Understanding the reasons for provincial discordance in cancer drug funding— a survey of policymakers

  • A. Srikanthan BC Cancer; University of British Columbia
  • N. Penner pan-Canadian Oncology Drug Review; Canadian Agency for Drugs and Technologies in Health
  • K.K.W. Chan Sunnybrook Odette Cancer Centre; University of Toronto; Canadian Centre for Applied Research in Cancer Control
  • M. Sabharwal pan-Canadian Oncology Drug Review; Canadian Agency for Drugs and Technologies in Health
  • A. Grill University of Toronto
Keywords: Cancer drugs, drug funding, discordance

Abstract

Background

Cancer drug-funding decisions between provinces shows discordance. The pan-Canadian Oncology Drug Review (pcodr) was implemented in 2011 partly to address uneven drug coverage and lack of transparency in the various provincial cancer drug review processes in Canada. We evaluated the underlying reasons for ongoing provincial discordance since the implementation of pcodr.

Methods

Participation in an online survey was solicited from participating provincial ministries of health (mohs) and cancer agencies (cas). The 4-question survey (with both multiple-choice and free-text responses) was administered between 4 March 2015 and 1 April 2015, inclusive. Anonymity was ensured. Descriptive statistics were used to evaluate responses.

Results

Data were available from 9 provinces (all Canadian provinces except Quebec), with a response rate of 100%. The 12 responses received each came from a senior policymaker with more than 5 years’ experience in cancer drug funding decision-making (5 from mohs, 7 from cas). Responses for 3 provinces came from both a moh representative and a ca representative. The most common reason for funding a drug not recommended by pcodr was political pressure (64%). The most common reason not to fund a drug recommended by pcodr was budget constraints (91%). The most common reason for a province to fund a drug before completion of the pcodr review was also political pressure (57%).

Conclusions

Political pressure and budgetary constraints continue to affect equity of access to cancer drugs for patients throughout Canada.

Author Biographies

A. Srikanthan, BC Cancer; University of British Columbia
Division of Medical Oncology; Department of Medicine
K.K.W. Chan, Sunnybrook Odette Cancer Centre; University of Toronto; Canadian Centre for Applied Research in Cancer Control
Division of Medical Oncology
A. Grill, University of Toronto
Department of Family and Community Medicine
Published
2018-08-22
How to Cite
Srikanthan, A., Penner, N., Chan, K., Sabharwal, M., & Grill, A. (2018). Understanding the reasons for provincial discordance in cancer drug funding— a survey of policymakers. Current Oncology, 25(4). https://doi.org/10.3747/co.25.3993
Section
Medical Oncology