Why are we making them wait?
There is a revolution underway in the way we treat cancer.
Instead of the traditional “cut and burn” approach to cancer treatment, precision medicine — or precision oncology — is allowing us to take targeted aim at tumours, reducing side effects and damage to healthy cells, as well as increasing the odds that the treatment works. It also means that the right cancer treatment gets to the right patient, at the right dose, at the right time. There’s more potential than ever before for cancer patients to live longer, enjoy a better quality of life and, most importantly, survive this devastating disease.
Except that for many Canadians who live with cancer, complex regulatory and approval pricing models and fragmented health-care systems make these innovative therapies impossible to access. This needs to change.
In our recently released report, Getting Better, Faster: The Case for Optimizing Access to Precision Medicines in the Wake of the Revolution in Cancer Care , we outline several government policies that are slowing the advancement of precision oncology in Canada and the steps we need to take to overcome them.
One of the biggest barriers is the long and complicated regulatory approval process for new therapies in Canada — especially compared to other OECD countries. An overly bureaucratic process wraps clinical trial design and monitoring in red tape, slowing Health Canada approvals. The result is Canadians who are denied treatments that are already available in other parts of the world, like the United States or Europe
The outdated process of setting prices for new drugs in Canada, as well as poor data collection, are two other roadblocks slowing access to precision oncology. Governments must reform drug-funding systems to better align drug cost coverage with performance goals. However, the lack of robust data systems within some provinces — notably Ontario and Quebec — that track real-world evidence on drugs prevent governments from adopting new drug-funding formulas.
And then there is Canada’s fragmented approach to health care delivery. When it comes to public funding for drugs, each province and territory has its own eligibility criteria, funding rules and list of treatments covered. This results in unequal access across Canada, with drugs covered under provincial health plans in some jurisdictions, but not in others. This is especially problematic for precision oncology oral drug treatments, which are often taken at home. Because patients are not hospitalized for the treatment, some jurisdictions do not cover the cost of the drugs, leaving patients to find ways to pay for these life-saving medications on their own or get access through their private drug plan — if they are lucky enough to have one. The federal government’s long-promised pharmacare plan could help alleviate regional disparities in drug coverage — as long it does not result in anyone eligible for drug coverage receiving less coverage than they have now
Another key factor to ensuring a robust system that provides timely access to the safest, most effective cancer precision medicines is the implementation of a robust, adaptive Pan-Canadian system that secures mutually-negotiated arrangements with the pharmaceutical industry that align with our health-care priorities.
In advancing precision medicine, it is time our governments also employed a model of value-based health care with value measured for the patient, and not just the health plan, hospital, doctor or employer. The focus should be on improving patients’ lives, measuring not just outcomes, but also critical factors like recovery time and quality of life.
Governments and regulators need to act now to make these changes. Cancer patients do not have the luxury of time. They need access to treatment advances, including precision medicine — now.
Their lives depend on it.
Photo courtesy of DepositPhotos
