Access to Oncology Medicines in Canada: Consensus Forum for Recommendations for Improvement

Author:

Sehdev Sandeep R.1ORCID,Rawson Nigel S. B.2ORCID,Aseyev Olexiy I.3,Buick Catriona J.456,Butler Marcus O.7ORCID,Edwards Scott89,Gill Sharlene10ORCID,Gotfrit Joanna M.1,Hsia Cyrus C.11ORCID,Juergens Rosalyn A.12ORCID,Manna Mita13ORCID,McCarthy Joy S.14,Mukherjee Som D.12,Snow Stephanie L.15ORCID,Spadafora Silvana1617,Stewart David J.1,Wentzell Jason R.18,Wong Ralph P. W.19ORCID,Zalewski Pawel G.20

Affiliation:

1. Department of Medicine, Division of Medical Oncology, The Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada

2. Macdonald-Laurier Institute, Ottawa, ON K1N 7Z2, Canada

3. Thunder Bay Regional Health Sciences Centre, Thunder Bay, ON P7B 6V4, Canada

4. Faculty of Health, York University, Toronto, ON M3J 1P3, Canada

5. Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada

6. Canadian Association of Nurses in Oncology/Association Canadienne des Infirmières en Oncologie, Vancouver, BC V6A 1B6, Canada

7. Princess Margaret Cancer Centre, University Health Network, Toronto, ON M5G 2C4, Canada

8. Dr H Bliss Murphy Cancer Centre, Eastern Health, St. John’s, NL A1B 3V6, Canada

9. School of Pharmacy, Memorial University of Newfoundland, St. John’s, NL A1B 3V6, Canada

10. Department of Medicine, Division of Medical Oncology, University of British Columbia and BC Cancer, Vancouver, BC V5Z 1M9, Canada

11. Department of Medicine, Division of Hematology, London Health Sciences Centre, London, ON N6A 5W9, Canada

12. Juravinski Cancer Centre, McMaster University, Hamilton, ON L8V 5C2, Canada

13. Saskatoon Cancer Centre, Saskatoon, SK S7N 4H4, Canada

14. Cancer Care Program, Newfoundland and Labrador Health Services, St. John’s, NL A1B 3V6, Canada

15. Dalhousie University, Halifax, NS B3H 2Y9, Canada

16. Algoma District Cancer Program, Sault Area Hospital, Sault Ste Marie, ON P6B 0A8, Canada

17. Northern Ontario School of Medicine University, Sudbury, ON P3E 2C6, Canada

18. Department of Pharmacy, the Ottawa Hospital Cancer Centre, Ottawa, ON K1H 8L6, Canada

19. CancerCare Manitoba, University of Manitoba, Winnipeg, MB R3E 0V9, Canada

20. Lakeridge Health, Durham Regional Cancer Centre, Oshawa, ON L1G 8A2, Canada

Abstract

Patient access to new oncology drugs in Canada is only possible after navigating multiple sequential systemic checkpoints for national regulatory approval, health technology assessment (HTA) and collective government price negotiation. These steps delay access and prevent health care providers from being able to prescribe optimal therapy. Eighteen Canadian oncology clinicians from the medicine, nursing and pharmacy professions met to develop consensus recommendations for defining reasonable government performance standards around process and timeliness to improve Canadian cancer patients’ access to best care. A modified Delphi methodology was used to identify consensus on 30 questions involving five themes: accountability, disparities, endpoints, timeliness, and cost-effectiveness. It was agreed that greater transparency is required across regulatory and HTA processes. Health professionals in oncology are frustrated for their patients because they are unable to deliver the modern guideline-supported therapies they want to provide due to delays in approval or funding. Canadian health care providers request improvements in timely access to life-saving therapeutics in line with other comparator countries. Clinicians expect urgent improvements in Canadian health systems to give our patients their best chance of survival.

Funder

Ottawa Hospital Research Institute

Abbvie Canada, AstraZeneca, Gilead, Lilly, Merck and Novartis

Publisher

MDPI AG

Reference33 articles.

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2. Rawson, N.S.B. (2023). Canadian Health Policy, Canadian Health Policy Institute. Available online: https://www.canadianhealthpolicy.com/product/canada-falls-behind-in-new-drug-submissions-compared-with-the-united-states-and-europe/.

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4. Palmer, N.W. (2022). The Patented Medicine Prices Review Board has Lost Its Way (Again), Macdonald-Laurier Institute. Available online: https://macdonaldlaurier.ca/the-patented-medicine-prices-review-board-has-lost-its-way-again/.

5. Yakabuski, C. (2024, January 08). Ottawa’s War on the Pharmaceutical Industry is Leaving Canada behind. Globe and Mail, 14 December 2022. Available online: https://www.theglobeandmail.com/business/commentary/article-ottawa-war-on-the-pharmaceutical-industry-is-leaving-canada-behind/.

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