Agonizing dilemma over costly cancer drugs


healthHow much is one month of life worth?

It's a question that has split governments, bankrupted patients and left hospitals with an agonizing moral dilemma.

Health Canada has approved drugs that prolong the life of cancer patients.

They're expensive. They're not a cure. And usually they only give the patient months more to live.

Patients think they're worth every penny.

Governments can't agree. Some provinces pay. Others say they're not worth the small benefit to a few.

"If we had unlimited dollars, it would be to fund all the drugs," said Dr. Hal Hirte, head of systemic therapy at the Juravinski Cancer Centre. "But it's not a bottomless pit. We have to make some decisions."

Hamilton's cancer centre is the only one in the province to allow patients to buy drugs not covered by OHIP and the centre will administer them intravenously for free. About 30 patients have done it over the last year.

It's a controversial decision because it's widely viewed as violating the Canada Health Act. But with no better options, the agency that runs cancer care in Ontario has recommended the rest of the province follow suit. The Ministry of Health is considering Cancer Care Ontario's proposal.

In the meantime, Roche Canada is paying for private clinics to open up across the country, including one last month in Hamilton on Main Street West, to administer cancer and arthritis drugs paid for by patients or their insurance companies.

"There's a recognition here that patients still need access to these products," said Samantha Ouimet, director of corporate affairs at Roche Canada. "We recognize the need to give people some options."

Roche has hired McKesson Canada to act as an entry point for patients prescribed the drugs by doctors.

The drugs cost $2,000 to $3,000 a treatment and patients can need up to 26 treatments a year.

McKesson will help them find the money through private insurance, government special access programs, Roche's patient assistant plan or their own bank accounts. Roche supplies the drugs and pays a clinic to administer them intravenously.

"It gives an opportunity for patients to get these treatments," said Hirte. "But it fragments their care. With multiple providers of care, the chances of things falling through the cracks are much higher."

Hirte doesn't like his patients going to private clinics, but he won't go so far as to say they shouldn't be allowed.

Without them, he knows patients will go to the United States to get the drugs or go without.

It all comes back to how much you'd pay for one more month of life.

source - Hamilton Spectator