Patient-Derived and Health System Benefits of Precision Medicine Project (HESPE)

Building learning health systems to improve precision oncology care in Canada 

Precision oncology personalizes cancer treatments based on the unique biological characteristics of a patient’s tumour. The field is rapidly advancing, making it challenging to evaluate its efficacy and cost-effectiveness and understand its value to patients. To inform patient access to precision oncology, more evidence is needed to help decision makers determine how widely to adopt and reimburse these methods. 

Dr. Dean Regier, Senior Scientist at the Cancer Control Research department of BC Cancer, is leading a project to help address these challenges.  

The project, titled “Patient-Derived and Health System Benefits of Precision Medicine Project (HESPE)”, was awarded $250,000 from the Marathon of Hope Cancer Centres Network (MOHCCN). It is being conducted alongside the Canadian Network for Learning Healthcare Systems and Cost-Effective ‘Omics Innovation (CLEO), a pan-Canadian collaboration dedicated to sustainable precision medicine. 

 “Patient access to precision oncology is variable and limited to a few centres where implementation trials are underway,” says Dr. Regier. “Improvements are urgently required to support learning healthcare within and between provincial health systems.” 

The project is meant to generate tools and evidence that will help advance learning health systems across the country to improve care for all Canadian cancer patients. A learning health system is one that undertakes an iterative process of generating new knowledge through integrating internal data and experience with external evidence, and implementing that knowledge into practice. 

While able to rapidly respond to advances in care, learning health systems also require large amounts of shared and accessible data to evaluate the safety, effectiveness, and cost-effectiveness of precision medicine developments. However, in Canada these types of data are currently siloed, collected in a non-standardized fashion, and difficult to access. 

Part of the HESPE project includes efforts to identify what kinds of data need to be collected to improve economic evaluations of precision oncology (for example, to determine whether a new method is cost-effective). The team is also aiming to develop, validate, and apply novel methods to evaluate new technologies and therapeutics associated with precision oncology. Through these activities, the project will help develop new methods of both collecting data and translating them into the type of rigorous evidence needed to inform the implementation and reimbursement of precision oncology approaches across the country. 

Importantly, Dr. Regier and his team are taking a patient-oriented approach to their research, for example conducting pan-Canadian focus groups in both English and French, to ensure that the policies and practices they develop for data collection, sharing, and governance are in line with patient and societal interests. 

To ensure that the outputs of this project contribute to precision oncology implementation decisions, Dr. Regier and his team are partnering with Health Canada, l’Institut national d'excellence en santé et services sociaux (INESSS), Canada’s Drug Agency (CDA-AMC), and the pan-Canadian Oncology Drug Review Expert Review Committee (pERC), among others. 

“This is a significant and ambitious project,” says Dr. Regier. “We are taking a multi-faceted approach to make equitable and timely access to precision oncology a reality for all Canadians. We also strongly believe that this project will help position Canada as a leader in learning healthcare systems.”