When Dwight Corbin went to the hospital in 2013 for a completely unrelated operation, pancreatic cancer was the last thing he expected.
“I was not sick, that’s the thing,” said the Lake Echo, N.S. resident of learning about the diagnosis seven years ago.
“If it hadn’t have been for this other procedure, I wouldn’t have even known. There are no symptoms for the person until it’s too late.”
Corbin is now cancer-free, but he’s a rare survivor of the disease. It’s the deadliest of all major cancers, killing 90 per cent of patients or more within five years.
This year, the Canadian Cancer Society projects about 6,000 Canadians will be diagnosed with pancreatic cancer, 5,300 of whom will die. In Nova Scotia, the disease currently impacts about 170 patients.
There is a second line treatment that can sustain life for many of those patients, but the drug — Onivyde — is not funded or distributed in Canada.
On Nov. 19, World Pancreatic Cancer Day, Corbin joined patient advocates and a number of oncologists in advocating for Canada’s lead drug negotiator to reconsider giving the treatment the green light.
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“We don’t have a lot of treatment options for pancreatic cancer,” said Halifax oncologist Dr. Ravi Ramjeesingh, who sees between 70 and 80 of the province’s pancreatic cancer patients.
“Onivyde was the only treatment in second line that actually there’s clinical trial data that shows that it actually works, so it doesn’t make a lot of sense to not have it available when it’s available elsewhere in the world.”
Ramjeesingh said it’s “difficult” to treat his patients, who are reaching the end of their lives, knowing there’s another treatment that can help — but it’s out of reach. It’s a tricky thing to explain to the patients, he added, who are hoping for extra time with their loved ones.
Onivyde is currently available in the United States. It was approved by Health Canada in 2017, with its Canadian producer — Shire Pharma Canada ULC — boasting a 45-per cent increase in overall patient survival, amounting to roughly two additional months.
It was also recommended by both the pan-Canadian Oncology Drug Review and the Quebec Institut national d’excellence en santé et en services sociaux, provided its cost-effectiveness could be improved.
In 2019, however, negotiations to fund the drug ended without agreement at the pan-Canadian Pharmaceutical Alliance (pCPA), an alliance of federal, provincial and territorial governments that negotiates on a range of public drug plan initiatives.
The reasons for the disagreement are confidential, but a written statement to Global News from the pCPA shed some light on the decision:
“When considering a drug, the pCPA has a responsibility to consider its clinical effectiveness, safety, cost effectiveness and affordability. We need to know that it will provide better health outcomes than existing medications, and that its cost reflects that benefit. We also need to make sure that we can continue to deliver that drug — not just for those who need it now but also for those who may need it in the future.”
Stefanie Condon-Oldrieve, director of the Craig’s Cause Pancreatic Cancer Society, said the pCPA ought to reconsider Onivyde — not only because Canada has funded more expensive cancer drugs in the past, but because of the difference it will make for Canadian cancer patients.
“This drug will offer them time with their families, time for potentially getting into clinical trials and looking at different treatment options. How can someone say no to that?” she asked.
“We’re really at a loss and we know that when asked why the decision was made, no one really knows. All we’re really is asking is that the regulators of this process go back to the negotiating table and take a second look at this.”