Science has enabled personalized and promising cancer treatments. The challenge now lies in whether the insurance industry can absorb the cost.
In 2024, 247,100 Canadians were diagnosed with a first or new cancer, and 88,100 others died from the disease, said Justine Côté, pharmacist and head of pharmaceutical expertise and management of high-cost drugs at Beneva.
The disease remains the leading cause of death in the country, she pointed out during the session Science is slowing cancer, but costs remain, held in February at the Group Conference, an event organized by the Insurance Journal Publishing Group at the Palais des congrès de Montréal.
“Twenty-two per cent of Canadians are projected to die from cancer,” said Côté, adding that the disease does not discriminate: it affects 45 per cent of men and 44 per cent of women.
Prostate cancer in men (21.9 per cent) and breast cancer in women (25.4 per cent) alone account for nearly half of cancer diagnoses in Canada. Lung and colorectal cancers rank second and third respectively.
Cancer is also increasingly affecting younger people: 40 per cent of new cancer cases are diagnosed in people of working age, noted Justine Côté.
“In recent years, we’ve seen a rather worrying upward trend in cancer cases among younger individuals,” she said during the conference.
Citing an international study published in 2023, she stated that the incidence of cancer in people under 50 increased by 79.1 per cent between 1990 and 2019. Canada is no exception.
Less invasive treatments
Scientific and pharmacological advances have led to more effective treatments for various types of cancer.
Côté referred to targeted therapies “which rely on identifying specific characteristics of tumour cells” and which spare healthy cells, resulting in fewer side effects associated with treatment.
“This can really improve patients’ quality of life, but also their chances of survival,” said Côté.
A bitter pill to swallow…
In 2022, nearly one in four patented drugs sold in Canada was for cancer treatment. Nine years earlier, they accounted for only 9 per cent. These treatments also generated nearly $4.6 billion in national sales in 2022.
Although new treatments are gradually entering the market, cancer care remains expensive.
“Cancer has a significant economic impact,” said Côté. “The societal cost of cancer, which includes both the direct costs to the health care system and the costs incurred by patients and their caregivers, amounted to $37.7 billion in 2024.”
That figure could grow by 23 per cent over the next decade, notably due to the aging population, demographic growth, and improved survival rates.
Targeted therapies are also very costly to develop and administer. “Some patients may develop resistance to certain treatments or require molecular tests to determine which mutations to target, which adds additional costs and affects the development and accessibility of these treatments,” Côté warned.
The high cost of targeted therapies also impacts both private and public insurance plans.
At Beneva, benefits paid for targeted therapies have quadrupled from 2014 to 2024, said Côté, while the average cost of treatments brought to market has nearly doubled, rising from $7,800 to $14,700 during the same period.
These increases are forcing insurers to better manage their files and claims. At Beneva, this involves prior authorization for treatment, the use of generic drugs, agreements with pharmaceutical companies, and a shift to biosimilar products.
… but savings are also expected
Targeted therapies offer the advantage of being available in tablet and capsule form, allowing for simple, at-home treatment instead of hospital-based radiotherapy sessions or intravenous chemotherapy.
This more cost-effective approach also reduces out-of-pocket expenses for patients—time off work, travel, parking, accommodation, and more.
Côté sees a promising future in these treatments, both for cancer patients and for the insurance industry.
“Research and development is making tremendous progress, and more innovations are yet to come,” she said. “The arrival of artificial intelligence will also play a significant role in advancing therapeutic and oncological fields.”
