Dube reform Concerns about access to exceptional medicines –

Dubé reform | Concerns about access to exceptional medicines –

(Quebec) Liberal MP André Fortin is concerned that the Dubé health reform is “complicating” access to exceptional medicines by adding “an incredible burden” to treating doctors. Concerns shared by the Regroupement québécois des Maladies Orphanes (RQMO).

Posted at 5:10 p.m.


The Pontiac MP called on Minister Christian Dubé to abandon certain legislative changes in his reform that affect the prescription of treatments for rare diseases. “The minister is making access to exceptional medicines more complex. We take the current regime and add a layer [pour les médecins] “, complained Mr. Fortin on Thursday.

Mr Fortin was accompanied by Julie Carignan, who suffers from a rare form of bile duct cancer. She fears that doctors will be discouraged by the steps required to justify the use of a drug whose therapeutic benefits are not recognized by the National Institute of Excellence in Health and Social Services (INESSS).

Section 336 of Bill 15 provides that a hospital’s Pharmacology Committee “shall not grant approval” for the use of a drug where INESSS has already submitted an adverse opinion to the Minister. If necessary, the doctor must then explain in writing “the potential for beneficial effectiveness of the drug and, on the other hand, the other reasons that justify his application”.

In addition, the doctor “must provide, in support of his application, scientific data showing that the drug he wishes to use significantly meets the user’s particular needs.”

“We are putting an incredible burden on the doctor who is prepared for him on a factual basis, perhaps with international studies.” […] to say, “Well, I’m going to try it on my patient,” laments Mr. Fortin. The RQMO is also concerned because “the vast majority of rare disease medicines receive negative views in terms of therapeutic value,” said Director-General Jonathan Pratt.

Dubé wants to be reassuring

In light of the concerns, Mr. Dubé presented an amendment that provides for an exception “when the taking of medication cannot be delayed” without the risk of “irreversible deterioration” of the patient’s condition. These articles are currently being examined as part of the detailed study of the reform proposal. These arrangements are inadequate in the eyes of Mr Fortin and Mr Pratt.

According to the RQMO, the “irreversible deterioration” criterion adds a “sense of urgency,” although this could limit access to medication for patients whose disease is slowly progressing.

However, Christian Dubé wants to reassure: “We have to stop scaring Quebecers.” No patient loses access to medication. Our priority is to ensure access to healthcare. We will not compromise on this,” the minister said in a statement to La Presse.

“We are now saying that doctors who want to prescribe a drug for which INESSS has received a negative opinion must provide a written opinion […] and he can continue to prescribe it. This does not affect medicines for which no advice has been given. We have also tabled another amendment this afternoon providing relief for doctors,” he argued.

The detailed examination of Bill 15, which aims to restore the health and social services network, continues on Tuesday October 3rd.