Another take: For cancer suffererers and their families and other loved ones, these drugs are priceless. A Page 1 story on Monday.
Mon Feb 6 2006
By Patti Edgar of Winnipeg Fress
CANCERCARE Manitoba needs an extra $12 million a year to cover expensive, breakthrough drugs that could mean the difference between life and death.
The agency is currently draining its annual drug budget from the province to give patients several new treatments on a "exceptional status basis."
That's because innovation comes at a steep price.
For example, Zevalin has helped non-Hodgkin's lymphoma patients remain in remission for up to seven years. But it costs $20,000 for a course of treatment.
While Health Canada approved Zevalin last spring, individual provinces also need to give the drug a go-ahead. So far, only Ontario and British Columbia have made the move.
"They will die if they don't get it," said Karen VanRassel, executive director of the Lymphoma Foundation Canada. "This is the last-chance treatment for patients. It's all they have left."
Winnipegger Keith Storey flew to Calgary last summer to participate in a study on a different, but just as expensive, new treatment for non-Hodgkin's lymphoma called Bexxar. It's not available in Manitoba.
Storey was willing to pay for treatment himself in the United States until he learned about the company-sponsored study.
His disease is now stable -- the tumours aren't growing and he's skiing again for the first time in three years.
"The ethical question is: how can they not give it to you?" Storey asked.
"If my oncologist says, 'I believe this drug can be of help,' then I believe I should get it without any quibbling from the government."
Manitoba sits in the middle of the pack when it comes to approving and funding new cancer drugs, according to a study released last Tuesday. The Cancer Advocacy Coalition of Canada -- made up of cancer survivors and former heads of cancer agencies -- found inconsistencies across Canada when they conducted the survey in December.
British Columbia had the best access to new cancer treatments in Canada, with 21 approved with full or limited funding. In Manitoba, only nine of the 24 treatments fit that category, according to the study.
Provincial officials say three more drugs are covered under Pharmacare, making them available to people who meet an income test. Unlike B.C., Manitoba doesn't automatically cover cancer drugs that come in a pill.
In this province, a committee of specialists decides whether drugs are approved, based on the quality of the medical evidence. It's then up to Manitoba Health to decide whether to pay for them.
"CancerCare has not been funded for most of these very expensive and breakthrough medications," said Linda Venus, director of cancer control for CancerCare Manitoba. "Patients are receiving these treatments on sort of an exceptional status basis and it's causing financial hardship here."
CancerCare Manitoba has requested $12 million from the province for five treatments listed in the Cancer Advocacy study. One of the drugs is used to treat two different types of cancer. The agency currently has a budget of $7.7 million for cancer drugs. That's about half the amount spent across the province.
The request will be part of the province's spring budget deliberations.
Dr. William Hryhiuk, chairman of the Cancer Advocacy Coalition, would like to see a Canada-wide plan to ensure equal access for cancer patients, so a patient in Manitoba, for example, can get the same drug as a British Columbian.
Hryhiuk said the differences between the provinces need to be corrected. "I think the way to do that is a catastrophic drug insurance plan," he said. "The province and the feds have to sit down and hammer out a plan."
It's an idea proposed in 2002 by Roy Romanow's federal commission on health care and supported by Manitoba Health Minister Tim Sale.
There are always tough decisions to make when it comes to health care, Sale said. For example, a new drug might extend a life for a few months, but spending that money on screening might save a life.
One drug Manitoba doesn't fund is Avastin, which extends the life of advanced colorectal cancer patients by an average of four months. CancerCare Manitoba is still studying that drug to ensure it is worth the estimated $7.7-million price tag.
patti.edgar@freepress.mb.ca
New cancer drugs come at a steep price
New cancer drugs that are part of CancerCare Manitoba's $12-million request to the provincial government:
ZEVALIN
Last-ditch treatment for some non-Hodgkin's lymphoma patients. Costs about $20,000.
RITUXAN
Used in combination with chemotherapy for most types of non-Hodgkin's lymphoma. Only funded by the Manitoba government for 60- to 80-year-olds at a cost of about $20,000 to $34,000. CancerCare Manitoba has spent more than $1 million making it available for all ages.
HERCEPTIN
Used for many years in treating advanced breast cancer. Today, it's part of a first-line, routine treatment for a small group of eligible women at a cost of up to $50,000 per patient.
ELOXATIN
Listed twice in the Cancer Coalition study because it's used in treatment of colon and advanced colorectal cancer. Funded in Manitoba on a case-by-case basis at a cost of about $20,000 to $25,000 for a course of treatment.
Drugs still under study that aren't part of the request:
BEXXAR
Another last-ditch treatment for some non-Hodgkin's lymphoma patients. Limited availability in five provinces.
IRESSA
For some patients with lung cancer. Limited access in B.C. and Ontario.
ZOMETA
Reduces bone complications from advanced breast cancer. Limited availability in Quebec, Nova Scotia and Newfoundland.
AVASTIN
With chemotherapy, it extends the life of advanced colorectal cancer patients by an average of four months. Recommended for use in eight provinces, but limited availability in some.
ERITUX
Used with chemotherapy for colorectal cancer. Not available in any province.
VELCADE
Targets a form of blood cancer called multiple myeloma. Manitobans get it on a case-by-case basis at a cost of up to $57,000 for a course of treatment.
Source: Cancer Advocacy Coalition of Canada, CancerCare Manitoba
PHOTO PHIL HOSSACK/WINNIPEG FREE PRESS