2025-26 Global Speaker Series on Sexual Orientation and Gender Identity Inclusion

Speaker: Craig Mitton, UBC School of Population and Public Health

This presentation examines decision making for expensive drugs for rare diseases (EDRDs) in BC, situating the EDRD process within the broader challenge of health system priority setting under conditions of scarcity. Drawing on economic and ethical frameworks, the presentation outlines how multi-criteria decision analysis (MCDA) is used to support transparent, consistent, and values-informed recommendations for both the BC Drug Benefit Council and the EDRD review process. Particular attention is given to the EDRD patient-level review model, including its strengths and its limitations. The talk explores a controversial 2025 case involving Batten disease, highlighting tensions between evidence-based, arms-length decision making and political intervention. The presentation concludes by arguing for greater transparency, inclusion of cost considerations, public engagement, and clearer delineation between expert advice and political accountability in high-cost health care decision making.

Craig Mitton is a Professor in the School of Population and Public Health at UBC and Senior Scientist at the Centre for Clinical Epidemiology and Evaluation. His work is focused on the application of health economics to impact health policy and to inform clinical practice. Specific areas of interest include the use of evidence to support health care decision making, public involvement in priority setting and health technology assessment. Craig is the lead author on a book titled “The Priority Setting Toolkit: a guide to the use of economics in health care priority setting” and is the lead or co-author on over 180 peer reviewed journal articles. He has delivered over 200 presentations across many different countries and regularly runs workshops and short courses on health economics. In 2015 he received a Killam Teaching Prize from UBC.