the cancer medication geographical roulette in canada
TRANSCRIPT
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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
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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.
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.
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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)
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
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Canadian Pharmaceutical Review and Approval Process
Drug Development
Health Canada Review
Patented Medicine Prices Review Board
Health Technology Assessment
Provincial Drug Plans
Patient Access
HospitalsPrivate Drug
Plans
pCPA
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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
PCPA PROCESS
pCPA Process Map
LOI signed
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How well is Canada doing?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.
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Impact #1: Not all cancer medicines are approved in Canada• More than 50 new cancer medicines and
indications are available outside Canada
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Canadian Pharmaceutical Review and Approval Process
Drug Development
Health Canada Review
Patented Medicine Prices Review Board
Health Technology Assessment
Provincial Drug Plans
Patient Access
HospitalsPrivate Drug
Plans
pCPA
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Why are some cancer medicines not available in Canada?
1. Medication is still in clinical trials2. Manufacturer has not submitted for approval
(or submitted later)3. Health Canada review process is slower
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Regulatory approvals
• Median delay in approval = 9 months• Health Canada delay is 3 months
• Delays due to manufacturers unknown
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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
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Canadian Pharmaceutical Review and Approval Process
Drug Development
Health Canada Review
Patented Medicine Prices Review Board
Health Technology Assessment
Provincial Drug Plans
Patient Access
HospitalsPrivate Drug
Plans
pCPA
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Where are the biggest holes in our patchwork quilt of coverage?
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Speed of public drug plan decisions
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)
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Canadian Cancer Survivor Network Contact Info
Canadian Cancer Survivor Network1750 Courtwood Crescent, Suite 210Ottawa, ON K2C 2B5Telephone / Téléphone : 613-898-1871E-mail [email protected] or [email protected] Web site www.survivornet.caBlog: http://jackiemanthornescancerblog.blogspot.com/Twitter: @survivornetcaFacebook: www.facebook.com/CanadianSurvivorNet Pinterest: http://pinterest.com/survivornetwork/