value refers to at least comparable value to tocilizumab or CS therapy alone.

Evidence from 1 double-blind, phase III randomized controlled trial (the SELECT-GCA trial) showed that upadacitinib results in added clinical benefit compared with placebo in patients with GCA. The SELECT-GCA trial demonstrated that, compared to placebo (with a 52-week CS taper; n = 112), upadacitinib (with a 26-week CS taper; n = 209) results in statistically significant and clinically meaningful improvements in the percentage of patients achieving sustained remission and the probability of being flare-free after 52 weeks of treatment. While CDEC acknowledged that differences in cumulative CS dose were partly driven by protocol differences in CS-tapering regimens, treatment with upadacitinib resulted in a statistically significant and clinically meaningful decrease in cumulative CS use over 52 weeks, an outcome highlighted as particularly important by patient and clinician groups. Health-related quality of life (HRQoL) outcomes, which were limited by low completion rates, suggest that upadacitinib may result in an increase in physical components of HRQoL and a decrease in fatigue compared to placebo, although the clinical relevance of these effects remains uncertain. Period 2 of the SELECT-GCA trial provided evidence on the effect of continuing upadacitinib treatment for 104 weeks or discontinuing upadacitinib treatment at 52 weeks. CDEC noted that while period 2 outcomes were limited by enrolment of responders and risk of bias concerns, results showed that a higher percentage of patients continuing upadacitinib treatment maintained in remission, received less CS therapy, had a longer period of flare-free days, and had improved physical HRQoL and lower fatigue compared to patients who discontinued upadacitinib at week 52. The committee noted that the harms associated with upadacitinib appeared consistent with its known safety profile.

The matching-adjusted indirect comparison (MAIC) of upadacitinib versus tocilizumab was associated with limitations and did not demonstrate significant differences in efficacy outcomes between the treatments for the indication under review. While acknowledging the uncertainty, CDEC found it reasonable to consider the drugs comparable in efficacy. Harms and HRQoL outcomes were not included in the submitted MAIC; therefore, it remains unknown if differences exist between treatments for these outcomes.

Further information on the committee’s discussion around clinical value is provided in the Summary of Deliberation section.

Developing the Recommendation

The determination of acceptable clinical value was sufficient for CDEC to recommend reimbursement of upadacitinib. As part of the deliberation on whether to recommend reimbursement, the committee also considered unmet clinical need, unmet nonclinical need, and health inequity. Information on this discussion is provided in the Unmet Clinical Need and Distinct Social and Ethical Considerations domains in the Summary of Deliberation section.

Because CDEC recommended that upadacitinib be reimbursed, the committee also deliberated on whether reimbursement conditions should be added to address important economic considerations, health system impacts, or social and ethical considerations, or to ensure that clinical value is realized. The resulting reimbursement conditions, with accompanying reasons and implementation guidance, are stated in Table 1.

Summary of Deliberation

CDEC considered all domains of value of the deliberative framework before developing its recommendation: clinical value, unmet clinical need, distinct social and ethical considerations, economic considerations, and impacts on health systems. For further information on the domains of value, refer to Expert Committee Deliberation at Canada’s Drug Agency.

The committee considered the following key discussion points, organized by the 5 domains of value.

The sponsor requested a minor reconsideration of the initial draft recommendation (to reimburse with conditions) for upadacitinib for GCA. There were 2 issues outlined by the sponsor in the request for reconsideration that were discussed by a CDEC committee subpanel. The first was a request to expand the initial reimbursement period to 104 weeks. The second was to account for potential differing treatment duration when assessing the total treatment cost in the pricing condition.

Clinical Value

• Appropriate comparators: CDEC noted that CS therapy alone and tocilizumab were appropriate comparators for upadacitinib in the target population. While the latter is considered standard of care, some patients may be treated with CSs alone if they are not eligible for tocilizumab because of intolerance or contraindication.

• Efficacy versus CS therapy alone: One double-blind, phase III randomized controlled trial (the SELECT-GCA trial) demonstrated that, compared to placebo (with a 52-week CS taper; n = 112), treatment with upadacitinib (with a 26-week CS taper; n = 209) results in an increase in the percentage of patients achieving sustained remission at 52 weeks (between-group difference = 17.1% [95% CI, 6.3% to 27.8%]; P = 0.0019) and the probability of being flare-free at 6 months (between-group difference = 11.5% [95% CI, 0.5% to 22.5%]) and 12 months (between-group difference = 17.9% [95% CI, 6.2% to 29.6%]). Patients receiving upadacitinib received less CS therapy over 52 weeks of treatment compared to placebo (median between-group difference = −1,267.0 mg [95% CI, −1,587.0 mg to −1,133.0 mg]; P = < 0.0001), highlighting the steroid-sparing benefit of upadacitinib, which was an important outcome for patients. HRQoL outcomes, which were limited by low completion rates, suggest that upadacitinib results in an improved physical HRQoL and decrease in fatigue compared to placebo. Period 2 of the SELECT-GCA trial demonstrated that, compared to discontinuing upadacitinib treatment after 52 weeks, continuing upadacitinib treatment for 104 weeks resulted in an increase in the percentage of patients maintaining remission (between-group difference = 38.9% [95% CI, 20.5% to 57.4%]), less CS exposure from week 52 to week 104 (median CS exposure among patients discontinuing upadacitinib = 1,048.0 mg [95% CI, 50.0 mg to 2,716.0 mg]; median CS exposure among patients continuing upadacitinib = 0.0 mg [95% CI, 0.0 mg to 0.0 mg]), and statistically significantly longer time to first disease flare in period 2 (hazard ratio = 0.10 [95% CI, 0.0 to 0.2]). In period 2, HRQoL outcomes were similarly limited by low completion rates, although results suggested that patients continuing upadacitinib treatment had improved physical HRQoL and a decrease in fatigue compared to patients who discontinued upadacitinib treatment.

• Harms findings versus CS therapy alone: Reducing harms was an important outcome for patients, and the clinical experts consulted for this review noted that serious treatment-emergent adverse events (TEAEs) and TEAEs leading to treatment withdrawal were the most clinically relevant. CDEC noted that treatment with upadacitinib did not result in a clinically meaningful difference in serious TEAEs (between-group difference = 1.5% [95% CI, –8.0% to 11.0%]) and TEAEs leading to treatment withdrawal (between-group difference = −8.7% [95% CI, −18.3% to 0.9%]), based on a 10% between-group difference suggested by experts. The rates of TEAEs of special interest, which included the occurrence of cancer or cardiometabolic-related harms, were generally low and occurred in a similar percentage of patients across the treatment groups. CDEC discussed the toxicity profile observed in the SELECT-GCA trial and agreed that the reported TEAEs did not differ substantially from those occurring with placebo, although longer-term harms remain unknown.

• Clinical importance of treatment effects: CDEC noted that important outcomes for patients included achieving and maintaining remission, reducing reliance on CSs, improving HRQoL, and reducing harms, all of which were assessed in the SELECT-GCA trial. CDEC noted that the difference between treatment groups in the proportion of patients achieving sustained remission at week 52, the probability of being flare-free at 6 months and 12 months, and cumulative CS exposure through 52 weeks were likely clinically relevant, based on expert input that a 10% or 1,000 mg difference would be a clinically important effect. CDEC noted that CS regimens may vary significantly in clinical practice and that there is no standard starting and final dose. While results suggested that treatment with upadacitinib may result in an increase in physical HRQoL and reduction in fatigue, the clinical relevance of these effects remains uncertain.

• Challenges assessing long-term treatment effect: CDEC highlighted that the clinical relevance of results in the second period of the SELECT-GCA trial remained uncertain due to low completion rates and limited between-group effect estimates.

• Certainty of the evidence: Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach, the certainty of the evidence for the proportion of patients achieving sustained remission at week 52 and the probability of being flare-free at 6 months and 12 months was rated as moderate due to serious imprecision in the between-group differences. The certainty of the evidence for cumulative CS and HRQoL outcomes was rated as low and very low, respectively, due to serious and very serious risks of bias stemming from missing data. The certainty of the evidence for serious TEAEs and TEAEs leading to treatment withdrawals was rated as moderate due to serious imprecision in the between-group differences.

• Efficacy versus tocilizumab: One MAIC was provided to inform the comparison of upadacitinib versus tocilizumab. CDEC noted that methodological limitations and ███████████ rendered the results for sustained complete remission, sustained remission, and time to first disease flare inconclusive. An unanchored MAIC — which is at an increased risk of bias — suggested a █████ ██████████ ██ ████████ █████████ ████████████ ████████ █ █████ ██████ ██ █████ ██ ██ ████ ██ ██ ████████ ██ ████████ █████████ ██████████. CDEC also noted that harms and HRQoL outcomes were not investigated in the MAICs, so whether upadacitinib results in an increase or decrease in HRQoL and harms compared to tocilizumab is unknown.

• Clinical value: Based on the preceding considerations, CDEC determined that there was added clinical value versus CS therapy alone. While the sponsor-submitted MAIC informing the comparison of upadacitinib versus tocilizumab was associated with methodological limitations and ████████████, CDEC noted that the results did not demonstrate significant differences in efficacy outcomes between the treatments and found it reasonable to consider them comparable in efficacy.

• CS regimens in clinical practice: CDEC acknowledged variability in clinical practice with respect to the starting CS dose, tapering regimens, and target final CS dose. Clinicians noted that CS doses may fluctuate as needed and that patients may be maintained in remission on low-dose CSs for a prolonged time instead of being tapered until CS-free.

• Continued usage: CDEC noted that GCA is generally considered a chronic, relapsing-remitting disease. As such, patients who do not show a complete, durable response in the first year of treatment may be at risk of relapse. Results from the second period of the SELECT-GCA trial showed that some patients in remission who stopped upadacitinib experienced relapse. CDEC noted that renewal of reimbursement beyond 52 weeks to prolong treatment may be warranted for patients who show suboptimal or delayed response. CDEC also noted that assessment of clinical response and discontinuation of treatment due to lack of response are highly personalized and should be left to the judgment of clinicians.

• Initial reimbursement period: During the feedback period on the draft recommendation, the sponsor, 1 patient group, and 2 clinician groups all requested that CDA-AMC extend the initial reimbursement period for upadacitinib from 52 weeks to 104 weeks, citing evidence from period 2 of the SELECT-GCA trial and the chronic, relapsing nature of the disease. They argued that a longer initial authorization would reduce relapse risk, corticosteroid exposure, administrative delays, and inequities in access, while better aligning with real-world clinical practice and patient priorities such as avoiding vision loss, stroke, and repeated high-dose steroid use. In discussing the reconsideration request, a CDEC subcommittee acknowledged that safety data and evidence of sustained benefit extend to 104 weeks, but maintained that the pivotal comparative evidence and economic model supporting reimbursement are limited to the initial 52-week period. As a result, CDEC concluded that the 52-week initial reimbursement remains appropriate, with period 2 data better suited to informing renewal decisions for patients at higher risk of relapse rather than justifying a longer initial authorization.

Unmet Clinical Need

• Input on unmet clinical need: Based on patient and clinician input, CDEC noted a need for alternative treatments that are effective at inducing clinical remission (thereby preventing vision loss) with an improved toxicity profile. This need is particularly important for patients with GCA whose disease is refractory to tocilizumab, who have contraindications to tocilizumab, or who have experienced prohibitive adverse effects that preclude the use of tocilizumab. Barriers to access of tocilizumab were also mentioned as a challenge for some patients.

• Severity of the disease: Based on patient and clinician input, CDEC noted that GCA is a life-threatening medical emergency, and while current treatment options can be effective at inducing clinical remission, the experience is marked by a heavy reliance on CSs. This reliance on CSs is associated with adverse events that negatively impact patients’ HRQoL and result in periods of prolonged uncertainty during CS tapering.

• Availability of treatment options: Tocilizumab is the only steroid-sparing drug currently available in Canada for this patient population. Based on clinician group input, CDEC noted that tocilizumab treatment administration via subcutaneous injection may be difficult for some patients to use or access due to storage temperature requirements, possibly disproportionately affecting patients who live in rural or remote areas or who have lower incomes.

Distinct Social and Ethical Considerations

• Equity considerations: Patient groups noted that equitable access to health care is essential, particularly for patients in rural or underserved communities and for those from various ethnic backgrounds who may face barriers to recognition, referral, or culturally appropriate support. CDEC discussed how clinicians indicated that the current standard of care, tocilizumab, poses transportation challenges for patients in rural or remote areas due to its storage requirements.

• Mode of administration: As tocilizumab is administered via subcutaneous injection, clinician groups observed that some patients experience difficulties with administration. CDEC noted that experts indicated that an oral therapy would be preferred for patients with needle phobia or with difficulties self-administering subcutaneous injections, thereby addressing some of the access limitations.

• Impacts of GCA on caregivers: Patient groups noted that the effects of GCA extend beyond the patients diagnosed with the condition. CDEC discussed how improved outcomes for people living with GCA could also reduce the physical, emotional, and financial burden for caregivers.

• Generalizability of the SELECT-GCA trial: CDEC noted that GCA tends to be more common in females than in males, and this phenomenon was observed in the SELECT-GCA trial. CDEC noted that the relatively high percentage of white patients enrolled in the SELECT-GCA trial (92.0% of patients in the upadacitinib group and 95.2% in the placebo group) is unlikely to be representative of the population with GCA in Canada. While subgroup analyses among white and non-white patients [wording from original source] showed similar results, these analyses were unlikely powered to detect subgroup differences.

Economic Considerations

• Health impacts of upadacitinib versus relevant comparators: Due to the methodological limitations and imprecision associated with the sponsor’s indirect treatment comparison, no definite conclusion can be drawn for the comparable efficacy of upadacitinib versus tocilizumab for patients with GCA. Conclusions about the comparative harms and impact on HRQoL, which were deemed important by patient and clinician groups, could not be made because these outcomes were not assessed in the indirect treatment comparison. The predicted health impact of upadacitinib versus 52-week CS tapering alone in the economic model was uncertain due to limitations with the submitted cost-utility analysis.

• Cost of upadacitinib versus relevant comparators: If there are no differences in health outcomes between upadacitinib and tocilizumab, the impact of upadacitinib on costs will be most dependent on the drug acquisition costs. The incremental cost of upadacitinib versus tocilizumab is dependent on the treatment duration of both drugs, such that if treatment with upadacitinib is longer or is associated with a higher rate of relapse requiring reinitiation than tocilizumab, the incremental cost will increase.

  • The health system cost of upadacitinib versus 52-week CS tapering alone is uncertain due to limitations with the sponsor’s analysis, including a lack of long-term data.

• Key findings of the economic evaluation: The cost-effectiveness of upadacitinib with 26-week CS tapering versus tocilizumab with 26-week CS tapering is uncertain. Based on the evidence reviewed for this submission, there is no robust evidence to suggest that upadacitinib with 26-week CS tapering provides greater health benefit than tocilizumab with 26-week CS tapering. If there are no differences in health outcomes between upadacitinib and tocilizumab, then the total treatment cost of upadacitinib should not exceed that of tocilizumab for the treatment of adult patients with GCA.

  • The cost-effectiveness of upadacitinib with 26-week CS tapering versus 52-week CS tapering alone is highly uncertain due to limitations with the submitted economic analysis. However, based on feedback from clinical experts and data presented by the sponsor, the use of 52-week CS tapering alone for this indication is anticipated to be small (approximately 10%) and CS tapering would only be slightly impacted if upadacitinib becomes available.

• Certainty of the evidence: The MAIC used to compare upadacitinib with tocilizumab did not demonstrate significant differences in efficacy outcomes between the treatments, and CDEC found it reasonable to consider them comparable in efficacy. Additionally, the lack of long-term data and limitations with the sponsor’s estimation of GCA-related and CS-related adverse event–related costs and health outcomes introduced additional uncertainty in the predicted benefit of upadacitinib compared to 52-week CS tapering alone.

• Other considerations: CDEC noted that a biosimilar version of tocilizumab was publicly listed for the treatment of GCA as of 2025, and if patients are transitioned to biosimilar tocilizumab in routine clinical practice, the cost of biosimilar tocilizumab should be considered.

• Reconsideration discussion: During the feedback period on the draft recommendation, the sponsor requested that the committee reconsider the pricing condition in the table of Reimbursement Conditions and Reasons to indicate that the annual cost of upadacitinib should be aligned with that of tocilizumab. In discussing the reconsideration request, a CDEC subcommittee maintained that the original condition reflects the committee’s intended pricing condition.

Impacts on Health Systems

• Anticipated budget impact: It is estimated that 6,371 newly diagnosed patients would be eligible for treatment with upadacitinib with 26-week CS tapering over a 3-year period (year 1 = 2,089; year 2 = 2,123; year 3 = 2,158), of whom 1,281 are expected to receive upadacitinib with 26-week CS tapering (year 1 = 209; year 2 = 425; year 3 = 648). CDA-AMC additionally estimated that 9,589 to 15,856 prevalent patients would be eligible for treatment over a 3-year period, of whom 1,928 to 3,189 are expected to receive upadacitinib with 26-week CS tapering (year 1 = 314 to 520; year 2 = 639 to 1,057; year 3 = 975 to 1,612). The estimated budget impact of reimbursing upadacitinib with 26-week CS tapering is predicted to be approximately $36.2 million to $50.4 million for the combined incident and prevalent populations over the first 3 years, with an expected expenditure of $78.0 million to $108.7 million on upadacitinib. The estimated budget impact is uncertain due to difficulty in estimating the number of prevalent patients who would be considered eligible for treatment and uncertainty in the treatment duration of upadacitinib and tocilizumab. The magnitude of uncertainty in the budget impact must be addressed to ensure the feasibility of adoption, given the difference between the sponsor’s estimate and the CDA-AMC estimate.

Sources of Information Used by the Committee

To make its recommendation, the committee considered the following information (links to the full documents for the review can be found on the project webpage):

• the CDA-AMC review of the clinical and pharmacoeconomic evidence submitted by the sponsor, as well as relevant ethical issues related to upadacitinib (refer to the Main Report and Supplemental Material documents)

• the sponsor’s comments on the draft report and the CDA-AMC responses

• patients' perspectives gathered by 2 patient groups, ACE and a joint submission from Arthritis Society Canada, the Canadian Arthritis Patient Alliance, Vasculitis Foundation Canada, and Vision Health Initiatives (refer to the Patient and Clinician Group Input document)

• input from 3 clinician groups, CanVasc, the Canadian Rheumatology Association, and Rheumatologists of Newfoundland and Labrador and Prince Edward Island (refer to the Patient and Clinician Group Input document)

• input from public drug programs that participate in the reimbursement review process (refer to the Supplemental Material document)

• input from 2 clinical experts with expertise in the management of GCA consulted by CDA-AMC.

CDEC Information

Members of the Committee

Dr. Peter Jamieson (Chair), Dr. Kerry Mansell (Vice-Chair), Sally Bean, Daryl Bell, Dan Dunsky, Dr. Ran Goldman, Dr. Trudy Huyghebaert, Dr. Dennis Ko, Dr. Christine Leong, Dr. Alicia McCallum, Dr. Srinivas Murthy, Dr. Nicholas Myers, Dr. Krishnan Ramanathan, Dr. Marco Solmi, Carla Velastegui, Dr. Edward Xie, and Dr. Peter Zed

Meeting date: October 22, 2025

Regrets: Two expert committee members did not attend.

Conflicts of interest: None