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Access to expensive cancer drugs in Canada: a comparison of Quebec, Ontario and British-Columbia

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Author(s): Hughes D

Journal: Pratiques et Organisation des Soins
ISSN 1952-9201

Volume: 43;
Issue: 1;
Start page: 9;
Date: 2012;
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Keywords: Canada | antineoplastic agents | drug evaluation | insurance pharmaceutical services | healthcare disparities | cost-benefit analysis | efficiency | equity.

ABSTRACT
SummaryAim: Among the new cancer drugs, some are extremely expensive and provide few benefits relative to their cost. There is a variation in the coverage of these drugs between provincial public plans. This exploratory comparative study has two main goals. First, to identify differences in coverage which are the results of cost-benefit decisions. Second, to identify structural elements that promote public coverage of cancer drugs that is accessible, efficient and equitable. Methods: We analyzed and compared the reimbursement decisions of Quebec, Ontario and British-Columbia. We also analyzed and compared the evaluation agencies and public drug plans in these three provinces. We examined the eligibility criteria and financial contribution requested. Results: The coverage of cancer drugs is more extensive in Ontario and British-Columbia. However, in terms of the evaluation of cancer drugs, the British-Columbia agency is perating in “silo”, lacks distance from oncology specialists and needs more transparency. In terms of drug insurance plans, the basic premium in Quebec distributes a share of the cost to all insured. Ontario has the advantage of modulating the contributions on the basis of income. British-Columbia provides free access to cancer drugs but since other groups of patients are requested to pay a significant financial contribution, this can be seen as unfair. Conclusion: British-Columbia is presented as the champion of access to cancer drugs. However, we believe that the conditions under which decisions are made in that province unduly promote access at the expense of efficiency and equity. Prat Organ Soins. 2012;43(1):9-18
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