OBJECTIVES: Prior to being considered for funding at a provincial level, all oncologics must first be appraised at a national level by the pan-Canadian Oncology Drug Review (pCODR), except in Quebec. This research aims to explore whether there are any differences between the speed of provincial oncologic access and whether this varies by provincial wealth and/or population. METHODS: All publically available provincial funding summaries were extracted from the pCODR website up to October 2014 from which the appraisal outcomes and dates were extracted. The population, GDP and GDP per capita of each province was extracted from the Government of Canada statistics website. Statistical comparisons were performed using one-way ANOVA and Student’s t-tests. RESULTS: The average delay between pCODR recommendations and provincial funding decisions was 8.9 months, which significantly varied by province (p<0.0001), with the lowest being British Columbia (2.8 months) and the highest being Prince Edward Island (15.1 months). The 4 provinces with populations lower than 1 million experience significantly greater delays to access versus the 5 provinces whose population exceeded 1 million (12.4 vs. 6.1 months, p<0.005). The 4 provinces whose GDP exceeds CAD75,000 million experience significantly faster time to access than the 5 provinces whose GDP is lower than this (5.1 vs. 12.0 months, p<0.005). However, this relationship does not reach significance when GDP is examined on a per capita basis (top 4 provinces: 7.2 months vs. 10.3 months for the bottom 5, p=0.11). CONCLUSIONS: There are significant variations in time to access for oncology drugs between different provinces. This is significantly related to the province population and overall wealth but not wealth on a per person basis. Further research can define whether this reflects differences in provincial assessments or whether pharmaceutical companies are prioritising larger provinces where better market returns can potentially be realised.