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The national body that reviews new drugs, including cancer drugs, for value and recommends to every province except Quebec whether, and on what conditions, the public plans should pay for them; formerly CADTH.
Canada's Drug Agency, formerly the Canadian Agency for Drugs and Technologies in Health (CADTH), carries out the health technology assessment between Health Canada's licence and the provinces' funding decisions. For cancer drugs that work began as the Joint Oncology Drug Review, run from Ontario between 2007 and 2010, became the pan-Canadian Oncology Drug Review (pCODR) in July 2011 and was later absorbed into CADTH, where the pCODR Expert Review Committee makes the final recommendation; recommendations are not binding, Quebec uses its own institute (INESSS) instead, and a positive recommendation is followed by price negotiation through the pan-Canadian Pharmaceutical Alliance.
Independent analyses describe what it decides. Between 2011 and 2020 pCODR issued 104 final recommendations on solid-tumour cancer drugs, 75 per cent positive and 92 per cent of those conditional; half of the positively recommended drugs had shown an overall survival benefit, with a median gain of 3.7 months. A study of 88 cancer indications found that after pCODR began the median time from licence to provincial funding fell from 522 to 393 days and agreement between provinces rose. Of 49 cancer drugs licensed through Project Orbis that CADTH reviewed between 2019 and 2023, 44 were conditionally recommended. In September 2023 the agency introduced a time-limited recommendation for conditionally licensed drugs, used with the alliance's temporary access process.
The agency's own website answered every scripted request from OnCo with a browser challenge, so this record is built from those published analyses rather than from its own documents; its methods guidance, including any willingness-to-pay value it uses, has not been read.
Running review and price negotiation at the same time can cut months off how long a new cancer drug takes to be paid for in Canada, but by the end of January 2025 only one drug had used the route.
Shared regulatory review gets cancer drugs licensed in Canada sooner, but licensing is only the first step; access depends on the value review and price negotiation that follow.
Approval in Canada is not access: a licensed cancer drug still has to pass a value review, a joint price negotiation and a provincial listing, and where you live decides how a take-home drug is paid for.
Canada's cancer drug review filters out some weak evidence, but a positive recommendation does not mean a drug has been shown to extend life; patients and clinicians should look at the trial result behind each funded drug.
A conditional Canadian licence means the evidence was early; the confirmatory evidence may never arrive, and the licence is not withdrawn when it does not.
A single national review made funding of cancer drugs faster and more alike across provinces, though it still took more than a year from licence to funding.
Shares Impact of the pan-Canadian Oncology Drug Review on provincial concordance and time to funding, Accelerating oncology drug reimbursement in Canada: the time-limited recommendation and temporary access process, Conditional approval of cancer drugs in Canada: accountability and impact on public funding, The pathway for new cancer drug access in Canada.
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