Recently, I’ve seen a different kind of innovation – this time at the policy level.

Ontario’s Funding Accelerated for Specific Treatments (FAST) initiative is a new model launched by the Ontario government in October 2025 that recognizes urgency and acts on it. And it works.

FAST shortens the time between Health Canada approval and public reimbursement of medicines, without lowering regulatory standards or compromising patient safety by funding and providing patient access while price negotiations continue. For cancer drugs funded through FAST, the average time from Health Canada approval to public funding in Ontario has dropped to about half a year. That stands in stark contrast to the roughly two years patients typically wait in Canada, twice the average in comparable OECD countries.

Our health care system consistently fails patients who need innovative cancer medicines. After a drug is approved by Health Canada, patients must wait while multiple government agencies conduct reimbursement reviews, negotiate pricing, and make funding decisions. Each step in the process happens in sequence – long after safety and efficacy have already been established.

Cancer does not wait for process. In practice, these delays matter. When patients are waiting for a treatment that could help them, every month matters, and for some, delays can mean the difference between life and death. Yet the system still treats time as negotiable, even for drugs deemed high priority by Health Canada.

FAST shows that Canada’s long delays are avoidable. 

However, as currently designed, FAST is too limited. Eligibility is restricted to about 7-10 cancer drugs per year – those reviewed through an international regulatory initiative called Project Orbis. Yet Health Canada already has a mechanism for identifying medicines that warrant expedited review: the Priority Review pathway. These are drugs intended to treat serious, life-threatening, or severely debilitating conditions, and that either address an unmet medical need or offer a significant improvement over existing therapies.

If a cancer drug is important enough to receive Priority Review, it should be important enough to receive accelerated funding. Expanding FAST to include oncology drugs granted Priority Review would be the practical next step. It would preserve Health Canada’s standards, require no new system, and eliminate avoidable delays between Health Canada approval and funding for treatments for devastating diseases.

Policy innovation should scale quickly when it proves effective. Extending FAST to Priority Review cancer drugs is a clear opportunity: a targeted reform built on an approach that is already in place and delivering results. Ontario has demonstrated leadership by showing that faster access is possible within Canada’s public system. The focus should now shift to expanding eligibility and examining how similar models could be adopted more broadly across other provinces. Patients with a cancer diagnosis should not face significantly longer waits for access to treatment based on where they live or the type of cancer they have.

At a time when health systems are under pressure to improve access, deliver value, and respond more quickly to patient needs, expanding existing accelerated pathways is a practical and achievable next step. Earlier treatment with new medicines can prolong cancer control, lengthen survival, reduce toxicities from older treatments, reduce hospitalizations, prevent complications, and help patients remain active in their families and workplaces. Delays carry real costs for patients, for caregivers, and for the health care system itself.

We already have clear evidence that FAST works. It’s time to expand FAST, and to move FAST.

Lives depend on it.

Medical Oncologist at the Ottawa Hospital Cancer Centre, Dr. Sandy Sehdev, is a co‑chair of the Cancer Clinician Advocacy Forum (CCAF), a national group of cancer clinicians advocating for faster and more equitable access to high‑quality cancer care across Canada. (Submitted by Sandy Sehdev)