During the last five years, we have seen a number of novel take-home drugs approved for the treatment of cancer.
These agents often target specific pathways that signal cancer cells to proliferate and spread or metastasize to other parts of the body.
What many of these new therapies have in common is that they are small molecules that can be formulated so they can be taken at home as a pill.
What they also have in common is their high cost.
The annual cost of these drugs per patient is somewhere between $30,000 and $100,000.
More than half of the new cancer agents in development by pharmaceuticals companies are take-home medications.
It is estimated that at least 50 per cent of new cancer therapies that will be reviewed annually by the Pan Canadian Oncology Drug Review (PCODR) panel are oral agents.
A significant proportion of the drug budget of those provinces that fully fund take-home cancer therapies is allocated for non-intravenous therapies.
Not all regions are the same
Unfortunately, while provinces in Western Canada fund oral cancer therapies through their cancer care programs, Newfoundland and Labrador continues to rely on a hybrid system where oral drugs are funded either by the Newfoundland and Labrador Prescription Drug Program, private drug insurance, pharmaceutical company co-pay programs, the patient and their families or a combination of some or all of the above.
In an April 19, 2012 announcement about a new initiative to fund oral cancer drugs, Manitoba Premier Greg Selinger stated, “This budget will help patients focus on their health rather than worrying about the financial burden expensive drugs have on their lives and families.”
Manitoba now covers 100 per cent of the cost of oral cancer therapies and support drugs on its provincial formulary, with no deductibles.
While our health authorities and provincial government have publicly stated that our current hybrid system of take-home cancer drug funding is second to none, experts within the system recognize the inadequacies that in some cases are placing significant financial burdens on cancer patients and their families.
All provinces will struggle with how to find the funds necessary to pay for these treatments.
Take-home cancer drugs are here to stay and the problem of funding will only escalate as more safe and effective treatments are approved.
Our health authorities and provincial government are aware of the financial burdens and inequities associated with our current system.
They should consider following the lead of Western Canadian provincial governments and develop a single public funding system for all cancer drugs, regardless of whether they are given intravenously or orally.
Cancer patients in this province and their families have enough to worry about without having to be concerned about who is going to pay for their oral chemotherapy, especially when the same drugs may be fully funded in Western Canadian provinces.
Dr. David Saltman writes from St. John’s.