A Vision for Access
April 22, 2024
Dr. Joanna Gotfrit works tirelessly to improve patients’ access to innovative cancer therapies
Canada’s complex drug approval and funding process sometimes leads patients to experience long delays before their oncologists can prescribe the drugs that could change their lives. For Dr. Joanna Gotfrit, a medical oncologist at the Ottawa Hospital Cancer Centre, the status quo leaves a lot to be desired. “As our population continues to age, I worry about increasing wait lists for care, especially for life-altering diseases such as cancer.”
It’s no coincidence that Dr. Gotfrit, who serves as an Ontario Medical Association representative for her region and specialty, focuses her research on drug funding and regulation. In one analysis, she and her colleagues examined the delays in access to 21 innovative drugs for advanced lung, breast, and colorectal cancers. Their conclusion: largely driven by the lag time from proof of efficacy to first public reimbursement, these delays cost patients a total of 39,000 life years. Not just that, but the delays varied from region to region. “We would hope that all eligible patients in Canada would have access at the time of first public funding, but in reality provinces fund drugs at different time points, and some may not fund them at all.”
“We would hope that access is consistent across Canada, but in reality provinces fund drugs at different time points.”
Access is not just about timing, but about choice: having the best possible treatment available to each patient. Dr. Gotfrit saw this play out in her own clinical practice when one of her young patients faced a diagnosis of colorectal cancer, decades before most people receive such news. Molecular tumour testing identified the patient as a candidate for a cancer immunotherapy that had shown impressive results in clinical trials. Dr. Gotfrit describes the development of such treatments as a “huge step forward. Instead of chemotherapy, which ‘shoots to kill’ any type of rapidly dividing cells and leads to highly bothersome side effects, immunotherapy can more directly target certain tumours.”
The treatment made all the difference for the patient: his tumour went away. “It’s hard to describe how good it feels when you make a clinical decision and get these kinds of results,” says Dr. Gotfrit, adding that she couldn’t have done it without the support of her colleagues at the Ottawa Hospital, who “wouldn’t settle for the old standards and were willing to think outside the box.”
Dr. Gotfrit hopes such outcomes will spur Canada’s single-payer system, which she holds in high regard, to “continue to evolve and offer better and more equitable access for our patients with cancer.” After all, “fairness is embedded in the Canadian psyche.”