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The pilot project is a response to complaints from patients and pharmaceutical companies that Canada takes too long to get new medications into the hands of patients.Melissa Tait/The Globe and Mail
Ontario has expanded public coverage of five cancer treatments more quickly than in the past, thanks to a pilot project launched last fall to speed up access to oncology breakthroughs.
The Progressive Conservative government will announce Thursday the names of five cancer drugs that recently qualified for its Faster Access to Specialized Treatments (FAST) program, The Globe and Mail has learned.
The drugs treat different subtypes of lung cancer, prostate cancer, leukemia and lymphoma. One medication entered the program as a new way to combat both colorectal and liver cancer, meaning the list includes five medications or drug combinations for six kinds of cancer.
Lisa Machado, the founder of the Canadian CML Network, a non-profit which represents patients with chronic myeloid leukemia, praised the Ontario program for quickly granting public funding to a targeted therapy called Scemblix for patients newly diagnosed with her type of rare blood cancer.
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“Whether it’s CML or another cancer, more options mean better lives and better outcomes for patients,” Ms. Machado said.
Ontario’s pilot project is a response to long-standing complaints from patients and pharmaceutical companies that Canada takes too long to get new medications into the hands of patients.
New pharmaceuticals take, on average, 2½ years to go from Health Canada approval to being publicly covered in at least one province or territory, longer than any other Group of Seven country. However, Canada’s rigorous approach gets lower prices and reserves public dollars for drugs with the best evidence, defenders of the system say.
Ontario’s three-year pilot project aims to reduce one step in the process: The time it takes for the pan-Canadian Pharmaceutical Alliance (pCPA) to reach confidential pricing deals with drugmakers.
Ontario’s pilot project identifies cancer therapies that are part of an international collaboration of regulators called Project Orbis and begins reimbursing them for patients before the pCPA, which negotiates prices on behalf of Canadian public drug plans, inks deals.
In the case of Scemblix, Health Canada in late July approved it as a first-line therapy for CML, meaning newly diagnosed patients can take it without trying and failing on alternatives first.
Ontario began funding Scemblix under those circumstance through the pilot project on Nov. 7, more than a month before the pCPA formally started pricing talks with Swiss drug company Novartis AG on Dec. 18.
The other drugs Ontario has funded through the pilot project to date are: Tagrisso for lung cancer, Nubeqa for prostate cancer, Calquence for lymphoma and Opdivo with Yervoy for liver and colorectal cancer. Most were already reimbursed in Ontario under narrower terms before the FAST program.
In the case of three of those drugs – Tagrisso, Nubeqa and Opdivo-Yervoy for colorectal cancer – the pCPA reached confidential pricing deals with drugmakers late last year, not long after Ontario began covering them through FAST. Each of those deals took less than seven weeks to negotiate, according to Mauro Chies, chief executive officer of the pCPA.
“Agreements for these drugs can be leveraged by all our federal, provincial, and territorial members, meaning all drug plans can take advantage of the same lower price,” he said in a statement.
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Mr. Chies said the pCPA is prioritizing the Project Orbis cancer drugs already in its pipeline as its own early negotiations process, launched in December, waits for the next new Orbis-qualifying drug to be submitted to Canada’s Drug Agency or its Quebec counterpart, which goes by the French acronym INESSS, the organizations that make expert recommendations on whether and how new drugs should be publicly covered.
The prices of new drugs for cancer and other diseases pose a continuing challenge for Canadian public drug plans.
Scemblix, to take one example, has a list price of $4,760 per 28-day cycle, although it would be cheaper with a negotiated discount.
Most CML patients who respond well to the drug will take it for the rest of their lives, according to Dennis Kim, a senior hematologist at Toronto’s Princess Margaret Cancer Centre.
Dr. Kim, who led the Princess Margaret clinical trial site of Scemblix as a first-line therapy for CML, said he welcomed Ontario’s quicker-than-usual funding because Scemblix tends to have fewer side effects than the alternatives and he likes being able to offer patients more choices.
Dr. Kim and the Canadian CML network have received funding from Scemblix-maker Novartis.
