Cancer patients and experts testify as to how the CDR is failing
OTTAWA, April 30 /CNW/ - Today, Dr. Jennifer Knox and other cancer
experts delivered a common message to the government - that the Common Drug
Review (CDR) is failing Canadian cancer patients. The Standing Committee on
Health invited Dr. Knox, among other experts and advocates, to present at the
hearing focused on cancer drugs as part of their evaluation of the
effectiveness - and future role - of the CDR.
"Flaws in the CDR's review and decision-making process are undermining
physicians' primary duty of care to their patients," states Dr. Knox, an
oncologist specializing in kidney cancer in Toronto. "CDR has recently
reviewed two important new drugs for the treatment of kidney cancer, and has
recommended that they not be reimbursed. For a disease with extremely few
treatment options this will cause Canadians with kidney cancer to be woefully
NEXAVAR - A Recent Failure of the CDR
NEXAVAR is one of the most recent examples of how the CDR review is
preventing Canadian cancer patients from receiving the care they deserve. As
the first effective treatment for kidney cancer in 10 years (and recently
proven to increase overall survival for liver cancer patients), NEXAVAR is now
the standard of care in Canada - and around the world - for a patient
population previously without hope. This kidney cancer treatment is approved
by Health Canada, covered in 13 countries, and by most Canadian private drug
"We oncologists agree that this drug represents a tremendous breakthrough
after decades of research in the treatment for kidney cancer and needs to be
made available for our patients," states Dr. Knox on behalf of leading experts
from across the country.
Despite this, the CDR has recommended government drug plans (outside of
Quebec) not cover NEXAVAR. The CDR has also recently given a negative
recommendation to SUTENT - another kidney cancer therapy. By recommending that
publicly funded drug plans not list either NEXAVAR or SUTENT, the CDR is
impeding access for patients who rely on government drug benefits to drugs
that has been approved by Health Canada, and that have been shown to prolong
progression-free survival in a patient population with very few treatment
"This is a devastating recommendation for Canadian kidney cancer
patients," says Tony Clark, co-founder of Kidney Cancer Canada and a kidney
Mr. Clark was first diagnosed with kidney cancer in June 2004 and
discovered soon after that it had metastasized to his lungs. He was told that
he had one year to live.
"That was a result I just couldn't accept," recalls Clark, "so I decided
to enroll in a clinical trial based in the United States of NEXAVAR, a
promising new kidney cancer treatment. I was fortunate enough to be accepted
and because of this breakthrough treatment, the disease is now stabilized and
I am back at work and am enjoying life. Without NEXAVAR I wouldn't be here
Ethics of Clinical Trials
"The CDR's decision is even more surprising when you consider that one of
the major reasons they provided for the negative recommendation was the lack
of long-term survival data," says Dr. Karakiewicz, a urologic oncologist from
the University of Montreal Health Centre. "This is unfortunate, and ironic,
when you consider that the FDA asked Bayer to stop clinical trials and allow
placebo patients to receive treatment because the interim results were so
It is unethical to withhold an effective treatment from research
patients. However, ending the trials also meant sacrificing longer term
survival data - data required for a positive CDR recommendation.
Access to Cancer Treatments
The fact that the CDR is not capable of effectively reviewing cancer
treatments has already been acknowledged by the government. The government has
recently created the Joint Oncology Drug Review for this purpose, but it
remains to be seen if this group will be any more effective.
To date, not one innovative, first in class medicine has been given a
positive review by the CDR.
The CDR is in effect creating a two-tiered health care system. NEXAVAR,
and other cancer drugs, is available to patients with private drug coverage.
Because of the CDR's recommendation, NEXAVAR will not be available to those
vulnerable Canadian patients who rely on provincial drug plans.
Our governments are obliged to ensure equitable, accountable and
transparent access to health care for all Canadians - this was the original
intent of CDR. Now, it is critical governments acknowledge that CDR is
fundamentally flawed and implement a solution to ensure that Canadian cancer
patients receive the treatment they deserve.
"Oncologists across Canada agree that both NEXAVAR and SUTENT represent
tremendous breakthroughs after decades of research in the treatment for kidney
cancer," states Dr. Knox. "We urge those who make listing decisions on
publicly funded drug benefits to ignore the CDR's recommendations for these
important new drugs and give patients access to these needed therapies."
About the Common Drug Review (CDR)
The CDR is a government appointed agency that makes recommendations to
provinces (with the exception of Quebec) regarding listing decisions for new
drugs. The CDR is governed by Deputy Ministers of Health who are in turn
appointed by provincial Premiers. As such the CDR is accountable to Canadians.
Before the creation of the CDR, Canada's federal, provincial, and
territorial drug plans had separate processes for conducting reviews and
making formulary listing recommendations. The CDR was set up to reduce
duplication, and to provide equal access to high level evidence and expert
About Kidney Cancer Canada
Kidney Cancer Canada is a new patient-led support organization with the
purpose of improving the quality of life of patients and their families living
with kidney cancer. Kidney Cancer Canada advocates for access to new
treatments, provides support and information to patients, and works to
increase awareness of kidney cancer as a significant health issue.
(1) CADTH/CDR Web site, http://www.cadth.ca/index.php/en/cdr/cdr-overview
For further information:
For further information: Steven Lott - Communications Director, Ward
Health Strategies, (905) 577-6200 ext. 424, (905) 928-5688 (cell),