ArticleThe oncologist2020
Potential Life-Years Lost: The Impact of the Cancer Drug Regulatory and Funding Process in Canada.
Article in The oncologist, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed.
- Early access to medicines in Spain: a retrospective hospital study with a proposal for a regulatory change.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026Review
- The cost of cancer care: how much would you pay for your drugs? Patient and oncology professional stakeholder opinions in Ireland.Irish journal of medical science · 2026Article
- The costs and benefits of an early access scheme for oncology medicines in Ireland.BMC health services research · 2026Article
- Impact of Market Access Delays on Time to Patient Access: Multi-Country Comparative Analysis Assessing the First Commercial Launch Indications for Five Oncology Medicines Across Europe and Canada.Journal of market access & health policy · 2026Article
- Survival analysis of time to reimbursement of novel medicines in five Eurasian countries.Global health research and policy · 2025Article
- Novel Systemic Anticancer Treatments and Health Services Use at the End of Life Among Adults With Cancer.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Article
- Consequences of Canada's Drug Agency Reimbursement Recommendations for New Medicines and Pan-Canadian Pharmaceutical Alliance Price Negotiations on Patient Access.ClinicoEconomics and outcomes research : CEOR · 2025Article
- Real-World Outcomes of Incurable Cancer Patients Treated with Unlisted Anticancer Treatments in an Academic Center in Quebec, Canada.Current oncology (Toronto, Ont.) · 2024Article
- The impact of proposed price regulations on new patented medicine launches in Canada: a retrospective cohort study.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Article
- The impact of willingness-to-pay threshold on price reduction recommendations for oncology drugs: a review of assessments conducted by the Canadian Agency for Drugs and Technologies in Health.Journal of comparative effectiveness research · 2024Review
- New Anticancer Drugs: Reliably Assessing "Value" While Addressing High Prices.Current oncology (Toronto, Ont.) · 2024Article
- Access to Oncology Medicines in Canada: Consensus Forum for Recommendations for Improvement.Current oncology (Toronto, Ont.) · 2024Article
- Impact of Systemic Delays for Patient Access to Oncology Drugs on Clinical, Economic, and Quality of Life Outcomes in Canada: A Call to Action.Current oncology (Toronto, Ont.) · 2024Review
- Timeliness of Health Technology Assessments and Price Negotiations for Oncology Drugs in Canada.ClinicoEconomics and outcomes research : CEOR · 2024Article
- Beyond Participation: Evaluating the Role of Patients in Designing Oncology Clinical Trials.Current oncology (Toronto, Ont.) · 2023Review
- Impact of Oncology Drug Review Times on Public Funding Recommendations.Current oncology (Toronto, Ont.) · 2023Article
- Current Challenges and Disparities in the Delivery of Equitable Breast Cancer Care in Canada.Current oncology (Toronto, Ont.) · 2023Review
- Understanding Characteristics, Treatment Patterns, and Clinical Outcomes for Individuals with Advanced or Recurrent Endometrial Cancer in Alberta, Canada: A Retrospective, Population-Based Cohort Study.Current oncology (Toronto, Ont.) · 2023Article
- RAPID framework for improved access to precision oncology for lethal disease: Results from a modified multi-round delphi study.Frontiers in health services · 2023Article
- Disparity in public funding of systemic therapy for metastatic renal cell carcinoma in Canada.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCanada has an established publicly funded health care system with a complex drug approval and funding process. After proof of efficacy (POE; key publication/presentation) and before becoming publicly accessible, each drug undergoes a Health Canada approval process, a health technology assessment (HTA), a pricing negotiation, and finally individual provincial funding agreements. We quantified potential life-years lost during this process.
methodsWe analyzed drugs for advanced lung, breast, and colorectal cancer that underwent the HTA process between 2011 and 2016. Life-years lost were calculated by multiplying documented improvement in progression-free and overall survival, number of eligible patients, and time from POE to first public funding. For conservative calculation, we assumed all eligible patients in Canada had access at the time of first public funding, whereas in reality provinces fund at different time points.
resultsWe analyzed 21 drugs. Of these, 15 have been funded publicly. The time from POE to first public funding ranged from 14.0 to 99.2 months (median 26.6 months). Total overall life-years lost from POE to first public funding were 39,067 (lung 32,367; breast 6,691). Progression-free life-years lost from POE to first public funding were 48,037 (lung 9,139, breast 15,827, colorectal 23,071).
conclusionThe number of potential life-years lost during the drug regulatory and funding process in Canada is substantial, largely driven by delays to funding of colorectal cancer drugs. Recognizing that interprovincial differences exist and that eligible patients may not all receive a given drug, if even a fraction does so, the impact of delays remains substantive. Collaborative national initiatives are required to address this major barrier to treatment access. IMPLICATIONS FOR PRACTICE: Patients may spend lengthy periods of time awaiting access to new and effective cancer drugs. Patients with private drug insurance or personal funds or who reside in certain Canadian provinces may obtain some drugs sooner than others, potentially creating a two-tiered access system. The cancer drug access and public funding system must be expedited to improve equity.
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