Opinion: Drug Access Navigators (DANs) take key financial stress away from patients (2024)

Drug Access Navigators help people with cancer get financial support for treatment and almost every cancer clinic in Canada has one.

by Alan Birch

Jan 19 2024

Opinion: Drug Access Navigators (DANs) take key financial stress away from patients (1) 4 minute read

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Opinion: Drug Access Navigators (DANs) take key financial stress away from patients (3)

Cancer patients should be able to see a DAN to understand the financial implications of their treatment. GETTY

Drug Access Navigators (DANs) or Medication Reimbursement Specialists (among other similar titles) are a critical part of the healthcare team, helping connect patients with cancer with financial support for their medications.

This meansassisting them with applying for approval from a private drug plan or making an application to a government program; getting authorization from the provincial or federal government for a medication; or filling in the financial gaps where private or public plans don’t fully cover a drug’s cost.

DANs speed up the time to access treatment for patients, which is critical in oncology. They save patients money at a stressful and confusing time, when they most need support. And perhaps paramount, DANs let patients focus on themselves and treatment, rather than worrying if they can get a certain medication, or who will pay for it. It’s because of these things that oncologists regularly comment on how much better their patients are because of their clinic’s navigator. (Currently in Canada, DANs are only available in the area of cancer, although there is hope to expand other health conditions, like mental health and rare diseases.)

New drugs and therapies, paperwork make drug access complicated

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Perhaps in an ideal world, the Ministry of Health would pay for all cancer treatments, with no criteria or authorization needed. Until that day, our Canadian healthcare system will be complicated and fragmented for patients to navigate.

In the past few decades, there has been a plethora of new cancer drugs — highly specialized drugs, new classes of drugs, new targeted therapies. Often, they’re given together in combination of two or three. This has also meant an increase in Patient Support Programs (PSPs) that support these drugs. In fact there are now dozens of drug manufacturer PSPs available to provide various services for patients.

And since cancer drugs need approval for usage by public and private payors, the paperwork associated with these approvals — which would take physicians hours per week — come at a high cost. Fortunately, this is taken on by DANs, allowing them to spend more time seeing more patients.

The reality is oncologists don’t know the cost of every treatment. They don’t know all the programs available to every patient. They don’t know what a patient’s private drug plan will pay for — and they don’t need to know if there is a DAN available in their centre. On a multidisciplinary healthcare team, everyone has an expertise: the pharmacist, the nurse, the dietitian, and the social worker, among others, all have specific areas of knowledge, providing better patient care as a unit. Just like a patient would see their pharmacist to understand how to take their medication and if it will interact with other medications, they should be able to go to see a DAN to understand the financial implications of their treatment, get financial assistance and also make sure they’re paying the appropriate amount.

How to contact a DAN

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Almost every cancer clinic in Canada has a drug access navigator. They may have a different title, but they’re there. If you have not seen one, there might be a financial benefit to meeting with one — just ask your physician, nurse or others on your care team.

There are also associations online that can connect you with a DAN, such as the Oncology Drug Access Navigators of Ontario (ODANO) , Association québécoise des coordonnateurs d’accès aux médicaments en oncologie (AQCAMO), Atlantic Canada Oncology Drug Access Navigators of Atlantic Canada (ACODANA), and Drug Access Canada (DAC) .

What happens when you don’t meet with a DAN

When patients don’t have the opportunity to meet with a drug access navigator, they often end up paying out-of-pocket for their drug or their copay or deductible when they don’t need to.

Consider this scenario. An oncologist has a patient with a private drug plan, so they assume that the plan will cover the cost of the drug. The patient goes to their pharmacy to fill the prescription and finds out that it costs $1000 per month and that the plan only covers $700 of that amount. The patient pays $300 out of their own pocket, assuming that is just the way it is. But had this patient seen a DAN, they would have been connected to the drug’s PSP that would have likely covered the remaining $300. Instead, they will be paying $3600 per year that they don’t have to. This could mean the difference between being able to stay on the drug or not, deciding not to pay other bills — like a mortgage — in order to afford treatment and impacting whether or not they get the most effective treatment possible.

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Another situation that often arises is that patients are told they do not qualify for their province’s drug plan and they end up paying for their cancer drugs instead. This is not true. For example, in Ontario, if you have an OHIP card, you qualify for Trillium. Still, the news is full of stories of patients who have been paying full price for their oral cancer drugs when Trillium was available all along. With Trillium, or other provincial drug plans, plus a manufacturer’s patient support program, you may not pay anything at all.

No patient should have to pay a dollar more than is necessary for treatment. If you are living with cancer and have not consulted with a DAN, ask your nurse or oncologist to be connected with on. If you’re paying out of pocket for your drugs, you may not need to. And if you’re a healthcare provider, check to see if your patient is paying out of pocket for their medication. If they are, did they miss an opportunity to see your centre’s DAN?

Financial toxicity is the harmful effect of high treatment costs on a person’s quality of life. It is a reality in Canada, but there is help.

Alan Birch is a former Drug Access Navigator from North York General Hospital. He currently works at Sentrex Health Solutions and is the founder of Drug Access Canada.

I am an expert and enthusiast. I have access to a wide range of information and can provide assistance on various topics. I do not have personal experiences or expertise, but I can provide factual information based on reliable sources.

Now, let's discuss the concepts mentioned in the article you provided:

Drug Access Navigators (DANs) or Medication Reimbursement Specialists

Drug Access Navigators, also known as DANs, are healthcare professionals who play a critical role in connecting cancer patients with financial support for their medications. They assist patients in applying for approval from private drug plans or government programs, obtaining authorization for medications, and filling in financial gaps when drug costs are not fully covered by private or public plans.

Role of DANs

DANs help cancer patients access treatment more quickly, saving them money during a stressful and confusing time. By assisting with financial support, DANs allow patients to focus on their treatment and well-being without worrying about medication costs.

Expansion of DANs

Currently, DANs are primarily available in the area of cancer in Canada. However, there is hope to expand their services to other health conditions, such as mental health and rare diseases.

Complexity of Drug Access

The Canadian healthcare system can be complicated and fragmented for patients to navigate, especially when it comes to accessing cancer treatments. The introduction of new cancer drugs, specialized therapies, and the need for approval from public and private payors have increased the complexity of drug access. This has led to the establishment of Patient Support Programs (PSPs) by drug manufacturers to support patients. DANs help alleviate the burden on physicians by handling the paperwork associated with drug approvals, allowing them to spend more time with patients .

Importance of DANs

Oncologists may not have comprehensive knowledge of the cost of every treatment or all available programs for patients. By consulting with a DAN, patients can better understand the financial implications of their treatment, receive financial assistance, and ensure they are paying the appropriate amount. DANs provide valuable expertise in navigating the financial aspects of cancer treatment, helping patients avoid unnecessary out-of-pocket expenses and ensuring they receive the most effective treatment possible .

How to Contact a DAN

Almost every cancer clinic in Canada has a drug access navigator. Patients can inquire about the availability of a DAN by asking their physician, nurse, or other members of their care team. There are also online associations, such as the Oncology Drug Access Navigators of Ontario (ODANO), Association québécoise des coordonnateurs d'accès aux médicaments en oncologie (AQCAMO), Atlantic Canada Oncology Drug Access Navigators of Atlantic Canada (ACODANA), and Drug Access Canada (DAC), that can connect individuals with a DAN.

Consequences of Not Meeting with a DAN

When patients do not have the opportunity to meet with a drug access navigator, they may end up paying out-of-pocket for their medication or covering copays and deductibles unnecessarily. For example, patients may assume their private drug plan will cover the cost of a drug, only to find out that they are responsible for a significant portion of the cost. By consulting with a DAN, patients can be connected to drug manufacturer PSPs that may provide financial assistance, potentially saving them from unnecessary expenses and ensuring they can continue their treatment .

In conclusion, Drug Access Navigators (DANs) play a crucial role in helping cancer patients navigate the complex landscape of accessing medications. They provide financial support, assist with paperwork, and ensure patients receive the most effective treatment possible. DANs are available in almost every cancer clinic in Canada, and patients can inquire about their services through their healthcare providers or online associations. Consulting with a DAN can help patients avoid unnecessary out-of-pocket expenses and ensure they receive the financial assistance they need for their treatment.

Opinion: Drug Access Navigators (DANs) take key financial stress away from patients (2024)
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