Stuart Peacock holds the Leslie Diamond Chair in Cancer Survivorship and is a Professor in the Faculty of Health Sciences, Simon Fraser University. He is currently Co-Director of the Canadian Centre for Applied Research in Cancer Control (ARCC) ;— a pan-Canadian research centre providing interdisciplinary leadership in health economics, services, policy and ethics research. Dr. Peacock is also a Distinguished Scientist in Cancer Control Research at BC Cancer Agency, a member of the Board of Directors of the Canadian Agency for Drugs and Technologies in Health and past President of the International Society on Priorities in Health Care. He has held university positions in Canada, Australia and the UK. Over the past 20 years, Dr. Peacock's main research interests have focused on research into developing more effective cancer services, making health system funding decisions fairer and more transparent, and improving the quality of life of cancer patients and survivors.

Dr. Peacock has received two 4-year grants awarded this summer though the Canadian Institutes of Health Research (CIHR), Cancer Partnerships for Health System Improvements competition. Six grants were awarded in total, and Dr. Peacock will be a Principal Investigator for two of the funded studies.

1. Deliberative public engagement to inform cancer control decision-making in Canada

Principal Investigators: Stuart Peacock, Michael Sherar and Michael Burgess

Co-Investigators: J Abelson, R Alvi, D Bethune, Y Bombard, A Chambers, K Chan, T Clifford, C Daly, C Finely, B Fraser, H Logan, M Moore, E Nicholson, K O'Doherty, D Regier, J Spinelli and D Turner

Amount: $775,128

The overarching aim of this study is to develop a framework for sustained public involvement to better support priority setting processes in the context of cancer control. Specific objectives include:

1. Developing a framework for deliberative public engagement for priority setting decisions in cancer control, informed by a synthesis of the evidence and interviews with key stakeholders;
2. Exploring the potential roles of deliberative public engagement at different stages of the cancer control continuum (from prevention, screening/early detection, diagnosis, and treatment to palliative care and survivorship);
3. Conducting two deliberative public engagement events to elicit the values and principles that Canadians feel ought to guide different priority setting decisions;
   
4. Developing recommendations for decision-makers from each of the deliberative public engagement events;
5. Conducting preliminary evaluations of each event in conjunction with key stakeholders; and
6. Developing guidance for decision-makers on appropriate models of participatory governance informed by the evidence-based framework and the two public engagement events.

Outputs will include:

1. An 'Atlas' of priority setting processes in cancer control in Canada;
2. A framework for deliberative public engagement in cancer control;
3. Recommendations from deliberative public engagement events to inform priority setting decisions at the pan-Canadian, provincial and territorial levels relating to interventions and programs from across the cancer control continuum;
4. Development of tools and strategies to inform priority setting processes at the pan-Canadian, provincial and territorial levels; and,
5. Recommendations concerning the most appropriate models of participatory governance for different priority setting processes in cancer control.

2. Developing a Framework for the Incorporation of Real World Evidence into Cancer Drug Funding Decisions in Canada

Principal Investigators: Kelvin Chan, Stuart Peacock, Michael Sherar and Wanrudee Isaranuwatchai

Co-Investigators: R Alvi, J Beca, Y Bombard, W Chueng, J Dancey, C Earle, J Hoch, R MacLeod, N Mittman, P Pechlivanoglou, M Trudeau, E Pullenayegum and C de Oliveira

Amount: $970,640

Drug costs represent a rapidly growing expense for health care systems. In cancer care, the emergence of new treatments has become a regular occurrence and easily outpaces budget growth. As a result, provincial funders must use evidence to prioritize and fund selected drugs from the pipeline of new drugs awaiting funding.

Dr. Peacock and his team believe that the prioritization process should not only consider the evidence for the drugs in the pipeline when allocating resources, but also for drugs that are already being funded. Decisions to fund these drugs would have been made based on controlled clinical trials, where the population or environment may not reflect practice in the "real world".

Their goal is to develop and test a framework for the generation and use of real world evidence (RWE) of cancer drugs to enable, one, a reassessment of cancer drugs by recommendation-makers, and, two, refinement of funding decisions or renegotiations/disinvestment by decision-makers/payers across Canada.

Their project has four objectives:

1. Develop an understanding of the current state of real world evidence in health care;
2. Develop and refine a framework for the generation and use of real world evidence dedicated to, one, policy/process and, two, methodological applications of real world evidence;
3. Conduct multi-province real world evidence evaluations using the framework developed in Objective 2; and
   
4. Employ knowledge translation strategies to establish and integrate a working RWE framework into sustainable practice of participating provinces and on a national level. 
   

Their team will assemble a national panel of clinical, methodological and policy experts to create adoptable real world frameworks for cancer drug funding decisions. The real world evidence framework will not only support evidence-based policy reform, price renegotiations and reallocation of funding from low- to high-value settings, but will also drive accountability and sustainability of the cancer system in an innovative way that can be replicated by all provinces and by other areas of health care.