Recommendations on new cancer drug review process fall short in several ways: CCAC

Lack of provisions for patient input, resubmission for previously refused targeted therapies and transparency cited

While the Colorectal Cancer Association of Canada (CCAC) congratulates Quebec Health Minister Yves Bolduc on the recommendations of the report of the Working Group on the evaluation process of new anti cancer medications (Rapport du Groupe de travail sur le processus d'évaluation des médicaments anticancéreux) recently issued, the CCAC notes that the recommendations fall short in several important ways.

Strikingly absent in both the mandate and the recommendations is the provision for patients to provide meaningful input. The recommendations do not provide for input either directly from a patient representative or input from patient groups, unlike the new pan-Canadian Oncology Drug Review (pCODR) process adopted by the other nine Canadian provinces. With pCODR, there is a defined process for ensuring patients can provide input into the review process.

"The opportunity to address the manner in which oncology drugs and biologics are evaluated represents an important opportunity for patients to address their concerns and in particular their right to equal and timely access to effective medications at least on par with the rest of Canada. While we are pleased that the new Quebec process allows for input into the decision by Quebec oncologists, we believe it is vital that the body that will make what can literally be life-or-death decisions for cancer patients be able to have input directly from patients. This input must be incorporated in the decision-making process," said Barry D. Stein, President of the CCAC.

The second shortfall according to the CCAC is that there is no provision for those drugs previously rejected under the old process to be re-evaluated using the new process. "The changes to the process are a tacit admission that the previous process was flawed," added Mr. Stein. "As a result, cancer patients deserve to have recently rejected treatments re-evaluated under the new process and to have them made available if they meet the new standards under the new process."

The CCAC is also concerned that the new Quebec process is not transparent. It is essential that this process be transparent at every step. "These are vital decisions that have a huge impact on peoples' lives and involve allocating our healthcare resources," added Mr. Stein. "We all have an important stake in it so the process must be as transparent as possible."

The CCAC notes that Quebec lags significantly behind other Canadian provinces in making new treatments for colorectal cancer available to patients, especially for patients who have advanced disease. Seven other provinces make available two of the latest treatments, Vectibix (panitumumab) and Erbitux (cetuximab), while Quebec does not. It is joined only by Prince Edward Island and Nova Scotia in not paying for colorectal cancer patients to receive these treatments.