Funding Process for High-Cost Cancer Drugs
Pan-Canadian Review Process
In Ontario, new cancer drugs are typically reviewed through a pan-Canadian review process:
Health Canada provides market authorization for a given drug and indication (reason for use).
Canadian Agency for Drugs and Technologies in Health’s (CADTH) pan-Canadian Oncology Drug Review will conduct a health technology assessment that evaluates the clinical and cost-effectiveness of the drug. This process considers information and perspectives from manufacturers, physicians who treat cancer, economists, and patients.
The pan-Canadian Pharmaceutical Alliance (pCPA) negotiates the price of the drug with the manufacturer on behalf of participating provinces and territories. This process allows for consistent pricing nationally and overall provides greater value to publicly funded drug programs and patients.
After the CADTH and pCPA review, each province or territory then makes its own funding decisions. For drugs that will be funded, the responsible provincial program will sign a product listing agreement with the manufacturer.
The above process is similarly used by other provinces so that drug coverage is aligned in Canada.
Provincial Review Process
Ontario has a rigorous process for evaluating drugs. It includes an explicit consideration of a drug’s safety, as well as the clinical- and cost- effectiveness of each drug. This process also incorporates input from patients on quality-of-life considerations.
For Ontario-specific drug funding gaps:
- Ontario Health’s Drug Advisory Committees (a group of physicians who specialize in treating cancer) will file a funding submission with the Ministry of Health.
- The Ontario Steering Committee for Cancer Drugs (OSCCD) will review the clinical and cost-effectiveness of the drug and make a recommendation to the Ministry’s Executive Officer, Ontario Public Drug Programs.
- The final funding decision will be made by the Ministry’s Executive Officer.
The Role of Ontario Health
Ontario Health, along with the Ministry of Health, participates in various points of the drug review process including:
- Providing secretariat support to the Ontario Steering Committee for Cancer Drugs (OSCCD)
- Working with Drug Advisory Committees (DACs) to identify Ontario-specific funding gaps. (We have nine DACs that have clinical experts in treating a variety of solid tumors and blood cancers).
- Working with the Ministry and DACs to implement funding for drugs approved for public funding.
- Verifying that patients meet eligibility for coverage for drugs funded by the New Drug Funding Program or Evidence Building Program.
For pharmaceutical manufacturers who need information on drug submissions, please see: