The Evidence-Building Program (EBP) complements and strengthens Ontario’s New Drug Funding Program (NDFP) and the process for making drug funding decisions in Ontario by maintaining rigour and consistency. The EBP seeks to resolve uncertainty around clinical and cost-effectiveness data related to the expansion of cancer drug coverage within Ontario.
For a cancer drug to be included in Ontario’s EBP there must be evolving, but incomplete evidence of benefits. This will allow us to fund the drug on a time-limited basis to collect real-world data on its clinical and cost effectiveness. This data will be used by the Ministry of Health and Long-Term Care to help inform a final change to existing funding criteria.
Eligibility – EBP
To receive drug coverage under the EBP, patients must be residents of Ontario and have a valid Ontario Health Card. Reimbursement is for the drug costs of those patients who meet the EBP eligibility criteria for the specific approved cancer drug.
Completed enrollment forms and supporting clinical documents (when required), must be submitted by the prescribing physicians before treatments begin. All eligibility criteria must be met as specified. Treatment claims and supporting documentation, if applicable, must be submitted to Cancer Care Ontario (CCO) according to the monthly submission schedule. All enrollment forms, treatment claims and supporting clinical documents, must be submitted through CCO eClaims.
Supplemental Forms – EBP
As a condition of participating in the EBP, Supplemental Forms are required and must be submitted at specific time intervals to ensure continued reimbursement. Supplemental Forms are also required following the completion of therapy to facilitate continued real-world data collection, in order to conduct analyses to inform permanent funding decisions. Please see Supplemental Forms for respective EBP drugs in eClaims for additional detail.
For detailed information on the eligibility criteria of EBP drugs, please refer to the drug-specific criteria in the below document.
Find out more about the Evidence Building Program