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Cancer Advocacy Coalition Releases Annual Report Card
on Cancer in Canada
Cross-country inconsistencies in access to new drugs and PET scans, inadequate screening programs, more wait time disconnects, wasted opportunities for efficiency and cost control - but also some hope
Toronto, February 5, 2007 -- The Cancer Advocacy Coalition of Canada (CACC) today released its annual Report Card on Cancer in Canada (Report Card), Canada's only national, independent evaluation of our cancer system performance. The research-based report, authored by oncologists and cancer patients across the country, highlights inadequacies, ills and disconnects within the system, and offers recommendations for improvements. It also reviews encouraging developments that may signal an increased understanding among policy makers of the need for a more equitable, truly national cancer system.
Report Card feature articles include:
Access to New Cancer Drugs
Access to highly effective and often expensive new drugs continues to be one of the most urgent problems cancer patients face. Report Card 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. Key observations:
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Alberta added the most cancer drugs in 2006, and Ontario funded more drugs in 2006 than in 2005; however both provinces still lag well behind B.C.
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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.
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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, New Brunswick, Ontario, Alberta, 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.
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During 2006, there appeared to be a movement toward increased concordance by provinces on which drugs to fund and which to decline; this bodes well for the development of nation-wide treatment guidelines.
PET Scanning in Canada
Access to PET scans is documented in a province-by-province review of publicly funded PET scans across Canada -- where they are, and how they are used. Key observations:
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Residents of Quebec have the best access, setting a standard for the rest of the country.
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For every 30 cancer patients investigated with a PET scan in Quebec, only one is scanned in Ontario.
Research Saves Lives; It Can Also Save Money
Who will pursue the 'other' research that reflects societal priorities for efficient and cost-effective cancer care?
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The organized cancer system frequently fails to take rapid advantage of research findings already generated, missing opportunities of potential importance to patients and payers.
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Using Herceptin adjuvant therapy for breast cancer as the test case, CACC explores three tests to make better use of the drug. All of them would help oncologists and patients get on with the best possible treatment rather than hit-and-miss attempts and would potentially save money. Unfortunately, all three tests await simple confirmatory studies that are not being prioritized by researchers.
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What has to be done to generate more Phase 4 (post-market) trials? Surely the payers (provincial governments) have a financial interest in uncovering knowledge that could improve patient selection for new drugs, and doctors have an interest in reducing unnecessary toxic effects of treatment.
Prevention and Screening: New Perspectives
The World Health Organization estimates that a vigorous program of prevention has the potential to reduce the overall cancer burden by up to 50 per cent. The Report Card explores the value of primary, secondary and tertiary prevention in Canada, with the following observations:
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Tertiary prevention strategies (measures taken to prevent recurrence), while well known, have not usually been part of the cancer control strategy and are neglected by the formal cancer system; overloaded cancer centres are discharging survivors from surveillance without appropriate instructions or resources to prevent a recurrence.
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Screening programs stall in Canada because recruitment strategies aren't effective; no province has introduced all components deemed necessary to make a program successful.
Disconnects and Waiting Times: Kudos to the UK -- and Winnipeg and Calgary
The total time from suspicion of cancer to treatment remains too long across this country. Report Card documents the success of the UK's NHS cancer plan, which has achieved important milestones, as well as a noteworthy Canadian example:
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99.5 per cent of UK cancer patients are seen by the appropriate outpatient cancer specialist within two weeks of GP referral.
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99.5 per cent of UK cancer patients begin their cancer treatment within one month of diagnosis.
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Rapid Access Clinics have the potential to greatly reduce the untracked waiting time from suspicion of cancer to diagnosis. The Rapid Access Clinics (for prostate cancer) in Winnipeg and Calgary are two of several now setting the standard in Canada. The total wait, from first referral to pathology result, can be reduced by two-thirds compared to only a few years ago. Canada needs more of these clinics, for more types of cancer.
The Cancer Advocacy Coalition has repeatedly documented the fact that Canada's healthcare system is inadequate for comprehensive cancer control. We are hopeful that the creation of a federal agency, the Canadian Partnership Against Cancer (CPAC) is the first step to helping create a truly integrated national system. Canadians are increasingly aware of the impact of cancer on their lives and have more than a vested interest in the outcome of this important initiative.
About the CACC
The Cancer Advocacy Coalition of Canada is the country's only full-time, registered, non-profit cancer group dedicated to citizen advocacy. The CACC is not a charity and operates on unrestricted grants from sponsors based on guidelines that ensure the organization's autonomy. For more information visit our website at www.canceradvocacy.ca.
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The full Report Card is available online at www.canceradvocacy.ca.
Please contact NATIONAL Public Relations for interview requests:
Charlotte Wilkinson/Michelle Marchione
(416) 848-1702/(647) 283-7466 (on-site)
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