Oncology Clinical Operations in Canada

The nature and structure of our health care system in Canada results in patients being followed at the same center throughout the evolution of their disease.

• This represents a competitive advantage because we can easily access historic data in order to precisely project enrollment performance.
  • We do not solely rely on medical teams’ ‘gut feeling’ when identifying potential sites, and projecting enrollment.
  • We rely on actual data, such as pharmacy lists of patients having received/receiving a certain line of therapy, lists of patients pending surgery, etc.
  • Pre-screening efforts are also facilitated because we can access specific sources of patients (example: follow-up on patients having received a 1^st line therapy and ‘catch’ then when they progress).

• Canadian oncologists do not compete for patient care.
  • Oncology patients are cared for within a network of cutting-edge comprehensive cancer centers across the country
  • Oncologists have established referral systems, both within their own sites as well as from multiple regional institutions.
  • Taping into these referral systems increases access to specific disease indications – optimizing enrolment for orphan/micro populations.
    • Physicians and oncologists from nearby centers will happily refer patients to a care center running a trial

• Provincial reimbursement plans for certain drugs represent a significant advantage for sponsors wanting to compare their therapy to a standard of care (SOC) regimen.
  • In some instances where (SOC) therapy is already reimbursed by the provincial public health care plan, sites will not charge the sponsor for the cost of the standard treatment, resulting in significant savings.
  • In instances where site policies require the sponsor to cover the cost of (SOC) regimen, sites will invoice the sponsor at cost, and will use their locally commercial stocks. This scenario still represents a big advantage since no drug import cost or duties are incurred.
  • It also simplifies study drug logistics and procedures:
    • No need for additional distribution centers, import or management.
  • Due to therapies availability (or unavailability) Canada has a large novel therapy naïve population.
    • These patients can significantly contribute to certain cohorts for which enrollment is harder at US sites, thus reducing recruitment delays and associated costs.

Over the past 20 years Scimega has developed strategies and established a strong collaborative network with the leading oncology sites across Canada.

 Contributed by: Ms. Julie Martin, Director, Clinical Operations