Cancer is the leading cause of death in the country. Nearly one in two people will suffer from it during their lifetime. Every 24 minutes, someone dies from it in Quebec.
Faced with data of this magnitude, we have an obligation to deploy all means at our disposal to save as many lives as possible. Especially when solutions exist and are within reach.
Unfortunately – oncologists and patient groups will tell you – far too many people die waiting for life-saving therapies… Not because there is nothing to help them, but because of bureaucratic delays in the process approval, reimbursement and access to medicines.
Every week, we receive calls from patients and their families who tell us of their sadness and desolation. In addition to fighting for their lives, they must fight against a system that has never adapted to our times.
A Conference Board of Canada study concluded last year that innovative cancer treatments could add as many as 225,000 additional years of life to the country’s citizens, if we ensured that eligible patients had access to them.
The COVID-19 pandemic has shown that our health system and the organizations that support it are capable of innovating and adapting quickly when circumstances demand it. To save lives, we have accelerated processes and removed unnecessary constraints like never before.
At the time, anyone infected with HIV risked certain and rapid death, and only effective treatment could delay or prevent it. A long and expensive randomized clinical trial was not really necessary.
Why aren’t we advancing cancer healthcare with the same sense of urgency? Why do we continue to use obviously outdated and slow processes?
The examples of aberrations in our system are piling up. To name just one, let’s think of the many intravenous treatments that are now available in subcutaneous format. These treatments could now be received in the form of an injection, in 15 minutes in a CLSC, instead of mobilizing several hospital staff members for three long hours. However, the Institut national d’excellence en santé et en services sociaux (INESSS) is calling for a complete re-evaluation of each treatment, even if it is a molecule already approved in another form and for which scientific evidence abounds. It’s better for the patient, less expensive for the system, but bureaucracy is an obstacle to progress.
In the National Assembly, parliamentarians have just resumed study of Bill 15, supposed to “make our health system more efficient”. If words have any meaning, modernizing the approval process for cancer treatments should be one of the issues on the agenda.
It’s time for government regulators to start working with patients, clinicians, the pharmaceutical industry and scientists to make a difference. It’s not about reinventing the wheel. Other jurisdictions use adaptive design and approve new drugs conditionally, based on promising data, with the requirement to provide additional data afterwards. Other countries are adopting value-based healthcare, and trying new methods to speed up access to medicines.
What are we waiting for to do the same in Quebec and Canada? We must stop being complacent and demand change.