Canadian health plans, pharma firm agree on terms to fund costly prostate cancer treatment

An organization representing Canada's public drug plans has come to a deal with a pharmaceutical company over a cutting-edge means of treating prostate cancer, bringing hundreds of patients one step closer to receiving the potentially life-saving but costly treatment. 

In November, the Pan-Canadian Pharmaceutical Alliance (pCPA), which negotiates drug prices for provincial, territorial and federal health plans, and Novartis broke off negotiations, leaving patients without coverage for Pluvicto — the brand name for a treatment that kills cancer cells with the radioactive isotope lutetium-177.

But the two parties reopened negotiations and, earlier this month, signed a letter of intent that lists the terms and conditions for funding the treatment.

Now, it's up to individual provinces to determine whether hundreds of eligible prostate cancer patients will have coverage for Pluvicto, which Novartis offers at $27,000 per dose — putting the cost of an average five-dose treatment at $135,000.

Acting pCPA CEO Dominic Tan confirmed with CBC News that an agreement had been signed but said no further details about the negotiations could be shared. 

"The agreement with the pCPA for Pluvicto represents a significant milestone for patients with advanced prostate cancer in Canada who have exhausted all other treatment options," Novartis Canada president Mark Vineis said in an email.

He added it's up to the provinces to determine how quickly the drug can be covered for patients. 

"We have heard from patients, patient groups and health-care professionals about the pressing need for timely access to this treatment," Vineis said. 

According to the B.C. Cancer Agency, about 3,500 British Columbians are diagnosed with prostate cancer each year and 705 people died from the disease in 2021 alone.

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Jim Larson says Pluvicto keeps his prostate cancer at bay, but a dispute between the drug company and the pan-Canadian Pharmaceutical Alliance, an organization representing public health plans, means Larson's coverage won't pay for the treatment.

Pluvicto is one of the first lutetium-177 cancer treatments approved in Canada. 

The isotope is injected intravenously and disintegrates when it encounters a prostate cancer cell, emitting beta particles that shred the cell's nucleus.

Health Canada approved Pluvicto in 2022, and it's one of more than a dozen similar treatments reaching Canada's drug approval process. 

Chiming Chow, a spokesperson for B.C.'s Ministry of Health, said B.C. Cancer is now deciding whether to add Pluvicto to its drug benefits list. 

Chow said the formal process for adding cancer treatments to the list is rigorous, evidence based and can take time.

"We recognize the process can be long and this puts stress, including financial stress, on patients and their loved ones, especially at a time when they are facing health challenges," Chow said in an email.