Pharmacist, Provincial Drug Reimbursement Programs

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The Provincial Drug Reimbursement Programs (PDRP) administers several cancer drug and service case adjudication and funding programs on behalf of the Ontario Ministry of Health (ministry). As part of the Clinical Institutes and Quality Programs (CIQP) portfolio, PDRP provides timely access to high-cost cancer treatments and services, while ensuring the rational use of limited health resources.

Reporting to the Manager, Provincial Drug Reimbursement Programs, the Pharmacist is responsible for providing authoritative advice to internal and external stakeholders on their specific area of expertise. As part of this role, the Pharmacist is seen as the subject matter expert in a highly complex or technical field, and consults with stakeholders in a strategic and advisory capacity.

The Pharmacist primarily supports the operations of Ontario Health’s three main population‑based cancer drug reimbursement programs within PDRP. The annual expenditure paid out to hospitals for eligible claims is $700M and growing which corresponds to over 26,000 treatments and 2,500 enrolments per month. The New Drug Funding Program (NDFP) provides coverage for standard treatment options and funds over 60 drugs for 150+ indications.

The Evidence Building Program (EBP) provides time‑limited funding for drugs/indications with emerging but incomplete evidence. The High Cost Therapy Funding Program (HCTFP) provides coverage for drugs with specialized administration requirements. A robust pipeline of new cancer therapies mandates careful planning in order to support their introduction and ongoing public funding. The Pharmacist’s primary responsibility will be to lead the clinical content development and implementation of new cancer drug funding policies.

This involves collaborative work with internal stakeholders within our unit, across other Ontario Health units as well as with our Ontario Cancer Leads (OCLs), their respective disease site drug advisory committees, other Ontario Health‑affiliated clinicians, the ministry, and other provincial cancer agencies. The Pharmacist will work with other Ontario Health team members (specialists/analysts, other pharmacists, managers, product management team members) to create and review funding and adjudication rules within eClaims, Ontario Health’s claims adjudication system.

This permits real‑time notification to hospitals of enrolment and treatment claim eligibility.

The Pharmacist is the primary point of contact for…