RPhT, Drug Access Navigator, Oncology Drug Access Navigators of Ontario
My name is Craig Woudsma, and I am a Director and team-lead for ODANO. I’m a Registered Pharmacy Technician with almost 20 years’ experience and I’ve worked in oncology pharmacy for the past decade. In 2017 I became the Drug Access Navigator for my centre’s oncology clinic, as well as a member of Oncology Drug Navigators of Ontario (ODANO). What is ODANO, and what role does a drug access navigator play in a patient’s cancer journey?
Oncology medications, both active therapy and supportive care, can be expensive. The question I hear most often is, “how am I going to pay for this?”
The answer to this question is rarely straightforward. The drug funding landscape in Ontario involves many potential payers — the patient notwithstanding — including but not limited to a variety of public drug plans, private insurance plans, and manufacturer-sponsored patient support programs. Within this network of payers is a complex, and often changing, drug authorization process. Each payer has its own submission processes, eligibility criteria, and limitations. Guiding the physician and patient through this web is the role of the hospital-employed drug access navigator, facilitator, or reimbursement specialist.
What exactly does the drug access navigator (DAN) do?
The process starts with a referral, either from the physician, nurse, pharmacist, or sometimes even the patient themselves seeking out the service. The DAN starts by determining if the patient has any drug coverage. This could be private insurance, provided by their employer, or one of the many public plans provided by the provincial government such as OHIP+ or ODB Seniors. If the patient doesn’t have insurance and is between the ages of 24 and 65, then the DAN will assist them in applying to the Trillium Drug Program; another public plan available to residents of Ontario.
The next step is determining if the medication is covered by the coverage that has already been established — is it a general benefit medication or does it require prior authorization? If going through a private plan, do they have full coverage or a percentage copay? Do they have an annual or lifetime drug cost maximum? Does the medication have an associated patient support program that can help mitigate these costs? Is bridging or compassionate access available? Does the medication need to be imported through the Health Canada SAP process?
The DAN pieces together this patchwork, which often requires a lot of paperwork, faxing, phone calls, and emails, until access is determined. Our goal is to get the medication to the patient at little-to-no cost and remove any worry about the process as they invariably have many other concerns regarding their cancer journey.
Does my clinic have a DAN?
All Ontario cancer clinics have access to a DAN as recommended by Cancer Care Ontario’s Summary: Quality and Safety Recommendations for Enhancing the Delivery of Take-Home Cancer Drugs in Ontario.
These drug funding experts have been in place for many years prior to this recommendation. In fact, ODANO was founded in 2007 to help support the roughly 50 DANs across the province at the time. Our membership now exceeds 120 navigators.
What is ODANO?
The Oncology Drug Access Navigators of Ontario (ODANO) is a non-profit provincial organization founded with the specific purpose of providing support, educational resources, and ongoing training for our members as they endeavor to remove the financial burden from patients during their cancer treatment.