Deborah Maskens was told she had a year to live when she was first diagnosed with stage four kidney cancer in 1996.
Twenty years later, the Guelph native is still very much alive and taking her fight for better chemotherapy coverage east to Nova Scotia, where residents pay the highest annual deductible rates for take-home cancer medicines in Canada. A co-founder of Kidney Cancer Canada, she attended the Atlantic Canada Oncology Group’s conference in Halifax Friday to make her case as part of the Cancertainty coalition of 30 patient groups.
“It’s inhuman to give somebody a cancer diagnosis and then to send them home to figure out how on Earth they’re going pay for the treatment,” said Maskens. “Getting cancer (drugs) shouldn’t be so difficult and it shouldn’t be so different from province to province.”
The Nova Scotia deductible amounts to an annual payment of $23,400 on a Family Pharmacare plan for take-home chemotherapy medicines, $9,000 more expensive than Prince Edward Island. From B.C. to Manitoba, cancer patients pay nothing.
“It’s a human rights issue,” said Maskens, who still has several active tumours in her body.
Unlike western provinces, Nova Scotia only offers full coverage for chemotherapy if the drugs are administered intravenously at a hospital.
But Maskens said that “60 per cent,” of new chemotherapy drugs are in pill form and Nova Scotia treats them the same as regular prescription drugs such as antibiotics or painkillers.
What’s more, patients taking pills must navigate a bureaucratic maze to access any funding at all, including applying for a provincial drug plan, filling out reams of paperwork and declaring household income, and make an appointment with a reimbursement specialist.
“All across Nova Scotia there are drug ‘navigators’ who will help patients figure this out because the process is so inherently complicated and difficult,” said Maskens.
She recalled one Nova Scotia man with terminal melanoma who thought he had insurance but would actually be out of pocket for $14,000. Eventually he received help from drug companies but he later passed away.
“He went night after night of not sleeping because he had no idea,” said Maskens. “To put that man through that when he had terminal cancer? That’s inhuman.”
Her solution is to bring take-home medicine prices into line with hospital treatments, saying that Manitoba had already cut patient drug costs to zero in 2012.
She also said that the actual treatment process also needed to be simplified. Patients in the western provinces can simply pick up their medication immediately after diagnosis and start treatment, just like for intravenous chemotherapy, said Maskens.
“Realistically that’s not going to happen overnight but we need to see some progress on this,” said Maskens. “We were here a year and a half ago raising this issue with government and we haven’t really seen any progress.”
Maskens said Health Minister Leo Glavine had previously expressed concern over the situation facing Nova Scotian cancer patients and the provincial government has also called on Ottawa to roll out a national pharmacare plan.
However, such a plan is not in the cards any time soon and even if implemented would take several years to roll out, too late for many cancer patients, according to Maskens.
“That’s not an acceptable answer,” said Maskens. “Nova Scotia can solve this if there is a political will to do it.”
But Ministry of Health spokesman Tony Kiritsis said that a specific patient’s out-of-pocket costs varied widely depending on what program they were enrolled in, their household income, number of dependents within a household, and other criteria.
“We recognize that for a small percentage of Nova Scotians who are under family pharmacare, the high cost of oral cancer drugs may present a challenge, but we know that the majority of oral cancer drug recipients are supported by other programs,” said Kiritsis.
He said that his department contributed more than $10 million toward oral cancer drugs in the 2015-16 period. Kiritsis also said that in this same time period, about 87 per cent of Nova Scotians who will access oral cancer drugs through one of the several drug programs on offer did so at minimal cost.
“Seventy-seven per cent of these people are enrolled in Seniors Pharmacare, with the remainder taking part in Community Services Pharmacare, drug assistance programs for cancer patients and other smaller drug programs,” said Kiritsis.
Via Fram Dinshaw