There has been much talk lately about Canada not attracting sufficient clinical trials in oncology. This is a problem. A big problem.
Clinical trials, are literally the lifeline to new treatments. They are usually designed for those who have exhausted all funded and known treatments and now must try something experimental with the hope of extending survival. For physicians, this is a way of not only offering an additional line of therapy to patients who need it, but a way to familiarize themselves with a drug, that may become part of their arsenal in the future. Also, clinical trials cover all the associated treatment costs, which is a nice financial reprieve for hospitals.
There are many reasons why we are not attracting clinical trials. In my point of view, these are 2 of the many key issues.
First, we have lost our status in the world markets. Canada is not a lucrative market. In fact, it can be detrimental to lucrative markets, as countries now choose to launch here after the US and EU due to reference pricing. There is so much pressure on pricing in Canada, that some companies do not even launch here.
Secondly, the fact that we do not run molecular biomarker tests such as Next Generation Sequencing (NGS) on all patients, is also an issue. NGS, or other screening tools, not only offers a precision oncology approach to patient care, but arms hospital with data that can attract in-bound clinical trials. How can you attract a trial for a certain genomic profile, if you don’t even know what % this profile represents of a cohort of cancer patients? You need retrospective data, as no company is going to keep its fingers crossed in the hope that you accrue enough patients.
These gaps, in addition to others, are hindering our ability to attract clinical trials. More importantly, patients are losing out on the chance to access cutting edge therapies. It’s a lose/lose situation.