Dr. Bishal Gyawali speaks with CBC News about Ontario’s new funding program to expedite access to cancer drugs

Dr. Bishal Gyawali spoke with CBC News about Ontario’s new Funding Accelerated for Specific Treatments (FAST) program to expedite access to cancer drugs. Listen via the podcast or read the article. While faster access is welcome, Dr. Gyawali has highlighted several important considerations. The pilot program will apply to 7-10 drugs per year for 3 years, selected from the drugs approved under the FDA’s Project Orbis pathway. This process will occur after Health Canada and Canada Drug Agency reviews, ensuring safety and efficacy filters will remain intact. However, it will bypass the pan-Canadian Pharmaceutic Alliance (pCPA) negotiations that serve to reduce drug prices.

Dr. Gyawali notes concerns that Project Orbis approvals are not necessarily associated with greater clinical benefit, as outlined by Kristina Jenei. Considering there are over 10 drugs approved through the Project Orbis pathway each year, how will the 7-10 drugs to expedite be chosen and prioritized? A task force could be implemented to make these decisions to ensure drugs with substantial clinical benefit are prioritized for expedited access.

Furthermore, pCPA negotiates drug prices with industry on behalf of provinces across Canada. Since Ontario’s FAST program bypasses pCPA, will Ontario no longer negotiate prices for drugs that are expedited, thus agreeing to higher prices for accelerated access? If Ontario agrees to pay higher prices, it may diminish the incentive for drug companies to reduce prices for other provinces. As such, there is a concern that the FAST program will result in a loss of pCPA’s negotiation power and higher costs across provinces.

Overall, his considerations underscore the importance of balancing timely access to therapies with rigorous evaluation and sustainable pricing to uphold equitable cancer care.