Ontario: The hidden cost of take-home cancer drugs
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Source: Canadian Cancer Society
New Canadian Cancer Society report uncovers the hidden costs of take-home cancer drugs in Ontario and the urgent need for provincial funding.
A new report funded by the Canadian Cancer Society (CCS) is renewing calls from patient organizations to fill the funding gap for take-home cancer drugs in Ontario. The report, titled Uncovering the hidden costs of Take-Home Cancer Drugs, finds that Ontarians are accessing take-home cancer drugs far less than those in provinces where the cost is covered by public health insurance.
The report estimates there is a gap between about $17 million and $44 million in take-home cancer drug spending in Ontario. The gap is currently borne by third parties including drug manufacturer patient support programs and/or patients paying out of pocket. The CCS and CanCertainty Coalition are calling on the Ontario government to step in and fill the gap so those needing these medications can access them without having to seek out assistance programs or draw from their own finances. This long-awaited step would bring Ontario in line with the majority of Canada.
At a time when hospital capacity is a greater issue than ever due to the COVID-19 pandemic, it has never been more important to fund medications that will help keep cancer patients out of hospital. This will reduce the burden on the individual and the healthcare system in the long-term.
“All too often people with cancer are left facing a steep financial burden that comes with their diagnosis,” says Dr. Stuart Edmonds, Executive Vice-President of Mission, Research and Advocacy at the Canadian Cancer Society. “Ontario patients struggling with the dual reality of a dire cancer diagnosis and the pandemic say that one of the greatest challenges continues to be difficulty accessing their cancer treatment. This simply has to change.”
For a long time, cancer drugs were often administered in a hospital setting, usually intravenously. But now, through advancements in cancer care, more than half of oncology medications being developed are in oral formulations that can be taken at home. Not only are these medications proven to better target and treat cancer, they reduce dependency on our hospitals and minimize patient-caregiver disruptions traveling to and from cancer clinics.
“Cancer treatment has progressed significantly in the last decade allowing patients to live better and longer lives. Unfortunately, Ontario’s cancer drug funding model has not kept pace with innovation,” says Dr. Edmonds. “There is no reason that anyone in Ontario facing a cancer diagnosis should still have to worry about whether or not they will need to pay out-of-pocket to access to the most effective and approved treatment for their individual diagnosis.”
CCS patient and caregiver surveys during the COVID-19 pandemic found that access to cancer drugs and prescriptions was ranked as one of the most important supports required by patients to manage their care. Despite being identified as a critical part of patient care, those uninsured or underinsured in Ontario are not able to take advantage because of the cost barrier. CCS’s new report estimates that about 20% fewer uninsured patients are accessing take-home cancer medications in Ontario compared to patients with comprehensive public coverage.
Currently, coverage eligibility for take-home cancer drugs varies significantly across Canadian provinces. In Ontario, take-home cancer drugs do not universally fall under the jurisdiction of the Ontario Drug Benefit program. Instead, coverage comes from a mix of private insurance, out-of-pocket cash payments and various provincial programs (if eligible). In contrast, Canadians living in western provinces and northern territories have their cancer drugs paid for by the provincial government regardless of their age, socioeconomic status and the drug’s route of administration.
The report determines that it would cost the Ontario government between $12 to $31 million to fill the gap through OHIP. The gap in coverage is something the majority of Canada has already filled more than a decade ago, proving that it is possible. CCS, alongside the Cancertainty Coalition are calling on the Ontario government to commit to equal access and follow suit.
About the report
The Canadian Cancer Society’s Uncovering the Hidden Costs of Take-Home Cancer Drugs report uses a model-based design to uncover the financial gaps in coverage for specified oral oncology drugs in the provinces of Ontario, New Brunswick and Nova Scotia. To find out more, view the full report.
About the Canadian Cancer Society
The Canadian Cancer Society works tirelessly to save and improve lives. We fund the brightest minds in cancer research. We provide a compassionate support system for all those affected by cancer, from coast to coast and for all types of cancer. As the voice for Canadians who care about cancer, we work with governments to establish health policies to prevent cancer and better support those living with the disease. No other organization does all that we do to improve lives today and to change the future of cancer forever. Help us make a difference. Call 1-888-939-3333 or visit cancer.ca today.
About the CanCertainty Coalition
The CanCertainty Coalition is the united voice of 30+ Canadian patient groups, cancer health charities, and caregiver organizations from across the country, joining together with oncologists and cancer care professionals to significantly improve the affordability and accessibility of take-home cancer treatments. For more information, visit CanCertainty.com.