Watchdog slams 'cruelty' of cap on cancer drug
October 1, 2009
Rob Ferguson
QUEEN'S PARK BUREAU
The Ontario government won't change its policy of limiting the length of time colorectal cancer patients can get the life-prolonging drug Avastin at taxpayer expense, despite charges from ombudsman André Marin that the restriction "verges on cruelty."
Health Minister David Caplan said Wednesday he would need better "medical evidence" before the government would raise the limit from the current 16 cycles of treatment, or about eight months.
"I rely on the advice of experts," Caplan said, noting the government has a drug evaluation committee that makes such recommendations, and taking Marin to task for "inflammatory language."
But Marin argued in his 44-page report entitled A Vast Injustice that the limit is "arbitrary" and does not take a patient's progress into account, forcing them to pay for the expensive medication out of their own pockets or do without.
The intravenous drug, which is not a cure and costs between $1,500 and $2,000 per treatment, increases survival by as much as five months in conjunction with other drugs, according to one study.
Caplan said Avastin patients can apply on compassionate grounds for an extension – a claim Marin described as "dumber than a bag of hammers" because patients must prove they've tried a drug that has not worked for them.
"If Avastin is working, you're constantly chasing in circles," he said, noting that because roughly 14 per cent of patients on Avastin are well enough to take it past 16 treatment cycles, the cost to Ontario taxpayers of lifting the cap would be about $9 million a year.
NDP MPP and health critic France Gélinas said after wasting $1 billion on trying to establish electronic medical records in Ontario, the Avastin cap looks bad.
"At eHealth, they were throwing good money after bad with no accountability. ... Here we have an area where $1 billion was squandered and we're trying to save a few bucks on the backs of dying people," she said. "Is this what this province has come to?"
Marin recommends treatment with the drug be extended on a case-by-case basis for patients doing well on Avastin, which cost Ontario $12.8 million for 283 people from July 2008 to April this year.
Deputy health minister Ron Sapsford said in a letter to Marin that the Avastin decision was based on the advice of 20 clinical experts on the government's committee to evaluate drugs, which found it not to be "cost-effective" in certain chemotherapy regimens.
The cap allows more people to get Avastin, he added.
"Admittedly this is a difficult decision to make, but we think it is better that more people have some access to this expensive drug than for none to have access at all."
Toronto Star
Featured Sponsored Listings