Special Issue "Access to Cancer Drugs in Canada"

A special issue of Current Oncology (ISSN 1718-7729).

Deadline for manuscript submissions: 31 December 2021.

Special Issue Editor

Dr. Paul Wheatley-Price
E-Mail Website
Guest Editor
Department of Medicine, University of Ottawa; Medical Oncologist, The Ottawa Hospital Cancer Centre/Ottawa Hospital Research Institute; President of Lung Cancer Canada; Ottawa, ON, Canada
Interests: lung cancer; mesothelioma; advocacy

Special Issue Information

Dear Colleagues,

The therapeutic landscape in cancer has been changing rapidly for a century now since the emergence of radiotherapy in the early 1900s, and chemotherapy a few decades later. However, it seems as though the pace of progress has continued to accelerate as we rapidly have entered the era of novel chemotherapies and combinations, monoclonal antibodies, targeted therapies, immune checkpoint inhibitors, drug-antibody conjugates and more.

The regulatory processes in place to deal with the increasing numbers of effective drugs naturally needs to develop and progress too, reflecting and balancing the efficacies of new therapies, their place in treatment algorithms, the potential high price and cost-effectiveness, and the more nuanced discussions around value.

In this Special Issue of Current Oncology, manuscripts are invited to reflect on or educate about the challenges of the Canadian regulatory system, ranging from Health Canada, the Patented Medicines Prices Review Board (PMPRB), the Canadian Agency for Drugs and Technologies in Health (CADTH), who oversee the health technology assessment (HTA) and Reimbursement Reviews (formerly pan-Canadian Oncology Drug Review, or pCODR), to the pan Canadian Pharmaceutical Alliance (PCPA) that recommends a price to the territories and provinces.

These multiple steps in the regulatory process are changing, and often poorly understood by rank and file clinicians. This issue will seek to educate readers, and discuss the implications of change, the international context that Canada works in, the role of physicians as advocates or adjudicators, the pros and cons of a potential national pharmacare system, and debates around cost and value.

Manuscripts are invited that address these issues, or other issues that are considered relevant to the Special Issue title ‘Access to cancer drugs in Canada’.

Dr. Paul Wheatley-Price
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Current Oncology is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 1600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Published Papers (1 paper)

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Describing Sources of Uncertainty in Cancer Drug Formulary Priority Setting across Canada
Curr. Oncol. 2021, 28(4), 2708-2719; https://doi.org/10.3390/curroncol28040236 - 17 Jul 2021
Viewed by 301
Over the years, there have been significant advances in oncology. However, the rate that therapeutics come to market has increased, while the strength of evidence has decreased. Currently, there is limited understanding about how these uncertainties are managed in provincial funding decisions for [...] Read more.
Over the years, there have been significant advances in oncology. However, the rate that therapeutics come to market has increased, while the strength of evidence has decreased. Currently, there is limited understanding about how these uncertainties are managed in provincial funding decisions for cancer therapeutics. We conducted qualitative interviews with six senior officials from four different Canadian provinces (British Columbia, Alberta, Quebec, and Ontario) and a document review of the uncertainties found in submissions to the pan-Canadian Oncology Drug Review (pCODR). Participants reported considerable uncertainty related to a lack of solid clinical evidence (early-phase clinical trials: generalizability, immature data, and the use of unvalidated surrogate outcomes). Proposed strategies to deal with the uncertainty included risk-sharing agreements, collection of real-world evidence (RWE), and ongoing collaboration between federal groups and provinces. The document review added to the reported uncertainties by classifying them into five main categories: trial validity, population, comparators, outcomes, and intervention. This study highlights how decision makers must deal with significant amounts of uncertainty in funding decisions for cancer drugs, most of which stems from methodological limitations in clinical trials. There is a critical need for transparent priority-setting processes and mechanisms to reevaluate drugs to ensure benefit given the high level of uncertainty of novel therapeutics. Full article
(This article belongs to the Special Issue Access to Cancer Drugs in Canada)
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