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Costly Colorectal Cancer Treatments Not Universally Available in Canada |
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Written by Wire Services/Staff
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Monday, 15 May 2006 |
The Colorectal Cancer Association of Canada (CCAC) is warning that Canada is facing a moral and potentially legal dilemma in the treatment of colorectal cancer patients. Patients across the country with metastatic colorectal cancer are being deprived of the life prolonging medication "Avastin" (bevacizumab) that is part of the standard of care in the treatment of the disease.
While selected hospitals in some provinces such as British Columbia, Quebec and New Brunswick have made it available to patients free of charge, in other provinces such as Manitoba the medication is either not available, or in the case of Saskatchewan only available to patients who are prepared to pay for it (approximately $36,000 for a six month treatment) and have it infused in hospitals in the public health care system, or in the case of Ontario have it infused in a private clinic.
Barry D. Stein, President of the Colorectal Cancer Association of Canada calls the practice "shameful" and adds, "This treatment, which was finally approved last year in Canada and which was long over due, is not reaching patients who are desperately in need of it. Worse yet, these very patients who are in the most vulnerable of positions are being held ransom for a treatment which is the standard of care in the treatment of the disease."
"What is the purpose of Medicare if not to guarantee the underpinnings of the Canada Health Act that the best possible care be universal across Canada and not be denied for financial, economic, social or geographic reasons?," says Stein. Yet that is exactly what some provinces such as Ontario are proposing. These are not experimental or exceptional therapies. They are part of the everyday treatment of the disease in cancer centres across the United States and elsewhere and clearly should be on the provincial formularies and covered. Patients should not be obliged to pay for the standard of care they are entitled to.
The problem does not stop here. Another medication, Erbitux (cetuximab) used in the treatment of metastatic colorectal cancer and which was approved at the same time as Avastin has not even been launched in Canada due to these problems and the inability to agree on a price with the Patented Medicine Prices Review Board. As the price of this therapy is expected to be even higher than Avastin, patients will likely also continue to be deprived of this medication.
Ontario and Alberta are also not paying for one of the most standard of treatments, Oxaliplatin (eloxatin). Patients are forced to rely in part on a compassionate care program that the manufacturer has set up to assist patients and pay the balance themselves. "When the provinces do not reimburse the cost of these treatments and patients are forced to pay for them (if they can afford it) it not only creates a two tiered system, but it actually deprives patients of the opportunity to prolong their life or even find a cure", says Stein.
This is not a problem only for colorectal cancer patients but for cancer patients in general. As new and novel therapies are introduced and become the standard of treatment they must be readily available for all patients. The trend for many of these new therapies is that they are not only used for one type of cancer, but they become excellent treatment options for other cancers as the clinical trials progress.
Stein points out that it is unacceptable for Ottawa to approve the latest drugs only to see the provinces refuse to place those same drugs on their list of available medications simply because of the cost. To do so says Stein places medications considered standard treatment out of reach to the very patients who require them the most.
"If we want to have an up to date health care system in the treatment of cancer in Canada we must not let this happen. Not only will we have unequal access to our health care system, but patients will be deprived of the medications due to cost restraints or the non introduction of new and novel therapies for the very same reasons," said Stein.
"We have known for a long time in Canada that colorectal cancer is largely preventable and yet to date no province has as yet put into place a screening program which would at minimum reduce the number of cases required to be treated. Provinces are complaining that they can not afford to pay for treatments they knew they could have prevented at least in part in the first place."
The CCAC is once again calling on all provinces to immediately initiate colorectal cancer screening programs in their Provinces without further delay.
The Colorectal Cancer Association of Canada is a non-profit organization whose mission is to increase awareness and educate Canadians about colorectal cancer, support patients and their families, and advocate for a national screening policy and timely access to treatment and diagnostics. More information can be obtained by visiting www.ccac-accc.ca or calling the toll-free info line at 1-877-50COLON. |
