Canada’s two-tiered process of approving potentially life-saving oncology drugs is preventing cancer patients in some provinces from accessing medication that’s readily available in other parts of the country, according to a new study.
The study, released by conservative think-tank on Thursday, looks at the effectiveness of the pan-Canadian Oncology Drug Review (pCODR), which was established in 2010 to recommend new cancer drugs to all the provinces and territories, except Quebec.
While pCODR recommends drugs for approval, provinces are not required to accept their recommendations. The result is certain cancer drugs are covered by provincial health care plans in some provinces, but not others.
"For negative recommendations, the provinces generally agree. For recommendations that are favourable, for provinces it's sort of a 'maybe,' or whenever (the provinces) can actually afford to fund these drugs," study author Nigel Rawson told CTV's Canada AM on Thursday.
Rawson said, in many cases, the key factor keeping drugs from being approved is cost.
"They are expensive because they are (used) for difficult cancers or cancers that are late-stage," he said. "There are often not a lot of patients projected for these drugs, and they take a long while to develop."
The study also found that, while the pCODR's aims to take between five and eight months to review a drug, some reviews take up to 10 months. It could then take a province up to a year to conduct their own review of the drug before deciding whether it will be covered.
The average time between a pCODR recommendation and provincial approval is the longest in Newfoundland and Labrador, where it was measured at 366 days. The average time spans in the other provinces:
- New Brunswick, 339 days
- Prince Edward Island, 309 days
- Manitoba, 249 days
- Nova Scotia, 218 days
- British Columbia, 197 days
- Alberta, 183 days
- Saskatchewan, 154 days
- Ontario, 150 days
"A lot of these patients, they're projected life expectancy isn't too great," Rawson pointed out.
The study referenced the struggle of an Ontario mother suffering from late-stage brain cancer who lobbied the provincial government to fund a cancer drug that could have prolonged her life.
Kimm Fletcher, a 41-year-old mother of two, went public with her fight to have the province help cover the cost of Avastin -- a cancer drug that's covered for brain cancer treatment in Manitoba, British Columbia and Saskatchewan.
In Ontario, however, the drug is only covered for patients with colon cancer.
Fletcher died of cancer earlier this year.
Rawson said many cancer patients are forced to turn to donations from family and friends to pay for unfunded drugs, while others forego the treatment all together.
The study recommends some ways to improve the current system.
Rawson recommends that provinces make a commitment to accept a "reasonable proportion" of these drugs.
"The pCODR has provided positive recommendations for just over 80 per cent of these products," he said. "It would be appropriate, in my opinion, for the provinces to make a commitment to take a high proportion of these products within a reasonable amount of time -- like 120 days."
Rawson added that the drug approval process in Canada is fragmented, as Ottawa is responsible for looking at the safety and efficacy of the drug, while the provinces look at the drug’s cost-effectiveness and makes the ultimate decision on whether it will be funded.
"The alternative is to take a national approach to providing funding for these drugs," he said. "That's more ideal, but more difficult."
In a statement to Â鶹´«Ã½, the pCODR says it welcomes the Fraser Institute assessment.
