This page provides a timely snapshot of our most recent negotiation activity, including an overview of open files and updates on key milestones from the past 4 weeks.
How current is this information?
The content on this page is updated on an ongoing basis to reflect the most recent available information. Please note that updates about negotiation activity may take 1–2 weeks to be processed.
“Under consideration for negotiation” means we’re currently considering the evidence and gathering other information to inform the negotiation approach, including the drug’s eligibility for expedited negotiation pathways. Once negotiation activities are underway, the drug is in active negotiation.
Letters of engagement
We send letters of engagement (LOE) to manufacturers at the end of the consideration phase, to begin active negotiations. The drugs listed below have recently entered active negotiation.
| Brand name | Manufacturer | Indication | LOE date |
|---|---|---|---|
| Dayvigo | Eisai Limited | Insomnia | 2026-06-26 |
| Kerendia | Bayer Inc. | As an adjunct to standard of care in adults with heart failure with left ventricular ejection fraction (LVEF) ≥ 40% to reduce the risk of cardiovascular death, hospitalization for heart failure, and urgent heart failure visits. | 2026-07-03 |
| TBC (ranibizumab) | Sandoz Canada Inc. | Neovascular (wet) age-related macular degeneration (AMD), or visual impairment due to diabetic macular edema (DME), macular edema secondary to retinal vein occlusion (RVO), choroidal neovascularisation (CNV) secondary to pathologic myopia (PM), choroidal neovascularisation (CNV) secondary to ocular conditions other than AMD or PM, including but not limited to angioid streaks, post-inflammatory retinochoroidopathy, central serous chorioretinopathy or idiopathic chorioretinopathy | 2026-06-17 |
| Padcev (Active ENP) | Pfizer Canada ULC | Keytruda, for the treatment of adult patients with muscle-invasive bladder cancer (MIBC) who are ineligible for cisplatin containing chemotherapy, in combination with enfortumab vedotin, as neoadjuvant treatment and then continued after radical cystectomy as adjuvant treatment. | 2026-06-23 |
| Keytruda (Active ENP) | Keytruda, for the treatment of adult patients with muscle-invasive bladder cancer (MIBC) who are ineligible for cisplatin containing chemotherapy, in combination with enfortumab vedotin, as neoadjuvant treatment and then continued after radical cystectomy as adjuvant treatment. | 2026-06-23 | |
| Keytruda (Active ENP) | for the treatment of adult patients with platinum-resistant epithelial ovarian, fallopian tube, or primary peritoneal carcinoma whose tumors express PD-L1 (CPS≥1) as determined by a validated test, and who have received one or two prior systemic treatment regimens | 2026-07-06 |
Letters of intent
A letter of intent (LOI) outlines the negotiated terms of an agreement between the pCPA and a manufacturer at the end of a successful negotiation. The list below reflects our latest LOIs.
| Title | Manufacturer | Indication | LOE date | LOI date |
|---|---|---|---|---|
| Ebglyss | Eli Lilly Canada Inc. | Atopic dermatitis | 2026-06-26 | 2026-06-26 |
| Epuris | Cipher | Acne Vulgaris | 2026-02-18 | 2026-06-25 |
| Symtuza | Janssen Inc. | HIV-1 Infection | 2025-07-02 | 2026-06-25 |
| Andembry | CSL Behring Canada Inc. | Hereditary Angioedema | 2026-03-05 | 2026-06-25 |
| Ahzantive | Valorum Biologics LLC | Multiple Indications | 2026-01-19 | 2026-06-25 |
| Livmarli | Mirum Pharmaceuticals Inc. | for the treatment of progressive familial intrahepatic cholestasis (PFIC) in patients 3 months and older. | 2026-06-26 | 2026-06-26 |
| Enhertu | AstraZeneca Canada Inc. | For the treatment of adult patients with unresectable or metastatic hormone receptor (HR)-positive, HER2-low (IHC 1+ or IHC 2+/ISH-) or HER2-ultralow (IHC 0 with membrane staining) breast cancer who have received at least one endocrine therapy in the metastatic setting and are not considered suitable for endocrine therapy as the next line of treatment. | 2026-03-12 | 2026-06-29 |
| Enhertu | AstraZeneca Canada Inc. | Advanced or Metastatic Gastric Cancer or Gastro-esophageal Junction (GEJ) Adenocarcinoma | 2026-04-21 | 2026-06-29 |
| Alyftrek | Vertex Pharmaceuticals (Canada) Incorporated | Cystic fibrosis, F508del or responsive CFTR mutation, 6 years and older | 2026-02-11 | 2026-07-02 |
| Tryngolza | Theratechnologies Inc. | As an adjunct to diet for the treatment of adults with familial chylomicronemia syndrome (FCS) to reduce triglyceride levels. | 2026-05-04 | 2026-07-03 |
| Movantik | Knight Therapeutics Inc. | Treatment of opioid-induced constipation (OIC) in adult patients with cancer and non-cancer pain who have had an inadequate response to laxative(s). | 2026-01-13 | 2026-07-07 |
| Conexxence | Fresenius Kabi Canada Ltd. | treatment of postmenopausal women with osteoporosis at high risk for fracture; treatment to increase bone mass in men with osteoporosis at high risk for fracture; treatment to increase bone mass in men with nonmetastatic prostate cancer receiving androgen deprivation therapy, who are at high risk for fracture; treatment to increase bone mass in women receiving adjuvant aromatase inhibitor therapy for nonmetastatic breast cancer; and treatment to increase bone mass for the treatment and prevention of glucocorticoid- induced osteoporosis in women and men at high risk for fracture | 2026-05-07 | 2026-07-07 |
| Bomyntra | Fresenius Kabi Canada Ltd. | reducing the risk of developing skeletal-related events in patients with multiple myeloma and in patients with bone metastases from breast cancer, prostate cancer, non-small cell lung cancer, and other solid tumors; treatment of adults and skeletally mature adolescents with giant cell tumour of bone that is unresectable or where surgical resection is likely to result in severemorbidity; and treatment of hypercalcemia of malignancy that is refractory to intravenous bisphosphonate | 2026-05-06 | 2026-07-07 |
| Pombiliti with Opfolda | Amicus Therapeutics Canada Inc. | Pompe disease | 2025-11-13 | 2026-07-08 |
Negotiations ended without agreement
Both negotiating parties strive to reach timely agreements. In rare cases, alignment between manufacturers and the pCPA can’t be reached. Each negotiation is unique, and decisions are made based on the information available at the time.
The pCPA always welcomes unsolicited offers, should a manufacturer want to re-engage and go back to the negotiation table.
When agreements can’t be reached, public drug plans may make decisions about providing coverage through their exceptional access programs.
| Title | Manufacturer | Indication | LOE date | Close date |
|---|---|---|---|---|
| Talvey | Janssen Inc. | For the treatment of adult patients with relapsed or refractory multiple myeloma who have received at least three prior lines of therapy, including a proteasome inhibitor, an immunomodulatory agent and an anti-CD38 monoclonal antibody, and have demonstrated disease progression on or after the last therapy. | 2026-01-23 | 2026-06-16 |
Negotiations that weren’t pursued - Last 4 weeks
We don’t pursue negotiations in cases where the drug’s health technology assessment (HTA) recommendations were negative or “do not reimburse.” Other reasons, such as the manufacturer declining to negotiate or a lack of supply of the drug in Canada, may be reflected on the drug’s page in the database.
There have been no negotiations which pCPA decided not to pursue in the last four weeks