We Canadians pride ourselves on our universal health-care program. But a study released recently by the Canadian Breast Cancer Network confirms that when it comes to cancer treatment, medicare is far from universal.
The study found that access to drug treatment for metastatic breast cancer – cancer that has spread – is highly variable across the country.
Cancer drugs go through a four-stage process before being added to provincial drug formularies. Formulary drugs are usually covered by public funding or private insurers, making them more affordable.
Seven provinces, for example, approved the breast cancer drug Halaven within an average of 12 months, but Nova Scotia didn’t approve it for 35 months.
Quebec, on the other hand, approved it in three months, while New Brunswick and P.E.I. still don’t list Halaven.
The study found delays in approving new drugs are particularly acute in Atlantic Canada, with Nova Scotia posting some of the longest wait times and only one metastatic treatment approved in Prince Edward Island.
For women like Julie Michaud, 34, whose breast cancer has spread to her lungs and bones, such a wait could be devastating. The Fall River mother of three small children says her drugs are working but she worries about what would happen if she needed to switch to a newer, more effective drug that is not yet on the formulary.
Whether delays are due to budgetary constraints, a lack of staff, or both, provinces must figure out solutions. That need is particularly acute in Atlantic Canada, where 30 per cent of residents don’t have private health insurance.
The Canadian Breast Cancer Network, which includes breast cancer survivors, has suggestions on how to close the gap on funding for metastatic breast cancer therapies.
It urges provinces to set deadlines for the approval of new drugs and fast-track reviews of drugs for patients with urgent needs. The group supports the push for a national pharmacare program.
There are other problems with cancer drugs, whose costs are covered depending on where they are administered and the patient’s drug insurance status.
While in-hospital intravenous treatment is covered, pills taken at home are not. For cancer patients without good public or private drug plans, costs can escalate to $72,000 a year or beyond.
Ill people coping with a devastating diagnosis should not be forced to navigate a complex collection of patchwork programs, sell their homes or exhaust their savings to pay for drugs they need.
It is a problem that affects many Canadians. According to a 2013 Public Health Agency of Canada report, some 40 per cent of us have, or will get, cancer.
The situation is improving. In July, the federal government indicated it is willing to join the Pan-Canadian Pharmaceutical Alliance of provinces and territories that is now bulk purchasing drugs. The premiers say the alliance is saving $190 million in this fiscal year.
But more can be done. When Canadians wake up Wednesday morning, they should be urging their newly minted MPs, no matter what their political stripes, to push for a Canada-wide fix for this inequity.