Good medicine

Good medicine

July 28, 2015

28 July, 2015

A woman who was experiencing a third occurrence of HER2-positive breast cancer was denied funding by the Ministry for the chemotherapy drug Kadcyla, although it was prescribed by her oncologist. The Ministry would fund the drug for women experiencing a second occurrence of the disease, but not a third – despite scientific evidence that women with third and even fourth occurrences did benefit from the drug.

A woman who was experiencing a third occurrence of HER2-positive breast cancer was denied funding by the Ministry for the chemotherapy drug Kadcyla, although it was prescribed by her oncologist. The Ministry would fund the drug for women experiencing a second occurrence of the disease, but not a third – despite scientific evidence that women with third and even fourth occurrences did benefit from the drug. The drug cost $4,600 every three weeks.

Ombudsman staff arranged for the woman’s oncologist to write to the Executive Officer of the Ontario Public Drug Programs, as well as meet with officials to discuss the Ministry’s funding criteria for the drug. After the meeting, the Ministry agreed to temporarily revise its funding criteria between October 2014 and October 2017 to include funding for some women experiencing third or fourth occurrences.

The oncologist estimated that approximately 100 women in Ontario will benefit from the temporary revision to the criteria in the next three years.