Kitchener-Waterloo

Waterloo family struggles with girl's cancer costs after OHIP+ changes

Abigayle Lobsinger takes a nutritional supplement to maintain her weight during treatment for neuroblastoma, but changes to the OHIP+ drug benefit program mean the prescription is no longer covered by the province.

Provincial government cut off coverage for children and youth in families with private plans as of April 1

Abigayle Lobsinger was diagnosed with neuroblastoma, an aggressive type of childhood cancer, in 2015. (GoFundMe)

A Waterloo family says because of changes to the provincial government's OHIP+ program, they're paying hundreds of dollars for a nutritional supplement their daughter needs during her cancer treatment. 

Abigayle Lobsinger was diagnosed with a childhood cancer called neuroblastoma almost four years ago.

The seven-year-old is currently undergoing treatment at Sick Kids Hospital in Toronto. To help maintain her weight during treatment, Abigayle takes a nutritional supplement.

The supplement was formerly covered under OHIP+, but last year the Progressive Conservative government changed that program, cutting off children and young adults whose parents have private health insurance plans, regardless of whether the private plan offers the same coverage.

The changes went into effect April 1 and since then, Abigayle's family has had to shoulder the cost of the supplement because it isn't covered under their private plan.

Kevin Lobsinger, Abigayle's father, says travelling to and from hospitals in Hamilton and Toronto over the last few years has already taken a financial toll.

"When you now throw in an additional fee of ... a nutritional supplement, it's just another anchor that you have to carry around," Lobsinger told CBC News.

"The cost of the nutritional supplement is $437 per case. She goes through an average of a case a week."

'You're affecting families'

Since Abigayle's diagnosis in 2015, Lobsinger says the family has spent the equivalent of two calendar years in hospital for treatments, including chemotherapy, surgeries, transfusions, radiation and a stem cell transplant.

They were also reduced to a single income, when his wife Lee Anne closed her daycare business to care for their daughter.

Lobsinger says the family has been lucky to receive support and donations from the community, but they have still had to cut back.

He wants the government recognize it made a mistake.

"It's great to sit at a desk with a pen and paper and cut this, cut this, cut this, so we can save the province money," he said. "

"But at some point you've got to look and say, you're affecting families and their financial well-being. You're affecting their health."

Assistance available, province says

In a statement to CBC News, the Ministry of Health and Long-Term Care said households with high out-of-pocket prescription drug costs can apply to the Trillium Drug Program for assistance.

"Young Ontarians with rare illnesses and diseases deserve every opportunity to enjoy healthy and happy childhoods," the statement said.

"Our government made changes to OHIP+ to ensure that all young Ontarians have access to the medications they need to live healthy and happy lives, whether through private insurance plans or through OHIP+ if they don't have a private plan."

The ministry also noted some nutritional products are eligible for coverage under the Ontario Drug Benefit program, if they are listed on the Ontario Drug Benefit Formulary and are prescribed as the sole source of nutrition.

Lobsinger says his family does plan to apply for the Trillium Drug Benefit, but they aren't sure if they will qualify or how long the process will take.

In the meantime, he says the focus is on his daughter as she starts a new treatment at Sick Kids.

"The priority is Abigayle right now, and keeping her comfortable and keeping her spirits up, because she's going to go through some pretty intense treatment over the next few days."

About the Author

Robin De Angelis is a multimedia journalist based in southwestern Ontario. She has previously worked as a reporter covering local news in Sudbury. Get in touch on Twitter @RobinElizabethD or by email robin.deangelis@cbc.ca

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