Science

Cancer drug coverage needs reform: report

Some cancer patients in Canada are paying thousands of dollars per year for drugs that keep them alive, while others don't pay a cent, according to a report that calls for an end to the discrepancies.
The average cost of treatment with newer cancer drugs is now $65,000.
Some cancer patients in Canada are paying thousands of dollars per year for drugs that keep them alive, while others don't pay a cent, according to a report that calls for an end to the discrepancies.

The Canadian Cancer Society released the report on the patchwork coverage for cancer drugs on Monday.

Joan Gaudet of Tignish, P.E.I., was 73 when she died last May of a stroke after her kidney cancer recurred following a 12-year remission. Her daughter Traci Gaudet is still grieving the loss of the retired school bus driver who brought up six children on a fixed income of less than $20,000 a year.

Gaudet was prescribed a drug called sunitinib malate, or Sutent, that is effective but expensive. Gaudet's provincial drug plan wouldn't pay the cost of $7,745 per month.

"You have to remember the whole time she was trying to fight cancer, the focus wasn't on the cancer, the focus was on trying to get enough money to cover the drug," her daughter recalled from Summerside, P.E.I. "So the focus was not on wellness, it was on finances."

  • One in 12 Canadians faces catastrophic drug costs (greater than three per cent of net household income) even in provinces where universal coverage exists.
  • About three-quarters of cancer drugs taken at home cost more than $20,000 a year.
  • The average cost per course of treatment with newer cancer drugs is $65,000 — close to Canada's average annual income.

Source: Canadian Cancer Society 

The Gaudet family and their community rallied to pay for Sutent until the province relented and picked up the tab months later. Her daughter blames the battle for weakening her mother.  

Medicare covers the cost of drugs administered in hospital, but increasingly, cancer drugs are given at home.

Patients who may or may not be covered by provincial or private drug plans pay for the therapies, and often only a portion is covered. Patient co-payment may run as high as 20 per cent of the drug cost and others have annual or lifetime reimbursement caps.

Geography and ability to pay

Lack of consistency among provinces and plans is the problem, according to the Canadian Cancer Society.

"Your ability to get the drugs you need is dependent upon where you live and how much money you have," said Dan Demers, director of national public issues for the Canadian Cancer Society. "In our minds, that's not universal health care."

Demers gave the example of one of the newer cancer drugs, which is fully paid for in B.C. Patients in Ontario have to pay $2,700 a year for the same drug, and $65,000 in New Brunswick and P.E.I.

The cancer society wants the federal government, in consultation with provinces and territories, the insurance industry and patient groups, to introduce a catastrophic drug program that would give all Canadians the same level of access.

The group is holding a symposium on cancer drug access in Ottawa on Tuesday. Demers hopes the idea will play a prominent role later this week when provincial and territorial health ministers meet in Winnipeg. A catastrophic drug plan has been proposed and endorsed by the three major federal political parties before, but never got off the ground.

Last year, an estimated 166,400 Canadians were diagnosed with cancer and about 73,800 died. About one in four Canadians can expect to die of cancer. 

With files from The Canadian Press