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Published: February 28, 2024
Kirsten Watson was weeks away from losing access to life-saving medications, a situation she found herself in because Ontario does not cover the cost of oral cancer drugs.
The 43-year-old woman is receiving treatment to help prevent a recurrence of breast cancer after being diagnosed in 2020. She lost her job last year due to company downsizing. Alongside her income, she was set to lose coverage through employer benefits for medications prescribed by her oncologist costing $7,000 per month.
Watson said in an interview, "Knowing this treatment was so crucial to have, and the pressure of not being able to access it, is almost exhausting."
Watson’s former employer extended her health insurance for a period after she was laid off, and there were only a few weeks left on it when she found another job where some drug costs are covered. The patient support program of the manufacturer of one medication covers the balance.
But she knows not everyone undergoing cancer treatment has private insurance, and she wants to see the province cover those oral drugs, saying that just having cancer and receiving treatment is a huge burden.
She added, "You are stressed about the diagnosis, undergoing treatment, dealing with side effects that are part of the treatment — you deal so much with cancer, which is already a significant pressure."
The Canadian Cancer Society Ontario is calling for funding of oral cancer drugs in the same way as cancer drugs administered intravenously in hospitals.
"Ontario is one of the only provinces, apart from Atlantic Canada, that does not cover oral cancer treatment," said Hilary Bushan Tyrrell, Advocacy Director at the Ontario Society, before a legislative committee hearing pre-budget presentations.
"The cost of living crisis is foremost on most Ontarians. They shouldn’t have to worry about choosing between paying their mortgage or cancer treatment."
This is not a new request. The cancer community has been calling for coverage of oral drugs for over a decade. Bushan Tyrrell said there was a glimmer of hope in the 2022 budget, promising a advisory table to explore improved access to drugs, but so far no progress has been made.
When asked, a spokesperson for Health Minister Sylvia Jones referred again to the two-year-old budget promise.
Hannah Jensen wrote in a statement, "Ontario will continue working with key stakeholders, specialized experts, and federal and regional partners to identify additional initiatives to achieve long-term sustainability for public drug programs."
"The government is also committed to establishing an advisory table to explore improvements in access to home cancer drugs."
The Canadian Cancer Society estimates that drug coverage would cost the province between $17 million and $44 million annually, depending on whether it aligns with the first-payer model or acts as a backup for patients without adequate private coverage.
Watson said she was eventually lucky to find another job with health insurance, but said she shouldn’t have had to limit her job search simply because of where she lives in Canada.
She said, "I can’t help but think, if I lived in another province, I wouldn’t have to go through this."
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