between People with Early Stage Breast Cancer and People Living with - PowerPoint PPT Presentation

DRUG ACCESS: How the Challenges Differ between People with Early Stage Breast Cancer and People Living with Metastatic Breast Cancer C a n a d i a n B r e a s t C a n c e r N e t w o r k D i a n a E r m e l

Patient-Directed We are the only national pa patient- dir directed breast cancer health charity. What does this mean? Our board of directors have all personally experienced a breast cancer diagnosis; we understand what the needs of patients and families are because we’ve been there .

DISCLOSURES CBCN received unrestricted educational grants from: Full Circle Foundation for Wellness, Amgen, Astra Zeneca, Novartis, Pfizer, Roche, Healthy Cravings, & United Awareness Group for this project.

Aly ly Sc Schneid ider Feb eb 28, , 1981 - Ja Jan 19, , 2017

DATA SOURCE • CBCN conducted a survey in 2017 of both early stage and metastatic breast cancer patients to better understand the lived experience of both patient population; where similarities existed and where they differed. • Results of this survey were published in the 2018 report “Breast Cancer: The Lived Experience” which is available at www.CBCN.ca • For the purpose of this survey Early Stage included Stage I, II and III.

KEY FINDINGS 1. The PATIENT EXPERIENCE varies significantly between patients with early stage breast cancer and those with metastatic breast cancer 2. PRIORITIES and PREFERENCES are also notably different between being treated in the curative setting vs. a non-curative setting. This presentation will focus on these experiences, priorities and preferences as they relate to DRUG ACCESS.

PATIENT PROFILE EARLY STAGE METASTATIC

PATIENT PROFILE EARLY STAGE METASTATIC

DEMOGRAPHICS EARLY STAGE METASTATIC Provincial/territoria ial representation Provinci cial/territoria ial representation Al Albe bert rta 6%, 6%, Br Brit itis ish Colum Columbia ia 8%, 8%, Manit Manitob oba Alberta 12 Alb 12%, , British sh Columbia 11 11%, , Mani anitoba 8%, Ne 8%, New Br Brun unswick 3%, 3%, Ne Newfoun undla land & 7% 7%, , New Brunswick 2% 2%, , Newfoundland & Labr Labrado dor 5%, 5%, Nor Northwest Terr rrit itorie ries 1%, 1%, No Nova Labrador 1%, Lab , Nor orthwest Terr erritories 0%, , Nova Sc Scot otia ia 9%, 9%, Nuna Nunavut 0%, 0%, Ontar ario io 24 24%, Princ ince Sc Scotia 2% 2%, , Nunavut 0% 0%, , Ontario 40 40%, , Prince Edw dward Isl sland and 2%, 2%, Qué Québec 17 17%, Sas Saskatchewan Edw dward Islan sland 2% 2%, , Qu Québec 15 15%, , 15 15% and and Yuk ukon 0. 0.41 41% Saskatchewan 7% Sas 7% and and Yukon 0% 0% Level of of Education: Level of Le of Educatio ion: 86 86% of of respo spondents s had had po post-se secondary ry 83 83% of f respondents ts ha have pos post-secondary educ ducatio ion educ ducatio ion Annual Ann l Ho Hous usehol old Inc ncome: Ann Annual l Ho Hous usehol old Inc ncome: 26% 26% - $1 $100 00,000 or hi high gher 30% 30% - $1 $100 00,000 or hi high gher 25% 25% - $6 $60,0 0,000 - $1 $100 00,000 25% - $6 25% $60,0 0,000 - $1 $100 00,000 21% 21% - und under $6 $60, 0,000 19% - unde 19% under $6 $60,0 0,000

PRIVATE INSURANCE EARLY STAGE METASTATIC

COST OF CANCER TREATMENT TO PATIENTS EARLY STAGE METASTATIC 39% of people with metastatic breast cancer were prescribed 14% of people with early stage breast cancer were cancer medications that were NO NOT covered through the public prescribed cancer medications that were NO NOT covered health care system. through the public health care system. 8% of people with metastatic breast cancer did 1% of people with early stage breast cancer did did NO NOT take a did NO NOT take a prescribed cancer medication due to cost. prescribed cancer medication due to cost.

COST OF SUPPORT MEDICATION TO PATIENTS EARLY STAGE METASTATIC 32% of people with early stage breast cancer were prescribed 85% of people with metastatic breast cancer were prescribed suppo support rt medications that were no not covered through the public support medications that were no not covered through the public health care system. health care system. 2% of patients did 7% of patients did did no not take a support medication due to cost. did no not take a support medication due to cost.

“I’m concerned with how long it takes to get a treatment approved and on the public health care lists and with the high cost of new treatments that have become available but are not yet covered under the public health care lists” ~ Patient living with metastatic breast cancer

HOW PATIENTS COVERED COSTS OF CANCER MEDICATIONS EARLY STAGE METASTATIC

HOW PATIENTS COVERED COSTS OF SUPPORT MEDICATIONS EARLY STAGE METASTATIC

IMPACT OF DRUG COSTS ON QUALITY OF LIFE • Respondents living with metastatic breast cancer were asked how much of an impact prescription medication costs had on their quality of life. • Results show that over 50% of people living with metastatic breast cancer had their quality of life impacted as a result of the cost of prescription medications.

FINANCIAL IMPACT EARLY STAGE METASTATIC 64% 64% exp xperie ience ced a a neg negative fin inanci cial impact ct 82% 82% exp xperie ience ced a a neg negative fin inanci cial impact ct

“I was in financial hardship and had to contact my credit card companies and speak to them about payment because we went from two incomes to one.” ~ Patient with early stage breast cancer “When medications aren’t covered, it is a tremendous financial burden, especially when I wasn’t working.” ~ Patient living with metastatic breast cancer

“If you do not have private insurance, or are out of pocket until someone can help you, I’m not sure how people get through it.” ~Patient with early stage breast cancer

KEY TAKE-AWAYS • Peo eople liv ivin ing wit ith metastatic ic br breast cancer ar are e 3 3 tim imes s mor ore lik ikely than ear early ly stage pa patie ients to to be be pr prescrib ibed cancer treatments that ar are no not t pu publi licly ly fu funded. . This s is s a a barr barrier that acc accounts for or 8% 8% of of peo people living wit ith metastatic br breast t cancer r no not t takin ing the cancer treatment rec ecommended by y their ph physic icia ian. • There is s an an increase sed ch chall llenge for or al all l br breast cancer pa patie ients to to ac access s sup support med edications through th the pu public hea health car are system. • It It is s important to to rec ecognize the cr crit itical role ole pl played by pr priv ivate insurance an and man anufacturer pa patient assis assistance pr programs in n faci acilitatin ing affordable le ac access to to cancer med edications an and sup support med edicatio ions, , part particularly in the metastatic se setting. • Dru Drug cos osts s neg negatively ly impact the qu qualit ity of of lif ife of of over ha half lf of of peo people le liv iving with th metastatic br breast cancer. . • A br breast t cancer dia diagnosis s neg negatively ly impacts the fi finances of of bo both th the ear early ly stage an and metastatic pa patient populations; having to pay for drugs that aren’t publicly covered fu further exacerbates th this is impact. 20

RECOMMENDATIONS • Cancer medications be covered through public health systems, particularly for metastatic breast cancer patients who experience the largest gap in public coverage. • New breast cancer therapies be added to public formularies in a timely manner to allow for patient access to innovative, life saving or extending treatments and not creating barriers to new therapies which are especially critical to the metastatic population • Support medications be accessible to all cancer patients to ensure optimal quality of life and minimize the risk of adverse events.

T H A N K Y O U w w w . c b c n . c a Diana Ermel +1 (613) -230-3044 Cbcn @cbcn.ca