We characterize the pan-Canadian Oncology Drug Review (pCODR) process as two stages: a decision to reject or not reject, followed by a decision to recommend full or condition approval (conditional on non-rejection).

Clinical aspects appear to carry the greatest weight in the decision to reject or not reject, whereas value for money had the greatest weight in full versus conditional approvals.

Notwithstanding pCODR’s implicit review process, there appears to be an identifiable and consistent set of factors driving pCODR recommendations.