Health audit fails some cancer patients, advocates say

An advocacy coalition for cancer patients says a report by Ontario's auditor general falls short in its recommendations to correct inequities for patients taking oral cancer drugs that aren't covered by the province's drug benefit program.

Coaliton says 22,000 Ontarians are paying for oral cancer drugs that aren't covered under benefit program

Some oral medications required for cancer treatment can cost up to $8,000 a month, according to an advocacy group for cancer patients. (9dream studio/Shutterstock)

An advocacy coalition for cancer patients says a report by Ontario's auditor general falls short in its recommendations to correct inequities for patients taking oral cancer drugs that aren't covered by the province's drug benefit program. 

CanCertainty is a coalition of 35 Canadian patient groups, cancer health charities, oncologists, cancer care professionals and caregiver organizations that lobbies for improved and more affordable take-home cancer treatments. 

Some of the oral drugs can cost $8,000 a month, according to CanCertainty. 

The coalition estimates more than 20,000 Ontarians under the age of 65 who are without private insurance will require take-home cancer drugs to treat their disease this year, and says many are paying out of pocket. 

Audit points to gaps

In her report released Wednesday, Auditor General Bonnie Lysyk highlighted gaps in drug treatment coverage for cancer patients.

I believe it's absolutely cruel and I believe it's unnecessary.- Robert Bick, CanCertainty

She noted the full cost of cancer drugs is not covered in Ontario unless the treatment is administered in a hospital. 

Robert Bick, co-lead of CanCertainty, applauds the auditor for "shining a light on the deficiencies" in the system, but said her criticism fell short.

"She's suggesting bare minimum repairs on an already outdated system," Bick said,

If a cancer patient can't afford to pay for oral medication taken at home, they can apply for financial help under two separate provincial programs: a special allowance for catastrophic drug costs under the Trillium Drug Program, and the Exceptional Access Program. 

Aid application process complex 

Bick said the process for applying for those funds is complicated, and patients can wait weeks just to find out whether they'll be covered. Lysyk recommended in her report that the approval process be sped up.

But Cancertainty wants the province to go further by simply covering all cancer drugs, wherever they're administered intravenously in hospital, or orally at home. 

"Treat all cancer patients universally, regardless if they are infused in a hospital or take the drugs in their home," Bick said.

Ontario Auditor General Bonnie Lysyk talks about her annual report at a news conference in Toronto on Dec. 6, 2017. (Frank Gunn/Canadian Press)

Alberta, Saskatchewan, Manitoba and British Columbia fully cover the cost of cancer drugs, whether they're administered in a hospital or not.

'Silo mentality'

Ontario suffers from a "silo mentality," according Dr. Sandy Sehdev, a medical oncologist at the Ottawa Hospital Cancer Centre. 

He said the government funding of cancer drugs hasn't adapted to the fact that treatment is increasingly being given orally, often at home. Those drugs should be funded the same way intravenous drugs are, Sehdev said. 

Sehdev said one family doctor told him filling out applications for financial aid are "more complex than filling out a tax return."

He said it's unacceptable that a patient battling cancer has to wait six weeks to hear whether they've been approved for aid.

"We've all had patients who have either passed away or become too sick to have treatment just because of the delay," Sehdev said. "I've seen some patients who, if they hadn't started their oral drugs within days, we would have lost them."

"I believe it's absolutely cruel and I believe it's unnecessary," Bick said. "I believe [that in] a health-care system that strives to be better, this should be one of the first things we try and repair"