Critical Illness; how much do cancer drugs cost Canadians?

Critical Illness; how much do cancer drugs cost Canadians?

Carmen Chai, Global News, November 6, 2017

Pierette Breton is not just fighting cancer, she is also battling with the insurmountable medical bills that she has accumulated to cover her treatment. 

In October 2009, Breton was diagnosed with a neuroendocrine tumor in her pancreas. It metastasized into her liver and bones. A single drug helped her fight the cancer – but at a hefty $8,000 a month.

For a few months, her employer’s insurance covered the bill, but shortly thereafter, the plan was changed due to the increased premium and she was left to cover the cost herself.  At that point, she was already on disability, and paying thousands of dollars for her medication each month just wasn’t plausible.

“It was a nightmare for me. It’s way too stressful, some days you can barely cope with going out the door,” Breton told Global News.  Unfortunately, Breton’s story isn’t abnormal as the financial fate of some Canadians battling cancer is at the mercy of the drugs that’ll hopefully save them. 

Deborah Maskens, founder of Kidney Cancer Canada, has seen it all: a patient in PEI who had to remortgage his home to free up some cash, couples in Nova Scotia who cashed in their retirement savings for the drug that could save a life and families in Ontario who maxed out credit cards to buy more treatments.  What’s worse is she’s seen some patients who decide that they won’t bankrupt their families - instead, they decline treatment altogether and choose to die.  

She warns, “if you’re a Canadian cancer patient, and on oral drugs, you need to expect to pay your mortgage, your bills and an additional $6,000 month, (on average), for your cancer drugs.  And treatment can be for a year or longer”.

People don’t realize that in Ontario, cancer drug coverage is spotty at best - a maze of deductibles and patchwork solutions based on your household income, your private insurance (if any), and OHIP.  And, in addition, patients often wait six to eight anxious weeks while all of this gets sorted out before they can start their treatment program – allowing the cancer to advance and worsen before treatment starts.  

Unfortunately, this is the case as many people assume that the government automatically pays for all drugs required to treat illness.  In reality, however, this is very far from the truth.  

In Canada, once you’re diagnosed with cancer, an oncology team creates your treatment plan based on the best medications available and approved.  They select the ones that fight your specific disease depending on the type of cancer, the stage, and provincial guidelines.  For many types of cancer, oral cancer drugs are becoming increasingly common; currently about 60 per cent of therapies are take-home options, (typically pills or self-injectables).  On the positive side, while these medications offer patients the freedom from lengthy stays in hospitals and the remove the discomfort of an intravenous, unless you have private insurance, (through your employer or personal Critical Illness policy), the bad news is that you’re on the hook for the bill.  

How Can Critical Illness Coverage Help? 

Critical illness insurance offers the financial support to cover the costs that are associated with a critical illness. If you become ill with an illness covered by your policy, you’ll be eligible to receive a lump-sum cash payment.  

You are free to decide how to spend the money, whether this be for treatment costs or to cover financial obligations;   

• Pay for medications not covered under government or employer plans 

• Reduce debt and other financial concerns while you cope with your illness

• Replace any reduced or lost income for you and your spouse (if they take time off to be your caregiver or come to treatments with you).

• Bring in caregivers to help at home, (private nursing cost is an average of $45 / hour) 

• Choose new medical treatments and medications not included in government formulary 

• Protect your savings & investments

Why Was There a 500% Price Increase on Cancer Treatment Lomustine?

Tori Marsh, Posted on June 12, 2017 

Yet another brand-name drug manufacturer is dramatically raising their prices.  In recent years, we’ve seen numerous cases of manufacturers increasing brand drug prices at an astronomical rate without any reasonable explanation. The makers of life-saving drugs like EpiPen (epinephrine), Nitropress (sodium nitroprusside), and many popular insulins have dramatically increased prices, causing some patients to go without treatment or turn to the black market. You’d think that all the recent bad press might prevent these kinds of increases, but apparently not.

The price of Gleostine (Lomustine), a popular anti-cancer drug used to treat brain tumors and Hodgkin’s disease has increased by more than 500% in just four years.  How can this happen?  

Back in 2013, GlaxoSmithKline discontinued production of CeeNu, the brand name for the generic drug Lomustine. With Glaxo out, NextSource Biotechnology, the only manufacturer of the generic version, was left as the only maker of the drug. At that time NextSource charged about $100 for one dose.  NextSource soon decided to “re-brand” the drug, and they then released Lomustine in 2014 as a brand name drug under the name Gleostine and then re-priced the exact same product they had sold previously for a new retail price of over $600 per dose.