Closing the Gaps to Timely Patient Access: Perspectives on Conditional Funding Models

Abstract

The Canadian system for approval of new cancer drugs is complex with multiple steps. Health Canada grants a license for a drug to be marketed and prescribed. The Canadian Agency for Drugs and Technologies in Health (CADTH) and Institut national d’excellence en santé et services sociaux (INESSS) make recommendations by way of health technology assessments (HTA). If positive, the latter then lead to confidential price negotiations at the pan-Canadian pharmaceutical alliance (pCPA), after which individual provinces and territories make a listing decision. Delays can occur at each stage, but post-HTA delays can be lengthy and unpredictable, denying or impeding access to an effective drug with the potential for devastating clinical outcomes. Conditional funding models have been adopted in a number of European countries with the goal of providing timely access to new medications in areas of unmet need, in advance of further steps in the reimbursement process. This manuscript discusses different stakeholder perspectives on conditional funding agreements—including a recent successful example of such a process in the UK—based on a panel discussion at the 2021 Canadian Association of Population Therapeutics (CAPT) Conference.

Access to Cancer Drugs in Canada

“…Related to this, Glennie et al, in their paper ‘Closing the Gaps to Timely Patient Access: Perspectives on Conditional Funding Models’ propose and discuss models whereby access to medications can be secured for patients while the regulatory process works through its often timely mechanism [ 14 ]. They provide examples from other jurisdictions, such as the UK and France, that are being established for the purpose of enabling patients to receive effective therapies without jeopardizing the robustness of the regulatory system.…”