Canada’s drug approval delays outpace moon mission speed

Canada sent astronaut Jeremy Hansen to the moon in just 10 days this spring, a mission that took nearly a decade to prepare. In stark contrast, bringing a new drug to Canadian patients can take between 10 and 15 years after approval—and another two to three years before it appears on public drug plans.

The Artemis II flight demonstrated what focused effort can achieve. NASA’s mission showcased years of engineering, rigorous training, and precise coordination. The drug approval process, however, remains a tangled web of delays that even the most bureaucratic space programs would struggle to match.

The process begins with four to six years of pre-clinical research, where scientists examine thousands of potential biological targets to identify promising compounds. If a candidate survives early testing, it moves into six to eight years of clinical trials, divided into three phases that grow increasingly costly and complex. By this stage, companies have already invested over a decade and more than $3.6 billion CAD—with no assurance the drug will prove effective. The vast majority of candidates fail before ever reaching patients.

Health Canada’s regulatory review typically takes about 300 days, similar to other global health authorities. But approval is only the first hurdle. The real delays begin with pricing negotiations. Manufacturers propose an initial price, which is then reduced through cost-value assessments that often undermine the financial justification for innovation. An independent body then engages in negotiations with provincial governments, each of which must independently decide whether to include the drug on their public formulary, sometimes reopening discussions or outright rejecting the proposal. The outcome? Only 18% of medicines available worldwide make it onto Canadian public plans, compared to the OECD average of 28%.

Canada now ranks last among G7 nations for the speed at which patients gain access to new treatments. As a result, patients face long waits, must rely on older therapies, or travel abroad, a phenomenon known as medical tourism. Every month spent in the approval pipeline is a month without treatment. Every year of bureaucratic delays represents a life that might have been extended.

This is not a failure of effort but a consequence of a system where excessive caution creates unnecessary complexity. Canada has a strong record of scientific innovation, stem cell research originated here in 1961, lipid nanoparticle technology developed in the 1980s played a key role in enabling mRNA vaccines, and the first Ebola vaccine emerged from Canadian labs in 2014. Yet translating these breakthroughs into tangible benefits for patients remains frustratingly slow.

The issue extends beyond national borders. The U.S. most-favored-nation drug pricing policy forces other countries to absorb higher costs for innovation while keeping American prices artificially low. If Canada does not address these challenges, its patients will face even longer waits for life-saving treatments.

The premiers’ meeting in Charlottetown on July 22 presents an opportunity to address these failures. Leaders could push for systemic changes, streamlining approval processes, modernizing negotiation frameworks, and ensuring consistent access to new medicines across all provinces.

Canada has already proven its ability to lead in space exploration. Now, it must demonstrate the same determination in medicine.