Cancer patients shouldn’t have to fight for coverage

When we at The Review heard our colleague’s story of waiting for funding for her incomprehensibly expensive cancer medication, we were shocked. She was facing months without her medication, and felt all the work her doctors had done might be undone while she waited on bureaucracy. Luckily, on Friday, she received news from her doctors: her medication would be funded. That doesn’t undo weeks of waiting without the medication, however, nor does it prevent the whole scenario from replaying itself next year.

We were surprised, but many Ontarians wouldn’t be. It’s easy to find media coverage of stories like Erica’s. In Brampton, a woman was denied coverage for a drug to fight her chronic lymphocytic leukaemia which would cost $52,000 per year. The CBC reported on a woman in Toronto with breast cancer; she, too could not get coverage from OHIP for her drug. Global News spoke with a man in Hamilton facing $15,000-per-month bills for his cancer drug. And so the list goes on. In some cases, patients couldn’t get coverage at all, while in other cases, people had to wait weeks and deal with a complicated application process before finally being approved.

The government shouldn’t be surprised about the need for these medications. In 2014, Cancer Care Ontario, which advises Ontario’s government on cancer, released a report about cancer medications used at home, as opposed to cancer medications administered in hospital. At-home medications, it said, “are emerging as a standard treatment option for many cancers.” The organization’s report raised many issues and challenges faced by patients who need at-home cancer drugs, and one of the report’s recommendations was that the government should “resolve inequitable cancer drug funding” and “simplify complex reimbursement processes.”

A coalition of dozens of groups, including Kidney Cancer Canada, Myeloma Canada, Lung Cancer Canada, and others, is fighting for the funding of at-home cancer drugs in Ontario and Atlantic Canada. The coalition says patients here and in Atlantic Canada face “discrimination” based on age, income, and what kind of cancer is involved.  The coalition says people in British Columbia, Alberta, Saskatchewan and Manitoba have full coverage of at-home, oral cancer medications, while people in Quebec pay a relatively small deductible.

The Canadian Cancer Society is also involved in advocacy on this issue, saying in a statement: “cancer patients should not face delays or financial barriers in accessing their treatments. Unfortunately, in Ontario, many patients and their families face these obstacles when it comes to take-home cancer medications.”

So, while MPP Lisa MacLeod’s private member’s bill, which asks for a committee to look into how other countries handle coverage for rare diseases and experimental drugs, is admirable, you have to wonder if we really need to go overseas to solve problems like the one faced by our colleague and so many others. If organizations like the Canadian Cancer Society and Cancer Care Ontario have identified a problem, and other provinces have apparently found a solution, perhaps we can fix it without straying too far from home for inspiration.