Ontario’s pilot project will run for three years, aiming to provide early access to seven to 10 new cancer drugs a year.Melissa Tait/The Globe and Mail
Ontario will give patients access to select new cancer drugs early as part of a pilot project that would make these medicines available whether or not public health plans have finalized price negotiations with the drug manufacturers.
At the same time, the pan-Canadian Pharmaceutical Alliance (pCPA), the national body that represents all public insurance plans, says it will try to speed up price negotiations so they are finished earlier, possibly eliminating the need for Ontario’s pilot project.
The changes are in response to long-time criticism from many pharmaceutical companies, patients and doctors that Canada has among the longest timelines for new drugs to be approved by public health plans – about 2½ years, on average.
“For thousands of Ontarians facing a cancer diagnosis, fast access to treatment is critical, which is why our government is transforming cancer care and speeding up access to new and life-changing treatment options,” Ontario Health Minister Sylvia Jones said in a statement in advance of Tuesday’s announcement.
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For a new drug to be approved, it has to run a gauntlet of departments and agencies. First the drug must be approved by Health Canada, where it is examined for safety and efficacy. After that, experts at Canada’s Drug Agency evaluate the drug and issue recommendations to public plans on whether to cover it, based on factors such as cost effectiveness. Next, public insurance plans negotiate prices with drug manufacturers through the pCPA. Finally, each province and territory has to decide whether to add the drug to its roster.
Ontario’s announcement, which is effective immediately, and the pCPA’s announcement, made Friday and effective after consultations that launch later this month, affect only cancer drugs that are included in an international collaboration of regulators called Project Orbis.
Ontario’s initiative, which it is calling the Funding Accelerated for Specific Treatments (FAST) program, will run for three years and aim to expedite access to seven to 10 new drugs a year.
Experts say that oncology drugs already tend to move through the system faster than other drugs.
Jackson Jacobs, spokesman for Ms. Jones, said the drugs will become available shortly after Canada’s Drug Agency has issued a positive recommendation in its final report. That way patients can have access to them before Ontario has settled on a final price with the manufacturer.
Mr. Jacobs said the province could not disclose whether it or the drugmaker will pay for the drugs patients take in this pilot project, or what would happen if negotiations concluded without a deal.
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Meanwhile, the pCPA’s initiative, which it is calling the Early Negotiation Process, would see the body begin price negotiations for Project Orbis cancer drugs while Canada’s Drug Agency is still examining the drugs.
Mauro Chies, chief executive officer of the pCPA, said the goal is for pricing negotiations to run over three or four months and be timed to conclude as Canada’s Drug Agency publishes its final recommendations for that drug.
He acknowledged that means that Ontario’s pilot project may not even need to kick in for a Project Orbis drug because there would be no major hurdles left for drugmakers to clear, other than signing listing agreements with the various provincial, territorial and federal drug plans.
Mr. Chies said the new process for Project Orbis drugs could become a template for the agency going forward.
“We’re going to run it until we get at least 10 drugs completed, do an evaluation, and then look to see if we have an opportunity to expand to other drugs in the future,” he said.
Ontario has been talking to other provinces for months about joining on to its plan. Provincial governments contacted by The Globe and Mail in recent weeks have not disclosed why they did not want to sign on, and Mr. Chies said he did not know.
The federal government has also signalled it wants to speed up drug-approval timelines. The governing Liberals included such a promise in their April election platform and Health Minister Marjorie Michel told The Globe in August it was part of Prime Minister Mark Carney’s drive to cut red tape.