Pharmacist, Provincial Drug Reimbursement Program (Full Time Temporary Contract)

At Ontario Health, we are committed to developing a strong organizational culture that connects and inspires all team members across the province. Our vision is that together, we will be a leader in health and wellness for all. Our mission is to connect the health system to drive improved and equitable health outcomes, experiences and value. How we work together is reflected through our five values: integrity, inspiration, tenacity, humility and care. 

What Ontario Health offers: 

Achieving your career goals is a priority to us. Benefits of working at Ontario Health may include the following based on employment type: 

• Fully paid medical, dental and vision coverage from your first day 
• Health care spending account 
• Premium defined benefit pension plan 
• 3 personal days and 2 float days annually 
• Individual contributors start at 3 weeks’ vacation with 4 weeks at 2 yrs. 
• Career development opportunities 
• A collaborative values-based team culture 
• Wellness programs 
• A hybrid working model 
• Participation in Communities of Inclusion 

Want to make a difference in your career? Consider this opportunity. 

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. In this role, the PDRP Pharmacist will be a subject matter expert for the program operations, case adjudication and issues management of the Case-by-Case Review Program (CBCRP). The CBCRP considers funding requests for take-home and hospital-administered injectable cancer drugs for patients with rare cancers and/or clinical circumstances. Each individualized case request requires a detailed clinical workup, with input from clinical expert reviewers, followed by a funding recommendation to the Executive Officer, Ontario Public Drug Programs.

The Pharmacist may also support 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 2500 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 adjudication-related issues for internal and external stakeholders and supports a team of Reimbursement Analysts who are the primary liaisons to over 80 hospitals/cancer centres. Overall, this Pharmacist will support the ongoing funding of cancer therapies and PDRP’s goal of making evidence-based, cost-effective treatments available to patients as quickly as possible. 

The Pharmacist may also support other PDRP staff with the assessment of systemic treatment clinical trials to ensure that participation within the clinical trial is congruent with public cancer drug funding both within trial or used subsequent to trial. 

The Pharmacist may provide secretariat support to the Ontario Steering Committee for Cancer Drugs (OSCCD) which is an expert advisory committee to the ministry on cancer drug reimbursement issues. The Pharmacist may also be asked to provide clinical expertise on submissions/items brought forth to the committee for review.

The Pharmacist may provide content knowledge related to the management of oncology drug shortages. This could include liaising with clinical experts and other provincial cancer agencies on developing conversation strategies and other risk mitigation measures.

Key areas of responsibility include:

• Strategic planning
• Subject matter advice
• Stakeholder engagement

Here is what you will be doing: 

• The Pharmacist works collaboratively with internal team members, OCLs, other clinical expert reviewers and the ministry to lead the timely implementation of new drug funding policies within NDFP, EBP and HCTFP. 
• The Pharmacist works with PDRP’s managers and other pharmacist(s)/program staff in the development, revision and implementation of policies, procedures and quality improvement initiatives related to program operations.
• The Pharmacist independently, and in collaboration with other pharmacist(s) and management in PDRP supports the Reimbursement Analysts and oversees the review of all cancer drug funding requests within our population-based funding programs (NDFP, EBP, HCTFP). This includes assessing prior approval requests submitted by hospitals along with appeals and/or resubmissions which are all time-sensitive and potentially contentious in nature. This may require input from our OCLs, other clinical expert reviewers and the ministry.
• The Pharmacist supports the communication strategy of the unit by liaising with PDRP staff/management, OH communications and ministry communications/public affairs on urgent or contentious requests, and supports messaging for internal/external inquiries by providing subject matter expertise.
• The Pharmacist supports the assessment of systemic treatment clinical trials to ensure alignment with cancer drug funding policies through Ontario Public Drug Programs.
• The Pharmacist may be asked to provide secretariat support to OSCCD, including but not limited to providing clinical expertise on submissions/items brought forth to the committee for review.
• Provides cross-coverage across PDRP as required. including operational support for CBCRP and subject matter expertise pertaining to the management of oncology drug shortages.
• Other duties as assigned. 

Here is what you will need to be successful:

Education and Experience 

• EA degree in Pharmacy and registration (Part A – can provide patient care) with the Ontario College of Pharmacists is required.
• A minimum of three years of experience in oncology, either as a clinical pharmacist or in drug benefit management (or equivalent experience), is required.
• Completion of a hospital pharmacy residency would be an asset.

Knowledge and Skills 

• Analytical Thinking & Problem Solving – The role requires an in-depth knowledge of the cancer drug funding landscape in Ontario along with the requisite skills to complete a thorough assessment of a patient’s clinical history and proposed treatment plan(s). 
• An understanding of, and experience with the application of, evidence-informed practice is required. Experience in critical appraisal and literature review is an asset.
• A detailed understanding of cancer drug reimbursement in Ontario is strongly preferred.
• An understanding of Ontario public drug reimbursement programs and knowledge of public healthcare systems is essential.
• Excellent written and oral communication skills, including the capacity to engage, and a demonstrated ability to build relationships among clinicians and other stakeholders is required.
• Ability to multi-task and prioritize assignments to meet deadlines.
• Demonstrated ability to work independently and effectively in a team environment.
• Ability to pivot quickly and be responsive to the ever-changing needs of the health care system to support funding requests for cancer patients.

Employment Type: Full Time Temporary Contract (18 Months)

Salary Band: 6

Location: Toronto, Ontario (currently hybrid; subject to change). All applicants must be a resident of Ontario to be considered for roles at Ontario Health. 

Internal Application Deadline Date: May 1, 2024

Ontario Health encourages applications from candidates who are First Nations, Métis, Inuit, and urban Indigenous; Francophone; Black and racialized; members of 2SLGBTQIA+ communities; trans and nonbinary; and disabled. 

We encourage applicants with accessibility needs to notify us if they have any accommodation needs in the application and/or interview process. 

Note: As part of the initial recruitment screening process, applicants must confirm that they are fully vaccinated against COVID-19. If applicants are not fully vaccinated, they will be required to identify any accommodation needs pursuant to a protected ground under the Code. Applicants who identify an accommodation need will be required to provide supporting documentation with respect to their need for accommodation when requested by Ontario Health. If no such accommodation is identified, the applicant will not be eligible to proceed through the recruitment process. 

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