Ont. cancer drug plan almost cruel: watchdog
Last Updated: Wednesday, September 30, 2009 | 11:45 PM ET
CBC News
Ontario ombudsman Andre Marin has called on the government to evaluate Avastin funding decisions on a case-by-case basis. (Adrian Wyld/Canadian Press) Ontario's ombudsman has slammed the provincial government for placing a limit on funding for people taking the colorectal cancer drug Avastin, a policy he calls unjust and arbitrary.
Several cancer patients in Ontario have had to pay for Avastin out of their own pockets or stop treatment after they reached an arbitrary limit set by the government, André Marin said in a report released Wednesday.
The government stops funding the drug after 16 two-week treatments, or about eight months, a limit that isn't supported by medical evidence, he said.
"The funding limit flies in the face of the acceptable standard of oncology practice in this province and beyond," Marin said in his report.
"Regrettably, this situation verges on cruelty for those already afflicted by this unrelenting illness."
Of the seven provinces that fund Avastin, only Ontario has a limit on the number of publicly funded treatments, Marin said. That's an arbitrary cutoff that doesn't take into account whether the patient is responding to treatment, he said.
"That's definitely wrong — not only are you giving false hope but you may also be causing more harm than good by cutting someone off," Marin told reporters in Toronto.
'Dumb as bag of hammers'
Marin is calling on the government to review funding for Avastin treatment on a case-by-case basis.
The ministry did not agree to those recommendations, but said it would work with Cancer Care Ontario toward a new compassionate review policy for cancer drugs, Marin said.
But he sharply criticized the proposed change.
"This policy right now ... is as dumb as a bag of hammers," Marin said. "It has nothing to do with compassion."
It requires patients who have been cut off from funding for Avastin to demonstrate they've tried chemotherapy and it didn't work, he said. This presents a "catch-22" situation, Marin said — people who are showing signs of improvement can't receive government funding.
According to government figures, the average length of survival for people who receive Avastin with other chemotherapy is close to 24 months, compared with 15 months without the drug.
About 14 per cent of colorectal cancer sufferers are doing well beyond the 16 cycles of treatment the province will pay for, Marin said. Each treatment comes with a price tag that ranges between $1,500 and $2,000.
According to an estimate in the report, the province spends about $16.7 million a year in funding Avastin treatment. For an additional annual cost of about $9 million, Marin said, the province can continue providing funding for those cancer sufferers.
He questioned why the province considered that amount too steep, given the provincial health budget stands at around $40 billion.
No medical evidence to warrant change: Caplan
But Health Minister David Caplan dismissed suggestions the drug policy was driven by cost considerations.
"First and foremost, the committee to evaluate drugs looks at the clinical evidence and … the scientific evidence that is produced about the safety and effectiveness of therapies and of drugs," he told reporters.
He accused Marin of using inflammatory language and said he would be open to changing the policy if Marin could provide medical evidence to show a change is needed.
Marin's probe was prompted by complaints from patients, as well as a letter from Progressive Conservative Joyce Savoline saying the 16-cycle limit appears arbitrary.
About 22,000 Canadians are diagnosed with colorectal cancer each year —including 8,100 in Ontario.
With files from The Canadian Press
