Dear Minister Duclos,

I am writing today to address the need for public reimbursement of treatments for ALK+ non-small cell lung cancer patients. After recently viewing the lung cancer advocacy video developed by the Lung Health Foundation, I would like to express my support for improving access to treatments for Canadian lung cancer patients. 

As illustrated in the video, targeted treatments including Lorlatinib and Brigatinib drastically improve patients’ quality of life. Accessing these innovative treatments is critical to the survivorship of ALK+ lung cancer patients, especially in the absence of special access, compassionate programs and clinical trials.

While over 20 jurisdictions including the United States, Australia, Europe, and most parts of Asia have already approved and secured public funding for Lorlatinib and Brigatinib, Canada still has no public coverage for these drugs.

As a result, patients in Canada must pay significantly more for these medications and experience substantially longer delays in treatment, which lead to shorter overall survival times and higher mortality rates.

Today, ALK+ non-small cell lung cancer patients enjoy one of the best overall survivals amongst lung cancer patients in countries like the United States and France due to early access to treatments. Though they are a unique subgroup of lung cancer patients that represent only 2-4% of all incurable lung cancers in Canada, they deserve the same quality of care and opportunities that are available to patients in other parts of the world.

A major reason for the longer overall survival in patients in the US and Europe has been the use of sequential targeted therapy. When one drug stops working, another ALK therapy is started. In this current situation in Canada, after first-line treatment, no second or subsequent line of ALK treatments has received a positive recommendation by the Canadian Agency for Drugs and Technology in Health (CADTH).

CADTH has issued a negative recommendation for both Lorlatinib and Brigatinib in the second line citing insufficient data. With such a small proportion of patients being ALK+, the requirements around comparative clinical trial data cannot be reasonably met.

I urge your government to re-evaluate the funding recommendations made for these treatments and give ALK+ lung cancer patients a fighting chance against their disease. The current situation has given way to significant inequities across the country and ALK+ patients risk regressing even further as certain compassionate programs end. The Ministry of Health must take immediate actions to increase availability and affordability.

I appreciate your attention on this important matter.