E-DRUG: Paying for expensive cancer drugs
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Dear E-druggers,
Do people in other countries have the same problem of companies not willing to market drugs because the patents have expired and then using some kind of an emergency drug release program to get their drugs sold in the country?
[see below for a Canadian example; WB]
If anyone has further information about either this drug or others I would be very interested to hear about it.
Thanks
Joel
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Joel Lexchin MD
121 Walmer Rd.
Toronto ON
Canada M5R 2X8
Tel: 416-964-7186
Fax: 416-736-5227
E mail: joel.lexchin@utoronto.ca
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Province not paying for pricey cancer drug
Treatment costs senior $10,000
Michelle Lang
Calgary Herald
Sunday, February 19, 2006
As Alberta prepares new legislation to become a leader in the war against cancer, some colon cancer patients are being forced to pick up big bills -- with tabs running as high as five figures -- for chemotherapy.
Alberta is one of three provinces that doesn't fund the drug oxaliplatin, considered an effective therapy for advanced colorectal cancer, because of a patent problem that never saw the drug go through a federal review process.
Yet oxaliplatin is often prescribed for colon cancer, leaving patients like 80-year-old Three Hills resident Eldon Brodner to pay for treatments that have cost him more than $10,000 in the past nine months.
"It makes one cross," said Audrey Brodner, Eldon's wife. "With all our rich oilfields . . . why can't they afford it?"
Officials explain that Alberta Health doesn't cover oxaliplatin because it hasn't gone through the formal federal regulatory review that the province requires before paying for pharmaceuticals.
'When we don't fund particular drugs, it's usually because the expert drug review panel hasn't recommended it as a drug of choice," said Health Minister Iris Evans.
Questions about oxaliplatin's funding come as Alberta prepares to introduce Bill 1, the Alberta Cancer Prevention Legacy Act, at the beginning of this week's legislative session.
The bill will provide more cancer funding for research, screening and prevention, making "Alberta one of the leading jurisdictions in North America in cancer expertise," according to a press release.
But critics say Alberta can't call itself a leader in cancer care if it isn't funding standard chemotherapy treatments like oxaliplatin.
"It is just another demonstration that with this government the left hand doesn't know what the right hand is doing," said NDP Leader Brian Mason.
Oxaliplatin has been available in Canada since 1998 and is used around the world to treat colon cancer.
But manufacturer Sanofi-Aventis says it never took oxaliplatin through Ottawa's standard drug review process because the therapy took a long time to develop and its patent protections have run out.
As a result, Sanofi-Aventis never sought a federal "notice of compliance" for oxaliplatin, which some provinces use to determine funding. Instead, Health Canada allowed the drug's release under its special access program.
The situation caused spotty provincial funding for the 3,000 Canadians taking the drug last year, with seven provinces paying for most treatments.
Alberta, Ontario and Nova Scotia don't cover oxaliplatin, according to a Cancer Advocacy Coalition report.
Sanofi-Aventis will subsidize lower income patients who can't afford oxaliplatin in those provinces and pays to treat 900 Ontario and 80 Alberta residents.
But that still means Albertans like Brodner, a farmer who has the income to pay for the drug, must foot the bill themselves.
The Colorectal Cancer Association of Canada said Alberta has a moral duty to cover the drug, despite the patent problem that has scuttled the federal review process.
"It's ridiculous . . . especially in a province like Alberta, which is giving 400 bucks to every person," said president Barry Stein.
Yet officials with the Alberta Cancer Board, which delivers cancer treatments for the provincial government, said they don't recommend funding for drugs without Health Canada's notice of compliance.
Dr. Neil Hagen said it's unfortunate oxaliplatin hasn't gone through the federal regulatory process, but said it would be irresponsible for government to fund treatments that haven't completed the review.
"The policy is the public purse won't be used to fund drugs unless they've got a notice of compliance," said Hagen of the Alberta Cancer Board, adding that other colon cancer treatments are available.
Brodner's family said they were surprised to learn that government didn't pay for a drug that physicians at Calgary's Tom Baker Cancer Centre recommended. Brodner has had mixed results from his oxaliplatin treatments and is currently in Red Deer hospital after undergoing emergency surgery last week.
"Here he has paid into the system for all these years and now when he needs help, he has to pay again," said Brodner's daughter, Jo Ann Schimke.
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