Clinician Perspectives of COVID-19-Related Cancer Drug Funding Measures in Ontario.

Rohini D Naipaul,Rebecca E Mercer,Lyndee Yeung,Scott Gavura,Leta Forbes,Kelvin K W Chan

doi:10.3390/curroncol28020103

Abstract

The COVID-19 pandemic has a significant impact on cancer patients and the delivery of cancer care. To allow clinicians to adapt treatment plans for patients, Ontario Health (Cancer Care Ontario) issued a series of interim funding measures for the province’s New Drug Funding Program (NDFP), which covers the cost of most hospital-delivered cancer drugs. To assess the utility of the measures and the need for their continuation, we conducted an online survey of Ontario oncology clinicians. The survey was open 3–25 September 2020 and generated 105 responses. Between April and June 2020, 46% of respondents changed treatment plans for more than 25% of their cancer patients due to the pandemic. Clinicians report broad use of interim funding measures. The most frequently reported strategies used were treatment breaks for stable patients (62%), extending dosing intervals (59%), and deferring routine imaging (56%). Most clinicians anticipate continuing to use these interim funding measures in the coming months. The survey showed that adapting cancer drug funding policies has supported clinical care in Ontario during the pandemic.

Highlights

Evidence that has emerged to date suggests cancer patients may be at a higher risk of contracting SARS-CoV-2, may have an increased risk of developing severe COVID-19 illness, and may have a higher fatality rate compared to the general population [1,2,3,4,5,6,7]
The survey addressed three topics: (1) What proportion of patients had their treatment plans modified? (2) What management strategies were used in the first wave of the pandemic? (3) Which management strategies did clinicians anticipate using in the 3 months? Each interim funding measure was mapped to a specific survey question
Between April and June 2020, 46% of respondents changed treatment plans for more than 25% of their cancer patients due to the pandemic

Summary

Introduction

The implications of the 2019 novel coronavirus disease (COVID-19) pandemic are of significant concern to the cancer community. Evidence that has emerged to date suggests cancer patients may be at a higher risk of contracting SARS-CoV-2, may have an increased risk of developing severe COVID-19 illness, and may have a higher fatality rate compared to the general population [1,2,3,4,5,6,7]. Prescribers are challenged with balancing the risks and benefits of treating cancer patients who are impacted, both directly and indirectly, by COVID-19. As countries try to contain the spread of COVID-19 and manage active COVID-19 infections, cancer patients may face treatment interruptions or delays in accessing standard diagnostic procedures and treatment modalities, including curative surgeries, radiation, and systemic therapies [8,9,10,11,12]

Methods

Discussion

Conclusion