Canada can be a frustrating place to be for sufferers of blood cancer. For decades, gaining access to newly-developed drugs has been slower in Canada than in the United States and the United Kingdom.

The facts

A 2012 analysis of 33 new cancer drugs approved for marketing between 2003 and 2011 discovered that only 73 percent of drugs received approval from Health Canada, whereas 91 percent were approved in the United States.

These are not drugs that are untested or deemed to be unsafe, they are treatments that have been proven to contribute to a significant extension in life. Yet, despite evidence showing these drugs to be effective, provincial Ministries of Health are slow to approve funding for breakthrough treatments, or not willing to provide funding at all.

“There’s a catch though: the provinces are not bound by the decisions the pCODR makes — it’s simply a recommendation. This creates an inconsistency across Canada, with some provinces listening and responding more quickly to pCODR recommendations than others.”

These decisions, made by those with power in the provinces, are having devastating consequences for the Canadians who are most in need of help from their governments.

Assessing the process

The Pan Canadian Oncology Drug Review (pCODR) was established in 2010 by the provincial ministries — excluding Quebec — with the aim of bringing some consistency to how new drugs are assessed and then, subsequently, funded. The pCODR gives new medications both a clinical and an economic review, and then submits its findings and whether or not it recommends the provinces to fund the drugs.

Sounds great, doesn’t it — the solution to finally get the provinces to move faster when it comes to getting drugs to patients with myeloma, lymphoma and leukemia? There’s a catch though: the provinces are not bound by the decisions the pCODR makes — it’s simply a recommendation. This creates an inconsistency across Canada, with some provinces listening and responding more quickly to pCODR recommendations than others.

Provincial differences

The proportion of drugs approved for funding by the provinces, after being recommended by pCODR, ranged from less than 10 percent in Prince Edward Island to around 80 percent in Saskatchewan and Ontario.

In the case of Brentuximab, for example, a drug that treats Hodgkin’s lymphoma, after a positive recommendation by pCODR, Saskatchewan took 150 days to decide to fund the drug and Ontario took 174. All of the other provinces are still considering whether or not to fund this life-changing drug. Why is it taking so long? Why can some provinces assess and approve a drug in five months yet others cannot?

This lack of portability and consistency cannot be accepted in a country that claims to offer universal health care. Imagine the frustration of a British Columbia family who has a child suffering with Hodgkin’s lymphoma. That child does not have access to the medication she needs for one reason: she lives in the wrong province.
Sufferers of lymphoma, leukemia, and myeloma deserve more than they’re currently getting. But only when the federal government shows a strong commitment to a drug approval policy will sufferers across Canada start to see some consistency to their treatment.