What does ‘various manufacturers of generic versions’ in MedSearch mean?

Breast cancer treatments can have multiple manufacturers, sometimes even when referencing the same treatment. In MedSearch, the term ‘various manufacturers’ is used when at least three manufacturers make the treatment listed in MedSearch.

About drug manufacturing:

Before a pharmaceutical company can start developing a new drug, they need a patent. A drug patent gives manufacturers the right to be the only company that can sell and produce a drug until the patent expires. The standard length of a patent in Canada is 20 years.

Once the drug patent expires, other pharmaceutical companies can produce and sell their own version of the same drug. When other pharmaceutical companies produce and sell their own version of the same drug, it is considered a generic version of the treatment.

Generic drugs are considered equivalent in safety, efficacy, and quality to the original drug. However, generic drugs will have a different brand name than the original drug. This means that every time there is a new manufacturer for the original drug, there may also be a new brand name.

What does ‘various generic versions’ in MedSearch mean?

In MedSearch, the term ‘various generic versions” is used when the treatment listed in MedSearch has at least three brand names. In these cases, it can be helpful to use the generic name instead of the brand name when using the search function in MedSearch.

About generic drugs:

Breast cancer treatments can have multiple names, sometimes even when referencing the same treatment. This happens because a single drug typically has both a generic name, and a brand name. The generic name generally does not change or changes very little. When multiple manufacturers produce the same treatment, it means there are also multiple generic versions for the same treatment.

A generic drug is a copy of the original drug. Generic drugs must meet Health Canada’s standards for bioequivalence. Pharmaceutical companies that produce and sell generic drugs must follow the same manufacturing and safety standards as the pharmaceutical company that developed and patented the original drug.

About drug manufacturing:

Before a pharmaceutical company can start developing a new drug, they need a patent. A drug patent gives manufacturers the right to be the only company that can sell and produce a drug until the patent expires. The standard length of a patent in Canada is 20 years.

Once the drug patent expires, other pharmaceutical companies can produce and sell their own version of the same drug. When other pharmaceutical companies produce and sell their own version of the same drug, it is considered a generic version of the treatment.

What is the difference between a Health Canada drug monograph and a product monograph?

A product monograph is a document pharmaceutical companies submit to Health Canada before they can sell a drug in Canada. A product monograph provides information about the drug such as what the drug is used for, who can use the drug, how the drug should be taken, possible side effects of the drug, safety warnings for the drug and scientific information about the drug. Once the drug is approved for sale in Canada, the product monograph becomes the standard reference for healthcare professionals. This ensures the drug is prescribed and used safely and consistently across Canada.

Learn more about product monographs here.

In contrast, a Health Canada drug monograph is an official document from Health Canada. A Health Canada drug monograph contains much of the same information as a product monograph. The Health Canada drug monograph also gives detailed information on what the drug is used for, who can use it, how it should be taken, possible side effects, and any safety warnings. Like the product monograph, the Health Canada drug monograph ensures that the drug is used the same way by all healthcare providers.

You can access Health Canada’s database of drug monographs here.

MedSearch provides the Health Canada drug monograph for each drug listed in our database. If a Health Canada drug monograph is not available, the product monograph is provided instead.

How do I share my feedback on MedSearch?

You can use our feedback form to share your feedback on MedSearch. Feedback from our community on our resources helps us that our resources serve the people the resource was developed for. Your feedback is valuable and helps us improve the quality and effectiveness of patient resources, ultimately enhancing the patient experience and empowering people to make informed healthcare decisions.

If you have questions about MedSearch or have information that you think would be helpful to include in this tool, please email cbcn@cbcn.ca or call us at 1-800-685-8820.

What is the difference between a generic drug and the generic name?

A generic drug is a copy of the original drug. Generic drugs must meet Health Canada’s standards for bioequivalence. Pharmaceutical companies that produce and sell generic drugs must follow the same manufacturing and safety standards as the pharmaceutical company that developed and patented the original drug.

Generic drugs will have a different name than the original drug. This means that every time there is a new manufacturer for the original drug, there may also be a new generic name. In these instances, the generic drug is the same, but the generic name will change.

Breast cancer treatments can have multiple names, sometimes even when referencing the same treatment. This happens because a single drug typically has both a generic name, and a brand name.

About drug manufacturing:

Before a pharmaceutical company can start developing a new drug, they need a patent. A drug patent gives manufacturers the right to be the only company that can sell and produce a drug until the patent expires. The standard length of a patent in Canada is 20 years.

Once the drug patent expires, other pharmaceutical companies can produce and sell their own version of the same drug. When other pharmaceutical companies produce and sell their own version of the same drug, it is considered a generic version of the treatment.

What is the difference between generic drugs and brand name drugs?

A generic drug is a copy of the original drug. Generic drugs must meet Health Canada’s standards for bioequivalence. Pharmaceutical companies that produce and sell generic drugs must follow the same manufacturing and safety standards as the pharmaceutical company that developed and patented the original drug.

Generic drugs use the same active ingredients as brand name drugs. Active ingredients are the part of a drug that treats the disease. However, the inactive ingredients in generic and brand name drugs may be different. Inactive ingredients do not treat the disease but are still part of the drug.

Generic drugs may also differ slightly from the brand name drug and from other generic drugs in ways that do not impact their effectiveness or bioequivalence. For example, generic drugs and brand name drugs may differ in colour, shape, flavour, or markings.

The biggest difference between generic and brand name drugs is the cost. Generic drugs are generally less expensive than brand name drugs.

For more information about the differences between generic and brand name drugs, visit Canada's Drug Agency (CDA).

About drug manufacturing:

Before a pharmaceutical company can start developing a new drug, they need a patent. A drug patent gives manufacturers the right to be the only company that can sell and produce a drug until the patent expires. The standard length of a patent in Canada is 20 years.

Once the drug patent expires, other pharmaceutical companies can produce and sell their own version of the same drug. When other pharmaceutical companies produce and sell their own version of the same drug, it is considered a generic version of the treatment.

What does using a drug “off-label” mean?

Off-label drug use describes using a medication for a different dose, combination schedule, intended disease, or type of cancer than what is officially approved by Health Canada. Off-label drug use is legal but it can present uncertainty about how someone will respond to the treatment.

Off label drug use may be seen when there are fewer Health Canada approved treatment options. For example, you may see off-label use in rare, aggressive, or metastatic breast cancers. Cancer research evolves quickly. Therefore, oncologists may rely on clinical guidelines, research studies and case reports as evidence about prescribing the drug off-label.

Ask your healthcare team about the potential risks, benefits and side-effects of off-label drug use.

What are biosimilars?

Biologic drugs are very complex drugs that use living cells or tissues from humans, plants or microorganisms. Biosimilars are drugs that are very similar to the reference biologic but are not exact matches.

Since the living cells used to create a biologic cannot be copied exactly, biosimilars cannot be an exact match of a biologic. Instead, biosimilar manufacturers recreate a similar environment to produce the same results as the reference biologic so each version of the drug will be comparable, but not identical.

You can learn more about biosimilars from our Biosimilars and Breast Cancer digital magazine.

About drug manufacturing:

Before a pharmaceutical company can start developing a new biologic, they need a patent. A drug patent gives manufacturers the right to be the only company that can sell and produce a biologic until the patent expires. The standard length of a patent in Canada is 20 years.

Once the drug patent expires, other pharmaceutical companies can produce and sell their own version of the same biologic. When other pharmaceutical companies produce and sell their own version of the same biologic, it is considered a biosimilar version of the treatment. This first, original biologic is called the reference biologic.

How can I get financial support to cover a prescribed breast cancer drug?

A breast cancer diagnosis can have a significant impact on a person’s finances. MedSearch provides information about which breast cancer drugs have patient support programs. A patient support program can provide financial support for prescribed breast cancer drugs. Check out the Therapy Patient Support section on a treatment listed in MedSearch to learn more.

Our FinancialNavigator is a database of local, provincial, and national financial assistance programs across Canada. You can use FinancialNavigator to find programs to help you pay for your prescribed breast cancer drug.

Access our FinancialNavigator database here.

How can I get financial support after being diagnosed with breast cancer?

A breast cancer diagnosis can have a significant impact on a person’s finances. CBCN’s FinancialNavigator is a database of local, provincial, and national financial assistance programs across Canada. You can use FinancialNavigator to find programs to help you pay for a prescribed breast cancer drug, income support while you are going through treatment, practical expenses, and more. Access our FinancialNavigator database here.

FinancialNavigator also offers financial support resources that can help you plan and prepare for the financial impacts of a breast cancer diagnosis.

Learn more about getting help with the costs associated with a breast cancer diagnosis here.

I have to travel for my treatment. Are there programs that can help with travel or with reimbursing the cost of travel?

Most people diagnosed with breast cancer travel frequently for appointments and treatment. This travel could be between their home and the cancer centre, or to other locations like specialists’ offices, radiation therapy treatment centres, diagnostic centres and more. Some of this travel might be local and involve a short car drive, while other travel could require a flight.

Our FinancialNavigator is a database of financial assistance programs across Canada. You can use it to find programs that provide support for travel and travel costs associated with cancer care and treatment. Access our FinancialNavigator database here.

You can also visit the Canadian Cancer Society’s website here to find support for cancer travel available in your province or territory.

What is a patient support program (PSP)?

A patient support program (PSP) is a program or service that helps patients access, understand, and manage their breast cancer treatment. PSPs vary in the type of support they provide and how long the support is provided. For example, some PSPs provide breast cancer drugs free of charge to those with a prescription. Other PSPs may provide emotional support for patients using the drug.

PSPs are usually provided by the drug manufacturer, but they can also be provided by non-profits, healthcare organizations and other similar service providers. PSPs are sometimes called patient assistance programs.

MedSearch provides information about which breast cancer drugs have an associated PSP. Check out the Therapy Patient Support section of a treatment to learn more.

You can also check out our FinancialNavigator database which provides information on PSP providers and vendors. Access the database here.

Learn more about getting help with the costs associated with a breast cancer diagnosis here.

Can I use private insurance to pay for drugs that aren’t covered through public funding?

If you have private insurance, the best way to find out whether it will cover the cost of your treatment is by contacting your insurance provider. Learn more about checking your insurance coverage here.

Paying for breast cancer drugs through private insurance can be an option, but it depends on several factors. The main factors are whether the drug is listed on the insurance company’s formulary, whether your specific plan covers the drug, and what your specific plan covers (full coverage versus co-pay). Even if you cannot use your private insurance to pay for drugs, there might be other costs that your private insurance can pay for, whether fully or in part.

Learn about making an insurance claim here.

Learn about the different types of health insurance and benefits here.

What should I do if my insurance claim is denied?

If your insurance claim is denied, you can appeal the claim. Find more information about the insurance appeal process and OmbudService here.

What is a Drug Access Navigator (DAN) and how can a DAN help me?

A Drug Access Navigator (DAN) is a healthcare employee who works alongside an oncology team. A DAN co-ordinates and investigates potential sources of funding and financial support for prescribed cancer drugs.

You can learn more about DANs here and more about accessing breast cancer drugs in Canada from a DAN here.

Some provinces have a dedicated organization of DANs that serve people who live in that province.

• ODANO is the Oncology Drug Access Navigators of Ontario. You can visit ODANO’s website here.
• The Atlantic Canada Oncology Drug Access Navigators Association (ACODANO) serves people living in New Brunswick, Prince Edward Island, Nova Scotia, Newfoundland and Labrador. You can visit ACODANO’s website here.
• If your province or territory does not have a dedicated organization or association of DANs, you might still be able to use the services of a DAN. Speak to your healthcare team, cancer center, or hospital to see what is available for you.

I have been prescribed a breast cancer drug that is not publicly funded in my province or territory. Can another province pay for my treatment instead?

Unless there are special circumstances, you are only eligible for drug funding in the province or territory where you are a resident. For example, if you are a resident of British Columbia, you are eligible for drug funding in British Columbia only.

You can learn more about travelling to access treatments and travel assistance here.

I have been prescribed a breast cancer drug that is not publicly funded in my province or territory. Can my treatment be paid for in another country instead?

Unless there are special circumstances, you are only eligible for drug funding in the province or territory where you are a resident. For example, if you are a resident of British Columbia, you are eligible for funding in British Columbia only. Outside of these special circumstances, if you travel to another country to access breast cancer drugs, you are responsible for your travel and any accommodations.

You can learn more about travelling to access treatment and getting travel assistance here.

If I use a breast cancer drug off-label, will it be covered by my private insurance provider?

Before private insurance will consider covering a drug prescribed for off-label use, your doctor must submit a request to the insurance company. This request should explain why the treatment is needed. Then, the insurance company will review the request before deciding whether to fund the treatment or not. This means private coverage for off-label drug use is considered on a case-by-case basis and is not guaranteed.

Learn about making a health insurance claim here.

Where will I receive breast cancer treatment?

Cancer treatment in Canada is primarily accessed through designated cancer centers, hospitals, and clinics. Where you will receive breast cancer treatment depends on many factors, as specialized services are offered at specific locations.

You can access a list of provincial and territorial cancer centre here.

I am reacting to a prescribed breast cancer drug. What should I do?

It is important to speak to your healthcare team if you are experiencing unintended reactions or responses to your drug. If you are reacting to a breast cancer drug, it may be an allergic reaction or a side effect from the drug.

An allergic reaction is the immune systems response to the drug that is unwanted. According to Health Canada, an adverse reaction or side effect is a harmful and unintended response to a health product. Both allergic reactions and side effects can range from mild to severe. Serious adverse reaction are side effects that are particularly harmful.

You can report a side effect through the government of Canada’s website here, or search the government of Canada’s adverse reaction database here.

For a list of possible side effects for a drug, review the Health Canada drug monograph or product monograph link provided for drugs listed in MedSearch. Click here  for a list of common side effects and ways to manage side-effects.

If you are experiencing reactions or side effects, you may consider complementary therapies. Complementary therapies work alongside conventional medicine and are often used to reduce side effects. Click here to learn more about complementary therapies.

How do I know if a prescribed breast cancer drug could interact with another drug?

A drug interaction is when one drug alters the effect of another drug. Interactions can happen not just between medications but also with food, alcohol, or supplements. You can use a reliable online tool such as Drug.com’s Interaction Checker to see if your treatment or therapies are known to interact.

Always discuss your concerns about drug interactions with your doctor before making changes to your treatment. Your doctor can advise whether there is a risk of drug interactions and if your treatment plan needs to be adjusted.

Consult the online drug interaction checker here.

Where can I learn about other people’s experiences with a treatment?

One great way to learn about other people’s experiences with a treatment is by joining a support group. Joining support groups or support networks is a good way to ask questions and find out how others have managed their treatments.

You can join a general support group for breast cancer, or a support group tailored to a specific type of breast cancer, such as triple negative, lobular, or male breast cancer.

Explore a listing of online support groups here.

What questions should I ask my healthcare team about breast cancer treatments?

PatientPath is CBCN’s navigation tool that helps you better understand a breast cancer diagnosis. This tool covers the various steps associated with treatment, care, survivorship, and living with breast cancer. This includes resources for those who have been diagnosed with metastatic breast cancer. You can use PatientPath to get a list of questions to ask your healthcare team. Access our PatientPath tool here.

How do I get a second opinion about my breast cancer treatment plan?

If you are uncertain about a diagnosis or a treatment plan, getting a second opinion may feel daunting and uncomfortable. You can read our blog article on Getting a Second Opinion in our Public Health System here for information and steps on getting a second opinion.

Where do I find information about the drug approval process in Canada?

The process of getting a drug approved and publicly funded in Canada is complex and lengthy. There are many steps to the process and it is not always straightforward or transparent. CBCN has created an infographic on how drugs get funded in Canada to make understanding Canada’s drug approval process a little easier. Access the infographic here.

What is a provincial or territorial drug formulary?

A drug formulary is a list of prescription drugs that are covered under a provincial or territorial government’s public drug benefit program. Drug coverage, also called drug funding, varies between provinces and territories. This means a treatment funded in one part of the country may not be funded in another part of the country.

A list of formularies and their contact information are available here.

What does using a drug “off-label” mean?

Off-label drug use describes using a medication for a different dose, combination schedule, intended disease, or type of cancer than what is officially approved by Health Canada. Off-label drug use is legal, but can present uncertainty about how the patient will respond to treatment. Off label use may be seen in rare, aggressive, or metastatic settings because there can be fewer Health Canada approved treatment options. Cancer research evolves quickly, and although not officially certified, oncologists may rely on clinical guidelines, research studies and case reports as evidence to inform off-label drug use for breast cancer.

Ask your healthcare team about the potential risks, benefits and side-effects of off-label drug use.

If I use a breast cancer drug off-label, will it be covered by my insurance provider?

Before private insurance will consider covering a drug prescribed for off-label use, your doctor must submit a request to the insurance company explaining they the treatment is needed. Then, the insurance company will review the request before deciding whether to fund the treatment. This means private coverage for off-label drug use is considered on a case-by-case basis and is not guaranteed.

Learn about making a health insurance claim here.

Can I access a treatment not approved for sale in Canada?

You might be able to access a treatment that is not available for sale in Canada through the Special Access Program (SAP). Your healthcare provider could submit a request if you met certain criteria.

Learn more about SAP and how to apply here.

What are clinical trials and how do they relate to the approval of breast cancer drugs?

Clinical trials are research studies that test new drugs, therapies and procedures with the aim of advancing knowledge for cancer treatment.

Learn more about clinical trials here.

Learn more about the phases of a clinical trial, randomization, blinding, and placebo effects here.

Click here for a list of questions to ask your healthcare team about clinical trials.

Find information on clinical trials that are recruiting participants here.

What are the key organizations involved in funding breast cancer drugs in Canada?

There are many organizations involved in funding breast cancer drugs in Canada. Before drugs can be approved for sale in Canada, they must be reviewed by Health Canada for drug safety, efficacy, and quality.

After the treatment is approved for sale by Health Canada, Canada’s Drug Agency (CDA) performs health technology assessments for all provinces and territories except Quebec. L’ Institut national d'excellence en santé et en services sociaux (L’INESSS) is a Quebec-based agency that performs health technology assessments for Quebec only.

A health technology assessment gives the information decision makers need to negotiate the cost of a medicine and understand the value of a new treatment. The pan-Canadian Pharmaceutical Alliance (pCPA) uses the health technology assessment to negotiate prices on behalf of all of Canada’s provincial, territorial, and federal drug plans.

Finally, drug plan owners decide whether to fund a medicine. Public drug plans are run by the federal, provincial or territorial governments. Private drug plans are usually offered through workplaces or personal insurance. Each plan, whether public or private, has its own unique drug formulary.

Learn more about the key organizations involved in funding breast cancer drugs in Canada here.

How can I get involved in the drug approval process as a patient, friend, family member, or healthcare provider?

There are several ways you can get involved in the drug approval process in Canada.

Clinical Trials: Patients and healthcare providers can volunteer to participate in clinical trials. When you participate, you are contributing to the generation of information that proves a drug’s safety and effectiveness. Learn more about clinical trials here.

Join patient advocacy groups: You can join a patient advocacy group to get involved. Prioritize groups that represent the interests of breast cancer patients and advocate for more efficient drug approval. Learn more about patient advocacy here.

Get involved in the drug approval and funding process: Read CBCN’s infographic to learn more about the terms related to the drug approval process, and the agencies involved here. Both clinicians and patients can get directly involved in the drug approval process by providing feedback on certain items like reimbursement reviews or provisional funding algorithms for oncology drugs. Learn more about getting involved in the drug approval process as a clinician here, or as a patient here.

Connect with healthcare professionals: Good communication with your healthcare team will significantly improve the quality of your care, as well as your overall health literacy. Learn more about improving communication with your healthcare team here.  

Stay up to date and informed: The Canadian Breast Cancer Network has a variety of newsletters that provide you with up-to-date and relevant breast cancer information. Learn more.

Contact the provincial government: Learn more about sending a letter to governing bodies and find samples here. You can also access CBCN’s Digital Advocacy and Storytelling Toolkit to learn about writing a blog, using social media, contacting government and media advocacy here.

How can I connect with CBCN directly about specific questions?

Connect with us via email at cbcn@cbcn.ca or on the phone at 1-800-685-8820.