The Government of Quebec's Ministère de la santé et des services sociaux has approved the addition of Revlimid(R) (lenalidomide) to the Province's Drug Formulary as a third-line therapy for multiple myeloma patients. The cost of the drug will be reimbursed under the Province's medicare system.
In a decision made public on February 1, 2010, the Province's Conseil du médicament published a detailed analysis which concluded that, based on supposed uncertainties related to cost and cost benefit, Revlimid would not be funded as second-line therapy.
John Lemieux, President of Myeloma Canada, commented: "The Conseil's decision, driven solely by cost considerations, sets Quebec apart from every jurisdiction that has approved Revlimid for public funding. Revlimid (with dexamethazone) is a second-line therapy in Ontario, British Columbia, Alberta and Saskatchewan and in a number of other international jurisdictions. The Conseil recognizes the therapeutic value of Revlimid, but ignores that fact. In so doing, the Conseil has failed to recognize that denying patients access to Revlimid until they have relapsed twice after other treatments means patients will not get the best therapy when they would most benefit from it. Keeping Revlimid from patients until later in the disease process will shorten their life expectancy and affect their quality of life."
The Conseil will also impose stricter eligibility requirements than in other jurisdictions, mandating an initial four-month trial period (compared to six months in other jurisdictions), before approving additional six-month cycles. Under the Conseil's rules, if a patient's disease progresses beyond narrowly defined limits in the initial or in a subsequent cycle, medicare funding of Revlimid for that patient will be discontinued.
Mr. Lemieux added: "Given how much the Province spends on other less effective drugs to treat non-life threatening diseases, this is an unacceptable setback for the myeloma patient community."
Myeloma Canada had joined other stakeholders in an advocacy campaign to obtain the approval of Revlimid on the same conditions as in other provincial jurisdictions. "We met with Quebec's Health Minister, Dr. Yves Bolduc, and believed that we had made a strong case for Revlimid as second-line therapy. We welcome the news that Revlimid has been approved after earlier non-decisions by the Conseil, but we will redouble our efforts to ensure that Quebec's multiple myeloma patients have appropriate access to Revlimid when they and their physicians believe it would be most beneficial to them.", Mr. Lemieux stated.