by Dr. Mona Sabharwal
DRUG REVIEw POLIcY
pcodr:
changing the conversation about access to cancer drugs
On any given week, media headlines extoll the benefits of a new “breakthrough” cancer drug. For governments, they face the difficult task of deciding how best to allocate limited public resources and at the same time, ensure the sustainability of the health care system.
14 BIOTECHNOLOGY FOCUS February/March 2014
Prior to 2011, each province had its own process for evaluating and funding cancer drugs. This “patchwork” and often unpredictable approach made it difficult for patients and oncologists to find out if a particular drug was currently under review in their province, or if it had been approved or turned down for coverage, and how the decision had been made. Two years ago, in an effort to make the process more open, efficient and consistent, the provinces and territories (except Québec which retains its own system) came together to create the pan-Canadian Oncology Drug Review, or pCODR. Based in Toronto, the pCODR’s mandate is to provide the provinces with the same set of evidence-based recommendations to guide their funding decisions. Many have been affected by cancer, whether directly or through a loved one, a friend or a colleague. pCODR recognies the importance of its work and the process’s value to patients, governments and clinicians in evaluating cancer drugs using an evidence-based, rigorous and non-emotional approach. The new process eliminates duplication by
individual provinces and introduces a transparent, rigorous, consistent and collaborative approach that involves the input of patient advocacy groups, pharmaceutical companies, economists, ethicists and clinicians, and the provincial advisory group. The establishment of a pan-Canadian process also provides a single entry point for pharmaceutical companies to have their oncology product evaluated for public funding. The process begins when a pharmaceutical manufacturer or a group of cancer experts in a particular area of cancer, called a tumour group, submits a new drug for review. The submitter provides required information about the drug including how well it works and its cost-effectiveness. Once a submission has been accepted, pCODR draws from leading experts from across Canada to conduct the clinical and economic evaluation of the drug. Individuals who serve on the clinical guidance panel bring expertise in the type of cancer targeted by the drug whereas individuals on the economic guidance panel have experience in applied health technology assessment. Drawing on reports from the two guidance panels, pCODR’s expert review commit-
