Patients with rare diseases or cancers could possibly lose access to their treatment due to certain provisions included in the health network reform proposed by Minister Christian Dubé.
Representatives of the Association of Councils of Physicians, Dentists and Pharmacists of Quebec (ACMDPQ) threw this stone into the pond, Thursday, during their visit to the parliamentary committee.
Towards the end of his presentation, the president of the association, Dr.r Martin Arata, asserted that section 336 of Bill 15 “changes access to drugs” and that it would result in a patient no longer being able to access treatment that had “not been given a value therapy authorized by [l’Institut national d’excellence en santé et services sociaux] (INESSS).
He added that if this provision was currently in force, “many patients would not have had access to chemotherapy treatments, treatments for orphan diseases in pediatrics”, he gave as an example. The Dr Arata estimated that over the past two years, at the CHU de Québec alone, more than forty patients with cancer or pediatric diseases have not had access to their medication.
When reacting to the presentation and questioning the members of the ACMDPQ, the Minister of Health, Christian Dubé, did not address the subject. Rather, he challenged the speakers on the role of doctors, the organization of work and interdisciplinarity.
Loss of agility
A few moments later, during an exchange with Québec solidaire MNA Vincent Marissal, Dr.r Jean Beaubien revealed that he had just emailed colleagues — as the board was running behind schedule — to approve medication for a lymphoma patient.
“There was a recommendation, a therapeutic refusal from INESSS, in 2021, on this drug for this indication, explained the anesthetist and vice-president of the ACMDPQ. Since that time, there is new literature and there is an indication or a possibility of giving it. »
In current practice, if the use of a drug has not been recommended by INESSS, but the pharmacological committee of a hospital has become aware of new favorable scientific literature, it may decide to go forward and administer the treatment to the patient.
one sentence
According to what the association denounces, it is the addition of a single sentence in section 336 of the bill to make the health and social services system more efficient that changes everything.
In the new version of the law, we seem to want to keep this leeway granted to establishment doctors and pharmacists, except that we can read in article 336 that:
“The committee cannot grant its authorization if the National Institute of Excellence in Health and Social Services has, in an opinion to the Minister, refused to recognize the therapeutic value of the drug for the therapeutic indication that is the subject of the application. authorization. »
It is precisely this new passage that we want to see disappear, confirmed the Dr Beaubien in an email sent to The Canadian Press.
“If INESSS issued an opinion in 2020, for example, and new scientific literature now supports the administration of the drug, the committee cannot grant authorization,” he interprets.
For his colleagues and himself, this is a loss of agility since the scientific literature is improved every day while the recommendations of INESSS or Health Canada take a lot of time.
According to the Dr Beaubien, this reality is observed especially in oncology, where research is evolving rapidly and where the ways of treating cancers are increasingly personalized.
The Canadian Press tried to obtain the position of the Association of Pharmacists of Quebec Health Institutions (APES), which is directly affected by this change. In a written response, the association indicated that it preferred to reserve its comments for its testimony scheduled for May 23 before parliamentarians.
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