HIT BY CANCER - AND BILLS
Pierrette Breton has two forms of cancer, and has to pay out of pocket for the drug she takes for one of them, Stage 4 NET (Neuroendocrine Tumours) cancer — at a cost upwards of $10,000 per month.
Pierrette Breton has been diagnosed with two types of cancer. But instead of concentrating on her extraordinary health challenges, the Ottawa businesswoman has been forced to focus on the financial implications.
That’s not something she says she expected in Canada.
“I thought in Canada we didn’t have these problems. We are supposed to be a country that covers these things.”
“These things” are the drugs she must take to treat neuroendocrine cancer. While cancer drugs administered in hospital — intravenous chemo, for example — are provided at no cost, patients must pay for many drugs they take at home, sometimes costing tens of thousands of dollars a year. A coalition of health groups called CanCertainty wants Ontario to close gaps in coverage that leave some cancer patients with massive bills because they are being treated with drugs at home rather than in the hospital.
In order to be able to function and to slow the growth of her neuroendocrine cancer, Breton was prescribed two drugs. One cost about $8,000 a month, the other between $1,700 and $1,800 a month.
She was on both drugs — at a cost of more than $100,000 a year — until last summer, when she received a second bout of devastating health news: She had breast cancer. Subsequent rounds of chemotherapy and surgery meant she had to temporarily go off the most expensive of the drugs, but she expects to be back on it sometime this summer.
Unlike many people facing massive cancer drug bills, Breton was fortunate to head a small company with health insurance when she was diagnosed, first with neuroendocrine cancer, then breast cancer.
But there was a problem. The insurer said the burden of covering her cancer drugs meant the company would have to begin paying thousands of dollars more a month for its employees’ coverage, more than her small company could afford. Breton could either reduce insurance coverage for everyone or take herself out of the plan.
After considering whether she and her husband would have to sell their home, she took the dramatic step of selling her company’s assets, including employees, trademark and equipment, instead. She now works with one other employee in a dramatically pared-down business. She has health insurance — for which she pays a large monthly premium — for now, but that will still leave her with monthly costs of up to $2,000 when she is on both drugs. As her cancer progresses and she can no longer work, Breton is not sure what the situation will be.
Breton says she was shocked to learn about the costs of drugs necessary to treat cancer, and even more surprised to learn of the inconsistencies. She paid nothing for the various treatments she needed for breast cancer, she said, but her treatments for the less common neuroendocrine cancer were not even covered by the Trillium Drug Plan that covers part of the cost of many cancer drugs in Ontario.
Deb Maskens, a kidney cancer patient who co-founded Kidney Cancer Canada and who is a lead organizer of CanCertainty, said Ontario’s Trillium Drug Plan is cumbersome and costly for many patients who must pay four per cent of the family’s total net income for drugs and often wait weeks to get them. Some patients must pay thousands of dollars a month for cancer drugs; others pay nothing.
“We realize Ontario has some fiscal restraints, but we need to resolve the discrimination,” Maskens said. “It is arbitrary, based on whether treatment is intravenous or in tablet form.”
And while Ontario Health Minister Eric Hoskins has been “a tremendous spokesman for a national pharmacare program,” Maskens said that could take years. In western provinces, she said, patients receive cancer drugs from a pharmacy at the hospital at no cost after seeing their oncologist.
Currently, about one-third of cancer treatments are take-home treatments, Maskens said, “and that number is going to be closer to 60 per cent in the coming years.”
The stress of whether they can afford the drugs is making cancer even more traumatic for many patients, she said.
And Breton’s case underlines the pressure on small business, said Maskens.
“It is a big stressor,” said Breton.