Less than ideal: how oncologists practice with limited drug access
Kelvin K Chan1, Bertha Wong, Lillian L Siu
1Sunnybrook Odette Cancer Centre; Princess Margaret Hospital, University Health Network; University of Toronto; Li Ka Shing Knowledge Institute of St. Michael's Hospital; and RS McLaughlin Durham Regional Cancer Centre, Oshawa, Toronto, Ontario, Canada.
Journal of Oncology Practice
|September 4, 2012
Summary
Canadian oncologists face challenges accessing new cancer drugs, impacting patient care for metastatic colorectal cancer. Many support private payment and a national formulary due to funding and approval process concerns.
Area of Science:
- Oncology
- Health Services Research
- Pharmacoeconomics
Background:
- Access to novel, expensive cancer therapeutics is a growing concern in clinical practice.
- Barriers to drug access can significantly influence treatment decisions and patient outcomes.
- Understanding oncologists' perspectives is crucial for improving drug approval and funding processes.
Purpose of the Study:
- To evaluate Canadian medical oncologists' perspectives on barriers to accessing new, expensive cancer drugs.
- To assess the impact of these barriers on their clinical practice.
- To understand their opinions on current drug approval and funding mechanisms.
Main Methods:
- A cross-sectional survey was administered to Canadian medical oncologists treating colorectal cancer (CRC).
- The survey used a self-administered questionnaire to gather data on practice patterns and opinions.
- Data were collected from a sample of eligible oncologists, with a 41.4% response rate.
Main Results:
- Only 29.4% of oncologists felt they could provide the ideal first-line chemotherapy for metastatic CRC.
- Despite bevacizumab's recognized importance, only 18% could use it routinely.
- Physicians expressed significant concerns (97%) about drug approval/funding and supported (85%) a national drug formulary.
Conclusions:
- Canadian oncologists struggle to deliver optimal care for metastatic CRC due to unequal access to preferred drugs.
- Physicians resort to clinical trials and private clinics, sometimes withholding discussions about drugs with limited access.
- Dissatisfaction with current funding and approval processes is high, with support for private payment for unfunded drugs.
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