Evaluating the Economic Impact of Novel Oncology Drug Coverage Through Patient Assistance Programs

Despite a universal public health care system, Canadian oncology patients often enroll in patient assistance programs (PAPs) to access oncology drugs that are awaiting funding decisions. Our multicenter study evaluated the pharmacoeconomic and clinical impact of PAPs for patients with cancer in British Columbia (BC).

Eligible patients were diagnosed with cancer and enrolled in a PAP between January 2016 and December 2019 in three BC centers. Charts were reviewed for treatment details and survival data. For each drug indication, the hazard ratio from clinical trial data was multiplied by the median overall survival (mOS) or median progression-free survival (mPFS) of our cohort to estimate the mOS or mPFS if the drug was not received. Person life-years gained (PLYG) was the difference between the actual mOS or mPFS and the estimated mOS or mPFS if the drug was not received. Incremental cost-effectiveness ratios and drug costs were obtained from the Canadian Agency for Drugs and Technologies in Health. A total economic value of quality-adjusted life year (QALY) gained for each cohort was calculated and compared with the cost of drugs associated with the gain.

Our cohort consisted of 1,025 patients who accessed 40 oncology drugs via PAP. The median time from Health Canada approval to provincial funding was 2.04 years. In the first PAP exposure group (N = 1,025), median PLYG was 0.38 years for OS and 0.80 years for PFS. The total estimated economic value of QALY gained was $83,068,819.32, with total drug costs of $97,026.661.44.

PAPs were involved in covering up to $100 million in costs to bridge gaps between regulatory approval and public funding. Economic value and PLYG gained from PAPs are substantial.