Ontario pilot speeds public coverage of five cancer drugs

Ontario's FAST pilot has expanded public funding for five cancer therapies, including Scemblix, by reimbursing treatments tied to Project Orbis before pan-Canadian pricing deals were completed.

Ontario has begun publicly covering five cancer treatments more quickly than usual under a three-year pilot called Faster Access to Specialized Treatments (FAST). The program identifies therapies in the international Project Orbis collaboration and starts reimbursing them for patients before the pan-Canadian Pharmaceutical Alliance (pCPA) completes confidential pricing talks. The pilot responds to concerns that Canada typically takes about 2½ years from Health Canada approval to public coverage, longer than other Group of Seven countries. The provincial government announced the list of drugs after launching the program last fall. Key details: - The five therapies named under FAST are Scemblix, Tagrisso, Nubeqa, Calquence and the combination of Opdivo with Yervoy; together they address six types of cancer including some lung, prostate, blood, colorectal and liver cancers. - Ontario began funding Scemblix on Nov. 7 after Health Canada approved it as a first-line therapy for chronic myeloid leukemia, more than a month before the pCPA began pricing talks with the manufacturer on Dec. 18. - The pCPA reported it reached confidential pricing deals late last year for Tagrisso, Nubeqa and Opdivo‑Yervoy, and said those agreements took less than seven weeks to negotiate. - Scemblix was reported with a list price of $4,760 per 28-day cycle before any negotiated discount, and many patients who respond may take the drug long term. - The pilot aims to shorten the step in which the pCPA negotiates prices; the pCPA has launched an early negotiations process and said it is prioritizing Project Orbis cancer drugs already in its pipeline. Summary: Ontario's FAST pilot has allowed earlier provincial reimbursement for several cancer therapies by starting coverage ahead of pCPA pricing deals, and some of those drugs have since had confidential agreements reached. The pCPA says it is prioritizing Orbis-linked cancer drugs in its early negotiations process. Undetermined at this time.