Last-hope prostate drug not funded

[SteveH]

HEALTH: Ontario is the only province that won’t pay for medication that can lengthen dying men's lives and lessen their pain





There are two tiers of men with advanced prostate cancer in Ontario: Those who get access to a remarkable drug through private insurance, and those who get a death sentence.

The grim news is often delivered at the London Regional Cancer Program to men whose shoulders sag and jaws drop when told Ontario's Health Ministry has for 15 months refused to pay for a medication covered by every other Canadian province.

"There's shock, fury and dismay," said oncologist Kylea Potvin. "Everyone thinks we have this wonderful universal health care system, but this is absolutely not the case. We've increasingly become a two-tier health care system where if you have money, you have access."

The drug Zytiga is a last resort for men whose prostate cancer has spread and who wouldn't benefit from aggressive chemotherapy or even chemical castration.

A pill with few side effects, Zytiga targets an enzyme needed to make a hormone that feeds the cancer and studies have shown it to slow its progression, leaving men living months or even years longer and without as much pain.

It was quickly approved in the United States and by Health Canada.

But Ontario rejected the application, a decision that's left heroic patients such as Percy Bedard of Zurich calling on Ontarians to ask their government why it has abandoned so many men to suffer and die before they should.

"(Health Minister Deb) Matthews: What's my life worth to you?" the 67-year-old Bedard told The Free Press.

The Free Press relayed his question Wednesday to Matthews, who expressed sympathy for Bedard, admitted it was the drug's costs that had been the holdup and said she hoped negotiations now under way would further reduce the price enough for the ministry to cover the costs.

"The sooner we can proceed, the happier I will be," Matthews said.

In the meantime, don't feel sorry for Bedard; he doesn't. Nor does he want anyone to write a cheque to pay for the $5,000 a month pill. If you do send money, he'll give it to an advocacy group to fight for all men with his condition.

He's got something bigger on his mind than himself after living a life in Huron County, where he raised a family, played hockey and hardball until age 60 and made a modest living renovating homes and doing woodwork.

"Since we have had OHIP, when we'd travel to the U.S.A., we'd argue high and low about the merits of our (Canadian) health-care system. You know what? I wouldn't want to be caught in those conversations now," he said.

It was that ideal of a health-care system that led Bedard, after his diagnosis in 2010, to volunteer for a new chemo drug, despite objections of family and friends who didn't want him to be a guinea pig.

"If I was a rich man, I'd donate to every cause, but I didn't have any money but I did have my body (to give)," Bedard said.

The chemo drug knocked back the cancer, but after six weeks proved so toxic it left him bleeding internally and in so much pain, he spent his nights pacing with his dog.

There's nothing left for him, or many other men, to treat their cancer beyond Zytiga.

The maker of the drug, a subsidiary of Johnson and Johnson called Janssen Inc., provided it free of charge for one year for all Ontario men but that ended in February, something the health ministry knew.

Since then, oncologists have pleaded with the ministry to cover the costs, writing letters to MPPs, the ministry, which makes the final decision, and to Matthews.

"We are struggling with this," Potvin said.

Potvin is no stranger to breaking bad news to patients; some will be told their cancer will kill them. But she's tired having to tell patients that there's a drug that would help, but the ministry won't fund it.

"It's becoming very common," she said. "I see it almost very day in my clinic."

http://www.lfpress.com/news/london/2012 ... 30276.html