Please share this video with anyone who may be interested! Watch all our webinars: https://www.youtube.com/playlist?list=PL4dDQscmFYu_ezxuxnAE61hx4JlqAKXpR In this webinar: ● A discussion on disparities in provincial reimbursement for cancer medications, and what patients can do about it ● Explanation of the different ways that cancer treatments are managed and funded across Canada, and outline the impact this has on patients depending on where they live in the country View the video: https://youtu.be/NN3AcGYMXac Follow our social media accounts: Twitter - https://twitter.com/survivornetca Facebook - https://www.facebook.com/CanadianSurvivorNet Pinterest - https://www.pinterest.com/survivornetwork YouTube - https://www.youtube.com/user/Survivornetca

1. The Cancer Medication Geographical
Roulette in Canada
November 26, 2015

2. Webinar Overview
• Introductions
• Welcome to Guest Presenter
– Susan Turner, Turner and Associates
• Review of Canadian Cancer Care
• Cancer Treatment Coverage Map
• The Cdn Cancer Meds Funding Review and
Approval Process
• The Impact on Patients
• Questions from Audience
• Conclusion
2

3. Welcome Susan Turner
She has worked with the Canadian Cancer Society, the Canadian
Cancer Action Network and the Campaign to Control Cancer,
preparing reports and conferences and facilitating working
groups to take action to improve cancer medications access.
3
Susan Turner, President of Turner &
Associates Inc., is an independent
consultant who has been involved
in the area of cancer medications
access for 10 years.

4. Review of Canadian Cancer Care
• Four models in Canada
– Comprehensive care provided via a provincial
cancer agency (BC, AB, SK)
– Care co-ordinated by a provincial cancer agency,
with shared responsibility for treatment coverage
(MB, ON)
– Centralized institutional/regional care with shared
responsibility for treatment coverage (NF, PE)
– Hospital-based care with shared responsibility for
treatment coverage (QC, NB, NS)
4

5. Source: Derived from data presented in Turner and Associates,
Issues of Access to Cancer Drugs in Canada, April 2008, p. 15
Public Funding for Cancer Treatment Meds Funding Review Process
Cancer Agency Individual Hospitals /
Regions
Public Drug Plan Cancer Agency Individual Hospitals /
Regions
Public Drug Plan
Cancer Treatment Coverage Map

6. 6
CanadianPharmaceuticalReviewand Approval Process
Drug Development
Health Canada Review
Patented Medicine
Prices Review Board
Health Technology
Assessment
Provincial Drug Plans
Patient Access
Hospitals
Private Drug
Plans
pCPA

7. 7
Manufacturer submits
Health Canada issues NOC and DIN
Manufacturer submits
pCODR products CDR products Non pCODR, Non CDR
PCPA
No Negotiations, collective or
individual
Pan Canadian Negotiations Dealt with at the P/T levels
Confirm participation and lead jurisdiction
PCPA informs manufacturer of decision
PLA with individual jurisdictions
No
Yes decisions and No decisions
Yes
Province specific review where applicable
PCPAPROCESS
pCPA Process Map
LOI signed
7

8. What are the impacts on
patients
…. and what can you do
about it?
8

9. How well is Canada doing?
9
1.Canada’s utilization of cancer
medicines ranked 13 among 14
developed countries in 2010
2. Canada ranked 21st of the 32
countries in the Organization for
Economic Development and
Cooperation (OECD) for access
to cancer medicines in 2011-12
1. Professor Sir Mike Richards. Extent and causes of international variations in drug usage. A report for the Secretary of State for Health. July 2010.
2. Wyatt Health Management. The Rx&D International Report on Access to Medicines 2011-12.

10. 10
Impact #1: Not all cancer medicines
are approved in Canada
• More than 50 new cancer medicines and
indications are available outside Canada

11. 11
CanadianPharmaceuticalReviewand Approval Process
Drug Development
Health Canada Review
Patented Medicine
Prices Review Board
Health Technology
Assessment
Provincial Drug Plans
Patient Access
Hospitals
Private Drug
Plans
pCPA

12. Why are some cancer medicines not
available in Canada?
1. Medication is still in clinical trials
2. Manufacturer has not submitted for approval
(or submitted later)
3. Health Canada review process is slower
12

13. Regulatory approvals
• Median delay in approval = 9 months
• Health Canada delay is 3 months
• Delays due to manufacturers unknown
13

14. 14
Action: Advocacy for regulatory reform

15. Impact #2: Coverage is essential
• The average cost of newer cancer medicines taken at
home is $72,300 (per course of treatment or per
year)
• Many Canadian oncologists do not recommend a
cancer medication if the patient is not covered
15

16. 16
CanadianPharmaceuticalReviewand Approval Process
Drug Development
Health Canada Review
Patented Medicine
Prices Review Board
Health Technology
Assessment
Provincial Drug Plans
Patient Access
Hospitals
Private Drug
Plans
pCPA

17. Where are the biggest holes in our
patchwork quilt of coverage?
17

18. 18
Issue: Unequal coverage of take-home &
hospital-administered cancer medicines

19. 19
cancertaintyforall.ca
Action: CanCertainty

20. 20
Issue: Provinces slow to approve
new medications

21. Speed of public drug plan decisions
21
BC AB SK MB ON QC NB PE NS NL YT NIHB
Funded 53 52 56 54 59 46 42 21 46 41 24 4
Rejected 12 10 10 8 5 9 9 21 10 15 10 11
Under review/pCPA 10 10 6 12 9 17 21 32 18 16 8 27
Funding Status of New Cancer Drugs & Indications Marketed Since 2006 (as of Aug 2015)

22. 22
Action: Advocacy for standards for
provincial decision timelines

23. 23
Issue: Strict authorization criteria

24. 24
Action: Advocacy for independent
appeals processes

25. Q&A
25

26. Canadian Cancer Survivor Network
Contact Info
Canadian Cancer Survivor Network
1750 Courtwood Crescent, Suite 210
Ottawa, ON K2C 2B5
Telephone / Téléphone : 613-898-1871
E-mail jmanthorne@survivornet.ca or mforrest@survivornet.ca
Web site www.survivornet.ca
Blog: http://jackiemanthornescancerblog.blogspot.com/
Twitter: @survivornetca
Facebook: www.facebook.com/CanadianSurvivorNet
Pinterest: http://pinterest.com/survivornetwork/
26