Developing new drugs is only half of the job for those treating lung cancer, according to a medical oncologist.
Most people know that the biology of cancer is extremely complex. What fewer know, Dr. Paul Wheatley-Price told audience members at Benefits Canada’s 2017 Employers Cancer Care Summit on Feb. 21, is that “the machinery of getting drugs to people is also extremely complex.”
Wheatley-Price, who also serves as president of Lung Cancer Canada, said a proliferation of new treatments that have emerged in the last decade make his specialty “a very exciting place to be treating patients.”
But while new drugs are welcome, “they’re absolutely useless unless we can actually get them into patients,” said Wheatley-Price.
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At the Ottawa Hospital, where Wheatley-Price spends his days in the medical oncology department, there are two drug reimbursement specialists on staff whose job is to co-ordinate with doctors, insurers, pharmaceutical companies and dispensing pharmacies to make sure patients get access to the drugs they need as quickly as possible.
Wheatley-Price urged the plan sponsors in attendance to speak up for the retention of similar professionals as hospitals scour their budgets for potential savings in an era of tight budgets.
“It’s programs like this that we are all fearful are on the chopping block,” he said.
While doctors could do the same job, Wheatley-Price said it would take them far too long in a field where every day counts.
“Advocate for specialists like this in hospitals. They give us good access to drugs,” he said.
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Wheatley-Price used one of his recent patients to illustrate the gaps in the system and the potential value of a professional who specializes in the complex world of drug funding.
He wanted to prescribe the woman, a non-smoker whose lung cancer was picked up soon after the birth of her first child, a new oral drug but he ran into Cancer Care Ontario’s policy to fund only intravenous chemotherapy medicine. After an application to the Ministry of Health’s expanded access program, Wheatley-Price was able to prescribe the drug, but that still left the small matter of payment.
The woman’s employer-sponsored health plan covered 60 per cent of her drug costs, leaving her with an unrealistic four-figure copayment each month. The pharmaceutical company ultimately agreed to absorb the copayment while she applies for further provincial funding.
“Fortunately, the system has worked for her but not without an awful lot of stress and anxiety and worry,” said Wheatley-Price.
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Despite advances in immunotherapy and precision drug treatments, lung cancer remains very deadly, killing more than 20,000 people each year. The reason, Wheatley-Price explained, is the disease has usually spread and become incurable by the time symptoms show up in the patient.
Historically, he said lung cancer specialists had a relatively straightforward job to do, with only a few chemotherapy drugs available to try on patients, each with a relatively low response rate.
However, as researchers have gained a clearer view of lung cancer, the field has become more complex. “It’s not just one disease but actually hundreds of different diseases,” said Wheatley-Price, noting that has enabled the development of drugs that target individual strains of lung cancer.