Disparities in access to precision oncology drugs across Canada and between Canada and the US, 2009-2025

In a unique funding initiative called Patient Voices inResearch, the Marathon of Hope Cancer Centres Network (MOHCCN) asked a group ofpatients from across Canada to develop themes for a research agenda and toselect the successful applicants. One theme was equity and disparities inaccess to precision medicine. I was a survivor-investigator in a study selectedto systematically document the approval process for new cancer drugs in Canadaand disparities in access between Canada and the U.S. and among provinceswithin Canada. Canadian cancer patients often hear about new oncology drugsthrough announcements that the FDA has approved a drug for use in the U.S.Because Canada has its own drug approval process, a drug approved in the U.S.may not be available in Canada. Furthermore, each Canadian province decideswhich drugs to fund under its health plan. Our research team, led by oncologistBishal Gyawali at Queen's University in Kingston Ontario, conducted aretrospective cohort study of adult solid-cancer approvals by the FDA andHealth Canada from 2009 to 2025 to identify where delays happen. Criticalvariables were time to approval, time to funding decision, and availability ofeffective anti-cancer drugs. We calculated the magnitude of clinical benefit foreach drug based on the validated ESMO-Magnitude of Clinical Benefit Scale toassess whether the delays would likely affect patient outcomes. My posterhighlights key research findings and how they can be applied to policies toaddress patients' concerns about inequities in access to cancer drugs.