We keep hearing how bad insurance companies are and how we need a government option and government control... Well, the Ontario government has set a limit on the cancer treatment Avastin to just 16 cycles. At that point the government is basically saying that the cost outweighs the benefits. There you have it... here is the Ontario version of the "death panel"...
During my dealings with Blue Cross Blue Shield here in Michigan they have never turned down coverage for anything requested by the doctor.
BTW, eHealth (an electonic health records for Ontario is under fire for money mismanagement and you can read that here:
http://www.ctv.ca/servlet/A...0?hub=TorontoNewHome )
By ANTONELLA ARTUSO, SUN MEDIA QUEEN'S PARK BUREAU
TORONTO -- An Ontario health ministry decision to limit public funding of a drug used to treat advanced colorectal cancer is based solely on cost considerations, ombudsman Andre Marin says.
Marin's investigation into the availability of cancer treatment Avastin -- A Vast Injustice -- concluded patients showing improvements were unfairly denied coverage after 16 treatment cycles.
"Many of these patients and their families are terrified and desperate," Marin said.
"Many find it bitterly ironic the ministry was so quick to justify cutting off Avastin funding, while at the same time its intemperate spending in connection with eHealth Ontario has been exposed and come under fire."
Marin said cancer patients are told they can seek more funding through a "compassionate review" process but he found it to be a frustrating "Catch 22" situation with little promise of success.
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"This policy right now as it's proposed is as dumb as a bag of hammers . . . it's contrived compassion, not genuine compassion," he said.
The health ministry publicly announced in July, 2008 that it would fund Avastin for treatment of metastatic colorectal cancer after it was shown to inhibit the growth of blood vessels supplying tumours and increase lifespan.
Health Minister David Caplan said three independent studies recommended a 12-treatment cycle, but the government opted for 16 treatments, and the option of an appeal to the compassionate review policy.
"Mr. Marin, of course, uses some very inflammatory language . . . I rely upon the advice of medical experts," Caplan said, noting Marin's report appeared based on anecdotal evidence.
A health ministry official said experts look at the clinical benefits of a drug and the cost effectiveness compared to other treatments in coming to a decision about funding.
Each cycle of Avastin costs about $2,500.
Marin said he got only "blank looks" from ministry staff when he asked to see the scientific evidence in support of an automatic 16-cycle cutoff.
"It's all a figment of the bureaucracy's imagination," he said. "It's all an issue of cost containment."
Dave Tomlinson, the cousin of Patricia Holmes, 69, one of the cancer victims profiled in Marin's report, said she's into her 20th cycle of Avastin and her tumours continue to shrink.
After the government cut off Holmes' funding, a volunteer in her community just south of Ottawa offered to raise funds to pay for more treatments.
Without that help, Holmes and her husband, both seniors, would have had to choose between selling their home or ending treatment, Tomlinson said.
"They shouldn't have to be making that decision at this point in their life to sell their home so one of them can live," he said.
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