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Canada has one of the most complex and rigorous drug approval and public reimbursement processes and is, unfortunately, one of the countries with the longest delays in drug access. To assess the overall impact of systemic delays in access to cancer therapy, a targeted literature review (TLR) was performed to identify studies associated with the clinical, economic, and quality of life impacts of delayed access to oncology drugs. Using MEDLINE/PubMed databases and snowballing, four unique records met the eligibility criteria. Results revealed that clinical outcomes were the most impacted by systemic delays in access to oncology drugs (e.g., life years lost, overall survival, and progression-free survival). The four articles retrieved by the TLR specifically illustrated that a substantial number of life years could potentially be saved by increasing systemic efficiency regarding the development, approval, and reimbursement processes of new drugs for advanced malignancies. It is imperative that initiatives are put in place to improve the performance and speed of Canadian drug regulatory and health technology assessment (HTA) processes, especially for new cancer therapeutics. The proposed solutions in this paper include better coordination between HTA and Canadian payers to harmonize coverage decisions, international collaborations, information sharing, and national standards for timeliness in oncology drug access. [ABSTRACT FROM AUTHOR]

Cancer treatment has evolved significantly over the past decade with the emergence of a multitude of new treatments across cancer types. Alongside the pace of drug discovery, the cost of cancer drugs has also increased. In the face of this growth in development and spending, it is crucial to have an understanding of the processes and pressures new drugs navigate to get to the market in Canada. This paper is a review of the complex, multi-step regulatory and funding process undertaken by cancer drugs in Canada. It reviews the role of Health Canada, the Patented Medicine Prices Review Board, the Health Technology Assessment, the pan-Canadian Pharmaceutical Alliance, and finally, the provincial, territorial, and federal payers. Recent developments are highlighted. Strategies to minimize duplication of effort, improve timeliness, and increase efficiency are explored. The cancer drug regulatory and funding process in Canada is complex, and an understanding of the current system and ongoing evolution is essential. [ABSTRACT FROM AUTHOR]

Purpose Imaging by fluorodeoxyglucose positron-emission tomography (PET) has emerged as a valuable tool in the management of locally advanced cervical cancer (LACC), both for assessment of lymph node status and determination of response to chemoradiotherapy. The aim of the present study was to survey Canadian radiation oncologists to determine access to pet imaging for LACC patients and to assess current patterns of practice. Methods Radiation oncology centres across Canada were contacted to identify radiation oncologists who treat patients with lacc. The focus of the survey was patients treated with radical chemoradiotherapy with curative intent. An anonymous online tool was used to distribute a 23-item questionnaire asking about access to pet imaging, opinions on indications for pet imaging, and practice patterns relating to the use of pet in this patient population. Questionnaire responses were tabulated and analyzed. Results The response rate was 65% (35 of 54 questionnaire recipients). Most respondents (80%) have access to pet for LACC patients, usually restricted to study protocols. Of the respondents,48% considered that access to pet was timely. Frequency of routine orders for pet before and after treatment (to assess response) was 63% and 15% respectively. With better access, 91% of respondents would routinely order pet before treatment, and 61% would routinely order it for post-treatment assessment. For initial staging,85% of respondents considered pet to be a standard of care, and nearly half (45%) believed it should be a standard of care to assess treatment response. Because of access limitations, nearly 70% of respondents (23 of 34) do not order pet as often as they feel it is clinically indicated, and 74% agree that better access to pet would lead to improved care for LACC patients in Canada. Conclusions Canadian radiation oncologists support the routine use of pet imaging in the initial workup of patients with LACC. Access to pet imaging limits routine use for these patients in clinically indicated situations. There is strong support for developing guidelines for pet use in this patient population. [ABSTRACT FROM AUTHOR]