London, UK and Calgary, Canada – Medlior Health Outcomes Research and CF have formed a strategic partnership under the Access Innovation BioBridge programme, a UK–Canada initiative. The collaboration aims to accelerate the generation of policy-grade real-world evidence (RWE) for global life sciences sponsors by aligning comparable, longitudinal healthcare datasets from England and Alberta.
By running protocol-aligned analyses in both jurisdictions, the partnership will support cross-jurisdictional studies in key chronic disease areas focused on cardio renal metabolic conditions including a wide range of cardiovascular conditions, chronic kidney disease (CKD), and type 2 diabetes and obesity. The objective is to generate transportable insights to inform clinical development, market access, and health economics and outcomes research (HEOR).
By combining Carnall Farrar’s expertise in and access to NHS data from England with Medlior’s expertise in analysing Alberta’s comprehensive population-level administrative datasets, the partnership offers a robust and credible alternative to US-centric evidence generation, providing valuable input for global decision-making. The results will be delivered as comparable, aggregate outputs across both universal health systems, facilitating faster learning and improved decision-making.
The collaboration aligns established approaches to the use of pseudonymised data for research. It combines CF’s instant access to linked, longitudinal NHS England data covering over 57 million people with Medlior’s expertise accessing and analysing Alberta’s population-level provincial administrative datasets (over 5 million people).
Unlike many US data sources – often affected by coverage gaps, payor churn, and limited historical depth—CF and Medlior provide access to whole-population, cradle-to-grave linked health data including demographic data, diagnostic coding, activity data and costing data. This enables robust longitudinal tracking of disease progression, treatment patterns, and outcomes over extended time horizons—critical for regulatory submissions and HTA dossiers requiring real-world evidence with demonstrable validity and completeness.
The initial focus of this collaboration is on cardiovascular renal metabolic, including a wide range of cardiovascular conditions, chronic kidney disease (CKD), and type 2 diabetes and obesity to generate “transportable” insights for clinical development, market access, and HEOR. CF and Medlior have extensive experience and published findings in these areas. Both parties have the ability to capture data on hundreds of thousands to millions of people within the whole population, limited by practices in coding and availability of data.
CVRM on both sides of the Atlantic
| Condition | CF England dataset1 | Medlior Alberta dataset |
|---|---|---|
| ASCVD | 4 million | 0.2 million2 |
| Obesity | 1.3 million | 0.7 million3 |
| Diabetes | 0.82 million | 0.2 million4 |
| CKD | 0.22 million | 0.6 million5 |
Data compatibility & transportability
CF and Medlior have conducted joint assessments demonstrating strong compatibility between the UK and Alberta data environments, particularly for long-term, chronic conditions.
Harmonisation is grounded in established frameworks for diagnoses, procedures and medicines; with linkage to vital statistics and cohort-level laboratory and pharmacy data. Joint mapping enables like-for-like measures and consistent healthcare resource utilization/cost attribution across inpatient (IP), outpatient (OP), and emergency care (A&E/ ED) settings.
Key findings include (see Appendix):
CF’s data capabilities operate at two complementary levels.
At the national level, CF provides instant access to linked Hospital Episode Statistics (HES) for 57 million patients—capturing every inpatient admission, outpatient appointment, and emergency attendance with ICD-10 diagnostic coding, procedure codes, and Healthcare Resource Group (HRG) costings.
For sponsors requiring laboratory values, biomarkers, and patient-level prescribing data, CF accesses Secure Data Environments across the UK which link primary care records, test results, and medication histories to secondary care activity.
These SDE datasets align closely with Medlior’s Alberta holdings, where the Pharmaceutical Information Network (PIN) captures all community (outpatient) pharmacy-dispensed medications and cohort-specific laboratory data (e.g., HbA1c, LDL-cholesterol, eGFR) enables direct comparison of treatment patterns, biomarker control rates, and clinical outcomes across jurisdictions.
Joint use cases to explore
The partnership will explore joint studies and sponsor collaborations, including:
- Clinical and demographic characteristics: age, sex, geographic location, comorbidities, concomitant medications
- Burden of disease & unmet needs: diagnosis/treatment gaps; on-target biomarker rates (LDL-C, HbA1c, ACR)
- Pathway & healthcare resource utilization (HCRU) mapping: IP/OP/A&E volumes, length of stay (LOS), readmissions; cost-to-serve
- Medicines optimisation & value: GLP-1/SGLT2 medication uptake, adherence/discontinuation, equity and access impacts
- Feasibility & counts for regulators/HTA: cohort discovery, inclusion/exclusion yields
- AI validation across jurisdictions: accelerate responsible analytics roll-out with transparent benchmarking
Comparability & transportability
CF and Medlior reaffirm a strong interest and commitment to collaborative research and industry engagement around population health (e.g., GLP-1 medication utilisation, indication inference/flags for T2DM/obesity, persistence/discontinuation). CF has access to NHS publicly reimbursed GLP-1 medication sales and patient-level activity via local data partnerships while Alberta’s health data includes population-level pharmacy dispensation data, allowing the identification of individuals dispensed a GLP-1 medication. Comparing cohorts between jurisdictions and conducting joint research on obesity, diabetes, and multimorbidity could enable industry partners to demonstrate the value of this drug class to alleviate disease burden and decrease costs/HCRU for health systems.
Partnership Benefits
The CF and Medlior partnership offers:
- Access to real-world cohorts and rapid feasibility using diverse health data assets
- Technical expertise in data mapping, coding harmonisation, and analytic validation
- Strong governance pathways supporting ethical data access and compliant delivery
- A value-sharing commercial model aligned with international regulatory and HTA expectations
“CF has a long history of using whole-population health data from the UK to improve outcomes and support research. By combining CF’s access to linked, pseudonymised NHS data with Medlior’s Alberta cohorts, we can address a critical question for sponsors: to what extent does evidence generated in one health system transport to another?”
Ben Richardson, Managing Partner, Life Sciences, CF.
“Our population-level cohorts, alongside Alberta’s comprehensive pharmacy data, complement CF’s UK platform – together we can deliver faster and deeper insights across borders to support decision-grade evidence needs.”
Tara Cowling, President, Medlior.
“The CF and Medlior partnership exemplifies exactly what the BioBridge programme was designed to achieve—bringing together world-class capabilities from both countries to create new pathways for life sciences innovation. By facilitating access to complementary healthcare datasets and regulatory frameworks, we’re helping to build the infrastructure that will drive the next generation of pharmaceutical research and development across UK-Canada corridors.”
Jaspreet Grewal, CEO & Co-Founder of AxialBridge and developer & Managing Partner of the Access Innovation BioBridge Programme.
Note to the Editor
About CF
CF is a leading consultancy with a purpose to make an enduring impact on health and healthcare. CF works with leaders and frontline teams to improve health, transform healthcare, drive adoption of innovation and create value through investment. We provide end-to-end services, from strategy through implementation, accelerated by data, digital and AI. We shape opinion through evidence-based thought leadership on key issues affecting health. With unmatched ability to access to health data, our consultants are a driving force for delivering positive and meaningful change.
CF headquarters are in London with Middle East headquarters in Riyadh and a presence in Dubai and Dublin. It serves clients in the UK and across Europe and the Middle East.
About Medlior Health Outcomes Research Ltd.
Medlior Health Outcomes Research is an independent, Canadian consultancy specializing in real-world evidence and evidence generation support. The company partners with life sciences organizations, health innovators, and public stakeholders to generate rigorous, decision-grade evidence that informs reimbursement, regulatory, and policy decisions. By combining advanced analytics with practical health-system insight, Medlior strengthens evidence quality and accelerates responsible healthcare innovation globally.
About Access Innovation BioBridge Inc.
The Access Innovation BioBridge Programme is a multi-jurisdictional health-innovation platform designed to accelerate responsible adoption of advanced medical technologies across global health systems. Operating at the intersection of regulatory strategy, addressing unmet health care and health system needs, commercialization and capital, the programme supports companies and public partners in navigating complex approval and market-access pathways while strengthening cross-border collaboration between the United Kingdom, Canada, Singapore, Australia and Switzerland. By aligning innovation strategy with health-system priorities and economic-development objectives, BioBridge enables more efficient evidence generation, reduced duplication, and improved system readiness for next-generation therapies. Developed in alignment with Canada–UK trade and innovation priorities, Access Innovation BioBridge benefited from early engagement with the Canadian Trade Commissioner Service (TCS) at the Canadian High Commission in London, whose support helped accelerate cross-border introductions and ecosystem integration.
Caveats and add a current geopolitical perspective
Cross-jurisdictional research requires careful harmonisation of coding systems, costing frameworks, and population structures. Analyses will therefore be conducted in parallel using protocol-aligned methods, with results delivered as comparable aggregate outputs rather than pooled patient-level datasets. All data remain within their respective national governance frameworks, with no cross-border transfer of identifiable information.
In a period of heightened scrutiny around data sovereignty, regulatory alignment, and supply-chain resilience, the UK–Canada partnership offers a stable, trusted alternative for global evidence generation. By leveraging two universal healthcare systems with transparent governance, the collaboration supports robust, policy-relevant real-world evidence grounded in publicly accountable health systems.
Supporting Information
Mapping: data structure – comparison of individual-level data
| Datasets | UK data with instant access under licensed by NHS to CF | Subnational Secure Data Environments | Canada – Medlior Albertan Equivalent | Notes/Key Differences |
|---|---|---|---|---|
| 🇬🇧 | 🇬🇧 | 🇨🇦 | ||
| Diagnostic coding | ICD-10 Systematized Nomenclature of Medicine (SNOMED) Red Codes | ICD-10 Systematized Nomenclature of Medicine (SNOMED) Red Codes | ICD-9 ICD-10-CA |
Mapping required across conversion of ICD-10 and SNOMED to ICD-9 and ICD-10-CA |
| Procedures | Operating Procedure Codes Supplement (OPCS) | Canadian Classification of Health Interventions (CCI)/Canadian Classification of Diagnostic, Therapeutic, and Surgical Procedures (CCP) | Not equivalent; manual mapping may be possible | |
| Hospital | Hospital Episode Statistics (HES) – inpatient, outpatient appointments, and emergency data | NHS Secure Data Environment (SDE) Network: Provides linked patient-level data across secondary care (HES) and other datasets including: | Discharge Abstract Database (DAD) for inpatient; National Ambulatory Care Reporting System (NACRS) for outpatient and emergency | Equivalent coverage. HES has data on outpatient appointments at NHS hospitals |
| Primary care | Primary Care Records (aggregate) | Primary Care Records including activity, disease registry per Quality and Outcomes Framework, biological risk values, etc. | Practitioner Claims Database | • UK GP data are based on Red Codes and SNOMED. • Alberta uses ICD-9 codes for billing |
| Prescribing | Prescription Data (NHS Prescription Services) provides data on all prescriptions at provider level (GP practice or hospital); analysis is possible of prescribing patterns by provider | SDEs have access to patient level prescribing data that can be linked with healthcare activity and diagnostic data; analysis is possible at patient level of prescribing patterns | Pharmaceutical Information Network (PIN) | PIN covers community-dispensed drugs (DIN-coded). Hospital dispensations not included |
| Costing | Costing / Resource Data (NHS Reference Costs, HRG Tariffs) | Canadian Institute for Health Information (CIHI) CMG+ / RIW system with Cost per Weighted Case (CPWC) | Costing frameworks align conceptually on weights | |
| Diagnostics | No laboratory, biomarker and imaging data in linked national hospital data | Available in various SDEs (e.g., HDL, LDL, total cholesterol, HbA1c, eGFR) as well as additional results such as MRI, CT, PET scans, and cognitive scores) | Province-wide laboratory data available, existing data for specific tests available for obesity, CKD, and T2DM cohorts (e.g., HDL, LDL, total cholesterol, HbA1c, eGFR) | Not equivalent |
| Demographic | Office of National Statistics demographic data; OHID (finger tips); ONS Death Registry | Vital Statistics (Alberta Health) | Directly comparable |
Abbreviations: ATC: Anatomical Therapeutic Chemical; BNF: British National Formulary; CCI: Canadian Classification of Health Interventions; DIN: Drug Identification Number; ICD: International Classification of Diseases; ICD-10-CA: Canadian enhancement of ICD-10; OPCS: Office of Population Censuses and Surveys Classification; SNOMED: Systematized Nomenclature of Medicine
References:
- Unmet care gaps in the treatment of chronic diseases: https://www.carnallfarrar.com/value-in-health-unmet-care-gaps-in-the-treatment-of-chronic-diseases/
- Incident ASCVD, 2012-2016. Chen et al. Clinical Cardiology (2021), 44(11), 1613–1620.
- Prevalent individuals with diagnosis codes for obesity, bariatric procedure codes, or anti-obesity medications, 2014-2023.
- Incident T2DM, 2011-2018. Lau et al. Canadian Journal of Diabetes (2024), 48(3), 155–162.
- Incident CKD, 2010-2019. Lau et al. BMC Nephrology (2024), 25(1), 244.
