What is ODANO?
Oncology Drug Access Navigators of Ontario (ODANO) is a provincial organization founded to provide support, advocate for members, share resources and educate existing and new navigators in order to maximize the appropriate funding for all cancer patients. Our primary goal is to remove the financial burden from the patient so they can focus on their health. Because of the increasingly complex system to obtain drug coverage, there is an Oncology Drug Access Navigator in nearly every cancer clinic in Ontario.
Navigators act as resident experts on drug coverage and criteria for coverage. We facilitate drug coverage by:
- accessing government funding through programs such as the Exceptional Access Program (EAP) and Special Access Program (SAP)
- accessing patient support programs (PSP), and
- finding other reimbursement means for unfunded drug costs.
Flaws in our current drug coverage system can lead to delays in treatment and result in negative health outcomes. For example, although cancer drugs administered in hospitals and clinics are often offered free of charge to patients, half of all new cancer drugs are taken at home and, therefore, many are not covered by the public health system. Unfortunately, many of our patients do not have any private insurance. If a patient is fortunate enough to have private coverage, many drug plans require a 20% co-payment, which can quickly become a financial burden to patients on expensive medications.
Drug access navigators work closely with pharmaceutical company representatives, who provide us with up-to-date information about their products’ coverage, including public and private coverage funding criteria and any patient assistance program.
To improve the quality of patient care by:
- Increasing our voice as a professional group
- Creating a forum for sharing best practices
- Educating members
- Creating training opportunities
- Creating opportunities to network to support one another
- Establishing and enhancing partnerships with strategic partners
- Finding the best funding for our patients
- Advocating for the role of navigator
What is a Drug Access Navigator and What They Can Do for You
- Helping with applications to the Trillium Drug Program
- For patients paying with a Private Insurance Plan we can help with:
- 3 way calls between patient, Insurer and Navigator
- Submit Prior Authorization forms
- Request exceptions to the plan formulary
- Submit renewals when required
- Appeal negative decisions
DANs also help connect patients to different programs to help them too. These patient programs can offer critical help and often include:
- Financial assistance
- Compassionate free drugs
- Providing free bridging drug supply while waiting for public drug coverage
- Nursing phone support
To contact a Drug Access Navigator, use the following link:
Drug Access Navigator Advocacy
- Providing input on issues and trends that impact cancer drug access.
- Collaborating with patient groups to provide education.
- Bringing attention to matters relevant to the enhancing access to drugs.
- Working with the provincial government to better our current drug reimbursement system.
- Supporting and participating in advocacy initiatives and public relations efforts.
Claire is a 45 year old woman with newly diagnosed breast cancer. She has a private drug plan through her employer.
Her oncologist has prescribed her 8 treatments of IV chemotherapy. Her chemotherapy is paid for by her hospital. The supplemental medications she takes outside of the hospital cost $12,000 for the duration her treatment.
Her oncologist refers her to the clinic’s Drug Access Navigator.
An investigation into her private plan shows drugs are covered at 80%. The drug plan has an annual maximum of $5000. She has adequate private coverage for 40% of the cost of the take home drugs she’ll require.
By collaborating with the Drug Access Navigator, Claire maxes out her private insurance and applies for public drug coverage through the Trillium Drug Program. Trillium continues to cover her drugs for the rest of her treatment.