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Article

Current Attitudes toward Unfunded Cancer Therapies among Canadian Medical Oncologists

1
Departments of Medical Oncology, British Columbia Cancer Agency, Vancouver, BC V5Z 4E6, Canada
2
Departments of Cancer Surveillance and Outcomes, British Columbia Cancer Agency, Vancouver, BC V5Z 4E6, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2021, 28(6), 4748-4755; https://doi.org/10.3390/curroncol28060400
Received: 24 September 2021 / Revised: 3 November 2021 / Accepted: 12 November 2021 / Published: 16 November 2021
(This article belongs to the Special Issue Access to Cancer Drugs in Canada)
Background: Despite successes in the development of innovative anticancer therapies, the fiscal and capacity restraints of the Canadian public healthcare system result in challenges with drug access. A meaningful proportion of systemic therapies ultimately do not receive public funding despite supporting clinical evidence. In this study, we assessed Canadian medical oncologists’ current attitudes toward discussing publicly unfunded cancer treatments with patients and predictors of different practices. Methods: A web-based survey consisting of multiple choice and case-based scenarios was distributed to medical oncologists identified through the Royal College of Physicians and Surgeons of Canada directory. Results: A total of 116 responses were received. Almost all respondents reported discussing publicly unfunded treatments, including those who did so for Health Canada (HC) approved treatments (50%) and those who discussed off-label treatments (i.e., not HC approved) as guided by national guidelines (48%). Respondents in practice for over 15 years versus less than 5 years (OR 0.14, 95% CI 0.04–0.50, p = 0.002) and those who worked in a community practice versus comprehensive cancer center (OR 0.17, 95% CI 0.03–0.91, p = 0.04) were significantly less likely to discuss off-label treatment options with their patients. Almost half of respondents (47%) indicated that their institution did not permit the administration of unfunded treatments. Conclusions: There is variability in medical oncologists’ practices when it comes to discussing unfunded therapies. Given the limitations within Canada’s publicly funded healthcare system, physicians are faced with the challenge of navigating an increasingly complex balance between patient care and available resources. Engagement of relevant stakeholders and policy makers is crucial in the continued evaluation of Canada’s drug funding process. View Full-Text
Keywords: unfunded cancer therapies; Canadian; medical oncology unfunded cancer therapies; Canadian; medical oncology
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MDPI and ACS Style

Wong, S.K.; Gondara, L.; Gill, S. Current Attitudes toward Unfunded Cancer Therapies among Canadian Medical Oncologists. Curr. Oncol. 2021, 28, 4748-4755. https://doi.org/10.3390/curroncol28060400

AMA Style

Wong SK, Gondara L, Gill S. Current Attitudes toward Unfunded Cancer Therapies among Canadian Medical Oncologists. Current Oncology. 2021; 28(6):4748-4755. https://doi.org/10.3390/curroncol28060400

Chicago/Turabian Style

Wong, Selina K., Lovedeep Gondara, and Sharlene Gill. 2021. "Current Attitudes toward Unfunded Cancer Therapies among Canadian Medical Oncologists" Current Oncology 28, no. 6: 4748-4755. https://doi.org/10.3390/curroncol28060400

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