What an amazing day it turned out to be for our national Strides – Walk for Awareness 2017! What were the odds that it would turn out to be the hottest day of the year for us here in Toronto? It really impressed upon me the need to be aware of the sun and using sun protection, including a good sunscreen all year, not just summer months. Thanks to our national sponsor, Neutrogena and for the much needed sunscreen. It was such a special day for my team in Mississauga – so many people and volunteers have come out year after year – it was a great day to catch up. It was touching to also meet so many new friends and families. I hope all of the site leaders across the country shared the same sentiment for this special event and we thank you for the generous financial support of all the participants and donors. It was a record for funds raised and for the number of participants across Canada as well as the record temperature. The last few months have also seen some good news on the drug approval arena. We are very pleased at the most recent positive recommendation from pCODR (Pan Canadian Oncology Drug Review) for the provinces to fund the combination immunotherapy of Opdivo and Yervoy as a first line therapy. This is a very positive step in the right direction, but the recommendation is still subject to price negotiations and then adoption by each province, so we may be some time yet before it is available for patients. The process is too slow and is getting in the way of timely access and coverage for patients in this country. For a quick update:
Targeted Therapies
• The Cotellic (cobimetinib) and Zelboraf (vemurafenib) combination therapy is now funded in all provinces except in Ontario, New Brunswick, Nova Scotia and PEI;
• All provinces except PEI are funding the combination therapy of Tafinlar (dabrafenib) and Mekinist.
Immunotherapies
• Opdivo (Nivolumab) is now funded in every province except PEI;
• Keytruda (pembrolizumab) is now funded in all provinces;
• Yervoy (ipilimumab) is funded in all provinces except Newfoundland.
• Opdivo/Yervoy combination: October 2017 – a positive recommendation was received from pCODR. Now subject to pricing negotiations and then provincial decisions to fund this combination therapy.
Significant hurdles remain for patients and the treating physicians, particularly for patients with no private insurance plan. While we are having good success in having therapies approved in first line (meaning the treatment is available with the treatment naïve patient), if the treatment does not work, in many cases under provincial funding, you will not have access to a second line treatment. Effectively in most situations, the patient has one shot. If the treatment that is selected for them does not work, that is all the provincial governments will pay for. You may have other options through clinical trials, but effectively the governments have said they will pay for one line of therapy only. There are options to pay out of pocket, but for most Canadians, this is simply not an option. If you have private insurance, often now, this will also be the case, but individual private insurance plans vary widely. Please check with your plan administrator. What is MNC doing about this untenable situation? We have been actively involved in the gathering of patient data to submit to pCODR for initial funding recommendations. We have also aligned with a number of other patient groups to raise our issues and concerns with each provincial health minister. We have actively been seeking government clarification for the mandate and role of a newly developed government agency – CAPCA (Canadian Association of Provincial Cancer Agencies www.capca.ca). We worry that this new agency, set up to provide guidance to provincial governments on cancer drugs will be another level of delay in the already protracted process of approval and funding of cancer drugs for melanoma patients. As you can see, there is much work to do and there is a need for active involvement of patients. There is no assurance that the therapies we desperately need will be available when we need them. If you would like to know more or get involved, please contact our office: (905) 901-5121. I hope to see some of you at our upcoming patient sessions in November. Until then, wishing you good health and warmest wishes for the upcoming holidays!
