Approval of new cancer-fighting medicines delayed due to extra layer of bureaucracy

TORONTO—The organization that reviews oncology medicines in Canada may unnecessarily delay approvals while cancer patients suffer, finds a new study released today by the Fraser Institute, an independent, non-partisan Canadian public policy think-tank.

The study, Has pCODR Improved Access to Oncology Drugs? , spotlights the pan-Canadian Oncology Drug Review (pCODR), which recommends new oncology drugs to the provinces and territories (excluding Quebec) after clinical and cost-effectiveness assessments. The pCODR was established in 2010. “If pCODR, which is funded by taxpayers, does not improve access to new oncology medicines, it’s fair to ask why the organization exists. Time is everything when you’re fighting cancer,” said Nigel Rawson, study author and Fraser Institute senior fellow. Under the current system, all new oncology drugs should first receive a favourable recommendation from pCODR before being approved by any province’s public insurance program. According to the pCODR, its drug review process takes between five to eight months to complete. However, the study finds that some reviews took up to 10 months.

---

Moreover, because provinces individually accept or ignore pCODR recommendations, access to new oncology drugs (covered by provincial insurance plans) varies by province. For example, the late Kimm Fletcher, an Ontario mother who died of brain cancer in 2014, unsuccessfully lobbied the Ontario government to cover Avastin—a drug covered for brain cancer treatment in three other provinces, but not Ontario. “Many cancer patients across Canada are forced to seek donations from families, friends and neighbours to pay for unfunded drugs while others have simply gone without,” Rawson said. When new drugs are finally approved by pCODR, the provinces add to the delay by taking additional time to approve the medicines for coverage under their insurance plans. The average approval time (from pCODR recommendation to provincial approval) is longest in Newfoundland and Labrador (366 days) followed by New Brunswick (339 days), Prince Edward Island (309 days), Manitoba (249 days), Nova Scotia (218 days), British Columbia (197 days), Alberta (183 days), Saskatchewan (154 days) and Ontario (150 days). The study recommends that provinces approve new oncology drugs within 120 days of any pCODR recommendation. Also, notes the study, the pCODR often duplicates work performed by other governmental agencies. “Rather than improve the situation, the pCODR has made it worse—adding another layer of bureaucracy to the cancer drug-approval process in Canada,” Rawson said. “Lack of access to new oncology drugs is a grave matter affecting thousands of Canadian patients and their families. While it’s important for regulators to understand the risks and benefits of new oncology drugs, it’s unacceptable for an inefficient government bureaucracy to contribute to drug-approval delays,” Rawson said.