Indian Institute of Management Bangalore

Health Economics : Theory and Practice

Reflection Note on

Challenges of access to Oncology Drugs in

Canada

Under the Guidance of

Prof. Allen and Prof. Arnab

Submitted by: Saurav Paikrao

Roll Number : 2211423
Word Count: 494
1) The dilemma highlighted in the case is the conflict between “ the need to provide
patients with access to the latest and most effective cancer drugs” versus “the
limited resources available to publicly funded organizations”. On one hand, they
want to provide these drugs, but on the other hand, they have limited resources.

Factors that prevent publicly funded organizations from provisioning cancer

medications for patients are:

● Cost-effectiveness analysis: Publicly funded organizations use CEA to

assess the benefits of a new drug and set priorities within a limited budget.
The high cost of new cancer drugs makes it difficult for these organizations to
cover them. They also must balance between this and other healthcare
spendings.
● Complex and time-consuming drug reimbursement process: The drug
reimbursement process in Canada can be long and complex. It can take a lot
of time for new drugs to be approved for public funding.
● Lack of transparency in the drug reimbursement process: It makes it
difficult for patients and physicians to understand why a particular drug may
be covered, and it can make it difficult for the industry to predict which drugs
will be reimbursed. This delays and creates hindrance to the process.
● Aging population and increasing cancer rates: The aging population had
higher rates of cancer resulting in increased demand for cancer treatments
which put extra pressure on publicly funded healthcare systems of the cost of
cancer drugs.
● Variations in access across Canada: Each province and territory has its
own drug funding agency with its own set of criteria for drug reimbursement.
This can lead to variation in access to cancer drugs.

2)

A) Patient
● Lack of access to new cancer drugs: Patients may have to wait a long time
to access new cancer drugs.
● High cost of cancer drugs: Patients may have to pay out of pocket for
cancer drugs, even if they are covered by public insurance. This can be a
significant financial burden for patients and their families.
B) Physicians
● Difficulty navigating the drug reimbursement process: Physicians
expressed frustration with the decision-making process for drug
reimbursement and felt that it did not adequately consider the clinical
effectiveness of new drugs.
● Ethical challenges and Impact on patient care: Physicians may face ethical
challenges when they have to make difficult decisions about which patients to
prioritize for treatment, given the limited resources available, and this can
have a negative impact on patient care. They also can’t prescribe new cancer
medication if it is not covered.

C) Industry
● Long and complex drug reimbursement process: The drug reimbursement
process in Canada can make it difficult for pharmaceutical companies to bring
new cancer drugs to market in Canada. There is an uncertainty if they’ll
receive the funds or not.
● Price negotiations with publicly funded organizations: Pharmaceutical
companies have to negotiate the prices of their drugs making it difficult for
companies to make a profit on their investments in cancer drug R&D and thus
it also poses an issue of sustainability for the cancer agencies.