Originally published in the Hamilton Spectator on March 25th, 2010. To go to The Hamilton Spectator website, please click here.
National report card concludes 1 in 12 Canadian patients hurt by coverage gaps
Hamilton patients are re-mortgaging their homes to pay for cancer drugs that costs tens of thousands of dollars.
“There’s a lot of those hard stories in Hamilton,” said local oncologist Dr. Pierre Major. “Sometimes they just don’t get the treatment.”
He’s raising alarm bells about the number of Canadians inadequately protected against catastrophic costs of cancer drugs.
A national report card released yesterday by the Cancer Advocacy Coalition of Canada concludes private insurance co-payments and caps on drug payouts can leave patients on the hook for thousands of dollars.
It also raised concerns about breast cancer diagnosis and treatment resulting in more than 1,500 Canadians a year getting unnecessary chemotherapy.
Major, who was the report card committee chairperson, has one patient who has maxed out her employer drug plan and her spouse’s benefit plan and still had to remortgage her home and count on handouts from family so she can continue to get injections every week that cost $5,000 each.
“You assume it’s covered and you only find out when it’s too late,” he said.
The Canadian Cancer Society estimates cancer drugs cost an average of $65,000 a year per patient. About one in 12 patients is not adequately covered to fund this.
“There is no national standard for how much Canadians should have to pay for cancer drugs,” said Aaron Levo, acting director of national public issues. “The Canadian Cancer Society believes Canadians should have equal access to cancer drugs regardless of where you live or your ability to pay.”
The report card also raises concerns about employees who get laid off or retire early having inadequate drug coverage. The report suggests there is a gap between the average age of retirement at 62 and when government programs kick in at 65.
“There are gaps definitely,” said Susan Eng, vice-president of advocacy for the Canadian Association of Retired Persons, “when you leave a place where you had workplace health benefits coverage and then you are not yet on the public pharmacare system.”
The other major issue flagged in the report was failure to use the most-up-to-date breast cancer diagnosis that would prevent hundreds of women each year from undergoing unnecessary chemo- therapy.
Only about 392 of 10,000 breast cancer patients in Canada last year had a sample of their tumour shipped to a centralized laboratory in California, which is the only place in the world that can test 21 genes to reliably predict outcomes such as risk of relapse and response to chemotherapy.
The test identifies which women will get enough benefit to justify the toxic treatment and which patients can avoid chemotherapy and its side effects such as hair loss, nausea, vomiting, immunosuppression and occasionally leukemia or even drug-induced death.
Ontario’s Ministry of Health has just started in the last few weeks to cover the $3,700 test for women who apply through the out-of-country health services branch.