Nova Scotia government could close coverage gaps for take-home cancer medications for less than $2 million

-- New estimate uncovers a modest investment into the province's cancer system could eliminate financial hardship for patients --

HALIFAX, April 26, 2017 /CNW/ - The McNeil Government has the opportunity to eliminate the financial hardship and related stress patient experience when they require cancer medications taken at home with a modest investment of less than $2 million dollars.

Canada's Western provinces all treat take-home cancer drugs and hospital-administered cancer drugs on an equal basis, regardless of cancer type, age, or income. This is not the case in Nova Scotia, where patients currently face the highest out-of-pocket costs in Canada for take-home cancer medication, as well as significant administrative delays in starting their critical, life-saving treatments.

While cancer patients under the age of 65 can apply to Nova Scotia's Family Pharmacare program for financial assistance, the deductible and co-payment ceilings are very high and represent a significant percentage of family income.

"Nova Scotians want a cancer system that puts patients first, that allows people to focus on their health, and puts the burden of funding, access and administration into the background – which could be achieved with a modest investment," says Deb Maskens, kidney cancer patient and co-founder of CanCertainty, the united voice of over 35 Canadian cancer organizations. "But we need to see change now, because cancer patients cannot wait any longer."

For over two years the CanCertainty Coalition has been asking the Honourable Leo Glavine, Minister of Health, to fix the two-tiered cancer treatment issue. But despite commitments to immediately look at the problem, no action has been taken.  

As recently as October 2016, the Health Minister was asked in the House of Assembly if he would estimate the costs to eliminate the financial hardship for patients having to pay for their cancer drugs taken at home. The Minister refused to commit to estimate the costs.ⁱ

Subsequently on December 8, 2016, the CanCertainty Coalition requested data from the Nova Scotia Department of Health and Wellness regarding current drug program expenditures and coverage.  When the data was received on March 29, 2017, the Coalition engaged a professional health economist to determine what the province would have to spend to close the gaps on coverage for cancer patients requiring take-home cancer drugs who had no private insurance, or limited private insurance.

The estimate assumes that private insurance remains part of the coverage solution, an approach that will minimize the incremental financial burden for the province.

"A modest financial investment will ensure that cancer patients prescribed take-home drugs will be treated equally to patients prescribed intravenous drugs.  Minister Glavine and the Nova Scotia government have the power to eliminate co-payments and deductibles that currently apply only to cancer drugs taken at home" says Angela Rocchi, Principal, Athena Research.

About 68 percent of Nova Scotians under 65 have private drug coverageⁱⁱ which generally includes take-home cancer drugs.  Even for these patients, however, out-of-pocket expenses due to co-pays, deductibles and annual maximums can be onerous, and some take-home cancer drugs can be excluded by private plans.  As a result, there can be significant funding gaps, even for Nova Scotians under 65 who have a private drug plan.  

The Evolution of Cancer Treatment

Traditionally all cancer treatments were administered to patients by an IV in the hospital. Over the past 10 years, an increasing number of effective cancer treatments can be taken at home by pill or injection.  Take-home cancer medications are now a fundamental part of today's cancer treatments and should be recognized equally within our health care systems. The majority of cancer patients today will require a take-home cancer drug.ⁱⁱⁱ

Patients requiring an intravenous treatment can start that medication as soon as needed and don't face any financial or administrative burdens provided the drug is included on the provincial formulary.

However, when take-home cancer medications are prescribed, patients in Nova Scotia who are under 65 have to apply to a variety of funding assistance programs and ultimately pay a significant deductible or co-pay from their personal savings. In some cases, the cost to the patient might be as high as $23,400 annually, based upon Nova Scotia's Family Pharmacare Program. To qualify for assistance programs, patients and their families have to submit significant amounts of personal and financial information and often face weeks of stressful delay in starting their cancer treatment until the paperwork and approvals are resolved.

Two in five Canadians will face a cancer diagnosis in their lifetime and Nova Scotia has the second highest rate of cancer mortality when compared to other provinces.^iv

About the CanCertainty Coalition
The CanCertainty Coalition is the united voice of 35 Canadian patient groups, cancer health charities, and caregiver organizations from across the country, joining together with oncologists and cancer care professionals to significantly improve the affordability and accessibility of cancer treatment.  For more information and to view our list of members, visit www.CanCertainty.com.

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ⁱ Nova Scotia Legislature Hansard, October 26, 2016 http://nslegislature.ca/index.php/proceedings/hansard/c97/house_16oct25/#HPage487. Accessed on April 25, 2017.
ⁱⁱ Canadian Life and Health Insurance Association.      https://www.clhia.ca/domino/html/clhia/CLHIA_LP4W_LND_Webstation.nsf/resources/Factbook_2/$file/2016+CLHIA+Factbook+ENG.pdf. Accessed on April 25, 2017.
ⁱⁱⁱ Beca J, Gavura S.  Shifting trends:  an analysis of the use of intravenous and take-home cancer drugs and public spending in Ontario.  CADTH Symposium 2017.
^iv Canadian Cancer Society Statistics, 2016 http://www.cancer.ca/~/media/cancer.ca/CW/cancer%20information/cancer%20101/Canadian%20cancer%20statistics/Canadian-Cancer-Statistics-2016-EN.pdf?la=en. Accessed on April 25, 2017.

SOURCE CanCertainty Coalition

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