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HIGHLIGHTS - REPORT CARD 2006
Cancer Drug Access
Access to highly effective and often expensive new drugs continues to be one of the most urgent problems cancer patients face. Report Card 2006 features a comprehensive
report of 24 top cancer drugs, describing how they are reimbursed - or not - in each province in 2006. Comparisons are drawn with a similar study conducted for 2005.
Methodology
- CACC surveyed oncology specialists and pharmacy experts in each province to determine current funding status and availability of the drugs as of Dec. 31, 2006
- Data were compiled from multiple sources, including public information on web sites and interviews with health professionals
- Researchers frequently encountered lack of clarity and absence of data; in such cases research was expanded until several sources confirmed facts
- Private pay options were investigated in each province: parenteral drugs (drugs given intravenously) were categorized as A) paid by the patient or third party but
given through the public system; and B) given through private infusion clinics
Findings
- Alberta funded the most new drugs in 2006, and Ontario funded more drugs in 2006 than in 2005; however both provinces still lag well behind B.C. (see Table "Summary
of Cancer Drug Access and Public Funding" below)
- To a varying degree, all provinces now impose a range of "limited access" conditions for key drugs, making it more challenging than ever to receive publicly funded
cancer treatment. B.C. has the fewest restrictions, Ontario has the most (see Table "Summary of Limited Access Variables for Cancer Drugs" below)
- In 2005 only one province in Canada (Alberta) had a formal private pay program for cancer drugs within its provincial cancer agency; this number increased to six
provinces in 2006 (Saskatchewan, Ontario, Alberta, New Brunswick, Nova Scotia and B.C)
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 Private infusion clinics jumped into the gap in 2006, with at least 20 Bayshore Infusion clinics scheduled to open in six provinces by the end of 2007
- During 2006, there appeared to be a movement toward increased concordance between provinces on which drugs to fund, and which to decline; this bodes well for the
development of nation-wide treatment guidelines
Key Trends
- Improved funding and availability of the studied cancer drugs
- Emergence of self-pay options within the public system and private clinics
- Increased concordance between provinces in funding for certain drugs for specific indications
 Continued lack of explicit cost-effectiveness analysis and transparency of decision making- Movement towards a National Pharmaceutical Strategy
Recommendations
- Establishment of a national catastrophic drug strategy and drug plan
- Timely development of Canada-wide guidelines
- Establishment of a single oncology drug budget and formulary in each province integrating parenteral and take-home cancer drugs
- Increased translational research to identify the subset of patients who benefit from the new drugs
- Phase 4 (post approval) trials to confirm treatment results
- Involvement of patients in decision making
- Increased transparency in decision making
- A repository of accurate information regarding applicable funding sources for each drug
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