Accelerating Access to Innovative Treatments: Ontario’s FAST Program

Viewpoint showing that this program should be extended to a wider variety of treatments and implemented across Canada, providing patients with more timely access to the care they need

Appendix

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This Viewpoint was prepared by Emmanuelle B. Faubert, Economist at the MEI, in collaboration with Tiago Lambie, Research Intern at the MEI. The MEI’s Health Policy Series aims to examine the extent to which freedom of choice and entrepreneurship lead to improvements in the quality and efficiency of healthcare services for all patients.

Imagine you or a loved one suffering from a disease in which an otherwise approved treatment is withheld due to the fact that the government and pharmaceutical companies have not yet finished negotiating a price point. This is exactly what Ontario’s Funding Accelerated for Specific Treatments (FAST) program(1) is designed to address, and Quebec would do well to pay close attention. In combination with Health Canada’s new Ministerial Reliance Order, which aims to accelerate approval times by relying on decisions made by select foreign regulators,(2) access to life-saving pharmaceutical innovations could be greatly accelerated.

FAST Access to Cancer Drugs

The FAST program is a three-year pilot project launched in October 2025 by the Ontario Ministry of Health that aims to fast-track access to high-priority cancer drugs for patients. The program aims to shave up to one year off wait times by offering access to these treatments while prices are being negotiated between the pan-Canadian Pharmaceutical Alliance and the pharmaceutical company in question, with an expected average acceleration of nine months(3) (see Figure 1). Shaving off close to nine months in what is normally a two-and-a-half-year process (from approval by Health Canada to public coverage) is significant for patients.(4)

Eligibility is limited to Project Orbis(5) oncology drugs that have received a positive final recommendation from the Canada Drug Agency. This process can be applied to either new drugs or new uses (“indications”) for existing drugs. To begin with, six treatments were fast-tracked: Tagrisso, Scemblix, Nubeqa, Calquence, and Opdivo with Yervoy (for two types of cancers).(6) Seven to ten drugs are to be fast tracked annually under this program. An Appendix to this Viewpoint on the MEI’s website shows the timelines of certain of the drugs that have been included in the FAST program so far.

Despite the program’s recent implementation, it is already producing positive results. Indeed, none of these treatments are widely accessible to patients in other provinces, showing that the program is already accelerating access to life-saving drugs for Ontario patients.

Another interesting aspect of the FAST program is that if negotiations between the producer and the pan-Canadian Pharmaceutical Alliance ultimately fail, the producer will be required to fulfill the remainder of existing patients’ prescriptions free of charge.(7) This ensures that patients who have started a course of treatment are able to receive the full treatment, without having to worry about the possibility of it being cut off.

In addition to benefiting Ontario patients, this program also benefits the pharmaceutical industry, as faster access to innovative drugs means an increased return on investment for drug companies. This, in turn, gives companies an incentive to launch their innovative products earlier in Ontario. Despite the risk that the pharmaceutical company might have to fulfill the remainder of the treatment uncompensated if price negotiations fail, several of these negotiations have already been concluded successfully (see Appendix).

How Quebec Could Benefit

Getting access to a treatment up to a year earlier can mean the difference between life and death for many cancer patients.(8) Moreover, quick access to innovative drugs has proven to be beneficial for the health system as a whole.(9) Patients who are treated more quickly are able to regain their quality of life sooner (and likely maintain it longer), which also allows them to return to work faster. This lowers the burden on the healthcare system while allowing patients to start contributing to economic growth again, thus creating a virtuous cycle.

Unlike Ontario, the province of Quebec does not rely on the recommendations of the Canada Drug Agency. Instead, it runs its own assessment process through the Institut national d’excellence en santé et en services sociaux. Therefore, a FAST program in Quebec could be triggered by a positive recommendation from that provincial body, at which point the Régie de l’assurance maladie du Québec could begin covering the medication. This provincial integration could allow a FAST program to be even more efficient in Quebec, as administrative delays due to back and forth between federal and provincial authorities would be eliminated.

While introducing a FAST program in Quebec to accelerate access to innovative pharmaceutical treatments would be beneficial to both patients and the healthcare system in the province, there is no good reason to restrict such a program to a limited selection of oncology drugs. If it works for this one category of drugs, it should be extended to a wider variety of pharmaceutical treatments. It should also be implemented in all ten provinces, providing Canadians from coast to coast with more timely access to the care they need.