2017 is an important year for Canadians. This year marks Canada’s 150th anniversary as a nation, and as Canadians, we have a lot to be proud of. The light bulb, the telephone, insulin — these are just some of Canada’s many contributions to the world.

While we are an innovative nation, we don’t always benefit from our inventions, especially when it comes to medicine.

Such is the story of people living with illnesses who are unable to access medications because either they don’t have public or private insurance, or the drugs they’ve been prescribed are not covered by a drug plan.

Access gaps

Diabetes is a case in point. “Canada gave the world one of the biggest discoveries in medicine — insulin — and yet, ironically, Canadians often face barriers accessing the next generation of treatments for diabetes,” says Rick Blickstead, President and CEO of Diabetes Canada.

Lisa Machado, who has chronic myelogenous leukemia (CML) and founded the Canadian CML Network for patients, hears similar stories all the time.

According to Machado, access varies “depending on the type of drug you need, which province you live in, and what drug plans (whether public or private) are willing to cover.” Where coverage gaps exist, people have to pay out of pocket, and not everyone can afford their medications — especially with newer drugs. “On the day that Ontario announced it was expanding pharmacare to children and youth under the age of 24 through its new OHIP+ program, the first email I received was from a 26-year-old CML patient who wrote, ‘Man, it really stinks to be over 25.’”

Machado says that although the initiative is a great step forward, there’s still a long way to go. “People living with CML take life-saving drugs that cost $4,500 to $6,000 per month, and that’s cheap in the realm of cancer and rare disease treatments,” she says. “But still, it’s not unheard of for people to remortgage their house in order to find the money to pay for them. Sounds crazy, but it’s happening.”

Looking for solutions

“The barriers to accessing new medicines experienced by Canadians with rare diseases highlights Canada’s outdated and inefficient drug reimbursement process,” says Durhane Wong-Rieger, President and CEO of the Canadian Organization for Rare Disorders (CORD). “New life-saving drugs are often stalled in cumbersome approval and review procedures, all while a patient’s condition deteriorates,” she adds.

Over the past decade, CORD has hosted many events bringing together patients, payers, and industry to consider how to make the whole process run more smoothly and be more patient-focused.

Summarizing the discussions from the latest CORD forum, which took place in March 2017, Wong-Rieger says, “We all agreed that there are solutions out there, but we have (mostly) bureaucratic impediments and, importantly, trust issues.”

In fact, the discovery and development of increasingly effective and targeted medicines is quickly changing the way we view and treat diseases. Many new specialized medicines, such as biologics and drugs for rare diseases, have the potential to save lives and improve people’s quality of life.

Louis Thériault is Vice-President of Industry Strategy and Public Policy at the Conference Board of Canada. He has studied the economic impact of funding new medicines, and observes that “while some newer treatments tend to carry a higher price due to things like the high cost of development and the limited number of prospective patients who can benefit from them, there are significant potential cost savings to public health systems and the economy, including fewer hospital visits and a more productive workforce.”

Next step: collaboration

While the debate about equitable access to drugs continues, there’s a lot to be optimistic about as we look to the future. As mentioned already, Ontario recently announced that it will provide pharmacare to anyone aged 24 and under (OHIP+). Innovative Medicines Canada’s Vice President of Innovation and Health Sustainability, Glenn Monteith, supports the new system as an important milestone for access to drugs in the province and the country.

“OHIP+ is a bold step forward,” says Monteith, who is pleased to see that all of Ontario’s youth will benefit from this program. “This initiative is going to be felt across Canada, where there are other policy innovations underway to expand access, such as Health Canada’s regulatory modernization initiatives, which will help speed access to life-saving therapies.” As Monteith concludes, “A great way to celebrate Canada’s 150th year is to advance health care for the next generation of Canadians."