Cancer patients shouldn’t have to pay

October 3, 2012

Category: Critical Illness Insurance

By Andre Picard
Globe and Mail

People already reeling from a diagnosis of cancer should not have to pay for treatment out-of-pocket

When Andrew Goodridge, a Fredericton property manager, was diagnosed with colorectal cancer in March, 2009, he faced a Solomon-like decision: “Financial ruin or the funeral home.”

The dire choice was due to the fact the drug oncologists recommended to limit the spread of tumours while he awaited surgery – bevacizumab (brand name Avastin) – cost $6,250 a month and was not covered by either the provincial health plan in New Brunswick or his private drug plan.

“Until I got cancer I thought I was covered. Everybody does,” Mr. Goodridge said in an interview. “But then you get this nasty surprise.”

Given the soaring cost of drugs and the spotty coverage afforded by drug plans around the country, those nasty surprises are all too common, said Aaron Levo, assistant director of public issues at the Canadian Cancer Society.

“It is not acceptable that cancer patients should worry about how they are going to pay for the drugs they need,” he said. “They should be able to focus on treatment.”

A new poll commissioned by the cancer society found that 85 per cent of Canadians are worried that a cancer diagnosis would have a negative impact on their finances because of the cost of drugs. Only one-third of respondents said they trusted the health-care system to provide them with affordable treatment.

Mr. Levo said universal access to medically necessary health care, the cornerstone of Canada’s medicare system, is being undermined by the fact that a growing number of patients have to pay for essential cancer drugs out-of-pocket.

The solution the society advocates is a national catastrophic drug insurance program, and it is pressuring Ottawa to act. (www.fightback.ca)

Another group, the Campaign to Control Cancer, has a similar campaign (www.fairtreatment.ca) but it is focusing its efforts on provinces and territories.

In September, 2008, provincial and territorial governments issued a public statement saying they held a “common view that catastrophic drug coverage is as essential to Canadians as physician and hospital coverage” before adding that the “federal government has a funding responsibility to establish a minimum standard of drug coverage for all Canadians.”

In other words, they have not acted because they are waiting for Ottawa to pony up.

Mr. Levo said Canadians are tired of the “blame game between the federal and provincial governments and they are looking for leadership and action.”

A catastrophic drug plan would not cover all drug costs, but would kick in when: a) a patient requires very expensive drugs or b) a patient has spent more than 3 per cent of his or her annual net income on prescription drugs.

The new poll shows that 70 per cent of respondents support a federally funded catastrophic drug program based on income. That number increases slightly, to 74 per cent, who support a national catastrophic drug insurance plan that would pay the full cost of drugs.

Mr. Levo said the message in the poll is that “Canadians clearly support establishing a national program to help them pay for cancer drugs, but unfortunately they are losing confidence in Canada’s health-care system to fix it.”

Cancer drugs taken outside the hospital – and hence not automatically covered by medicare – cost about $20,000 for a course of treatment. For newer drugs, the cost exceeds $65,000.

Mr. Goodridge was facing a drug bill of $75,000 a year. His friends rallied and raised more than $125,000 through charitable auctions. He also lobbied the New Brunswick government and it agreed to add Avastin to the list of drugs covered by the provincial plan.

Still, the experience left him shaken and determined to help others in a similar situation.

“People with cancer are already vulnerable and scared. We can’t do this to them. We need a catastrophic drug plan,” Mr. Goodridge said.

An estimated 173,800 new cases of cancer will be diagnosed in Canada in 2010, according to projections from the Canadian Cancer Society. At least 76,200 Canadians will die of cancer this year.