Tuesday, 14 April 2015

The Right to Free Healthcare: Funding At-Home Cancer Drugs

Daffodil Pins for Daffodil Days
It might've been on your commute or as you were walking into a multi-storey office building downtown or in a grocery store you attend. A person in a yellow apron carrying a box filled with plastic pins and a money slot. Daffodil Days. I myself raised some funds downtown. Meanwhile at the end of March I heard about the Daffodil Days campaign starting back at my high school and felt pride to my former teacher supervisor for continuing my initiative. As it is Daffodil Month, today's blog post shifts towards healthcare rights in, as you most likely guessed in the last second, cancer.

First as a backgrounder, cancer is caused by cells in the body dividing uncontrollably due to a negative mutation, or change in its DNA information. Different methods of treatment currently include chemotherapy, radiation therapy, biological therapy, hormonal therapy, stem cell therapy and surgery. Chemotherapy uses drugs to kill cancerous cells, radiation therapy uses high-energy light (radiation) to repeatedly destroy cancerous cells, hormonal therapy changes specific body hormonal levels to prevent cancerous cells from growing, biological therapy changes cancer cell behaviour by using substances mimicking regular substances which cancer cells use, stem cell transplants introduce stem cells to the bone marrow if it has been damaged by other types of therapy while surgery removes the cancer-infected portion of a patient's body. In 2009, it was predicted that "45% of men and 41% of women" will develop cancer in their lives while 2006-2008 estimates predicted that the five-year-survival rate is 63% of those diagnosed, ranging between 17% for lung cancer and 96% for prostrate cancer.

Three types of the treatment I mentioned above require specific cancer drugs to be treated. Alongside treatment-specific drugs, cancer patients are prescribed medications to reduce negative side effects of treatments.

Approximately one-third of cancer medications are taken at home rather than the hospital, though this number is expected to reach sixty percent. If taken at the hospital, cancer patients do not have to pay for their drugs. If taken at home, they pay additional costs. According to the Canadian Cancer Society, "about three-quarters of newer cancer drugs taken at home cost over $20,000. The average cost of a single course of treatment with newer cancer drugs is $65,000." Even though Ontario has its Drug Benefit Plan which covers cancer medication costs for those on social assistance or seniors, co-payments result in paying $6,000 annually. The plan also sets an annual deductible of around $100. Furthermore differences in cost coverage between provinces have that a patient's location decides what amount they pay. Canada's western provinces (British Columbia, Alberta, Saskatchewan and Manitoba) and Quebec cover costs for home-administered drugs while the same coverage lacks in other provinces. Three years ago Manitoba introduced its initiative to "fund oral cancer drugs through the new Manitoba Home Cancer Drug Program (HCD) which is a program for Manitobans diagnosed with cancer that funds eligible outpatient oral cancer and specific supportive drugs, as listed in the HCD Program Formulary, at no cost to the patient." For almost a year in New Brunswick, the program has been in effect. Yet some believe that the insurance rates of the plan are costly for rates which "range from $800 per year for an individual earning less than $26,360 or a single person with children or a couple with or without children earning $49,389 or less. The highest fee is $2,000 per year for an individual earning more than $75,000 or a single person with children or a couple with or without children earning more than $100,000." At the same time, it requires a 30% co-payment for each drug, limited to thirty dollars per prescription.

What impact arises from paying large amounts of money to receive cancer medications? According to the Canadian Cancer Society, nine of ten cancer patients experience financial difficulties in paying for cancer treatment. 16.5% of Ontarians in a study found out-of-pocket treatment costs "significant" and 3.9% found them "unmanageable." Rural patients have travel costs for treatment, an estimated of $1000 in Newfoundland and Laborador. The younger a patient is, the larger the financial impact the patient pays for treatment. Additional costs arise in those that take time off work to be treated or to care for a family member with cancer. Some have sold property or assets to pay for costs. Recently the Ottawa Citizen covered a woman who sold her business to pay for her cancer treatment, leaving it with only one other employee. Some cancer patients are skipping doses or treatment altogether to avoid the financial impact. A study performed by the University of North Carolina showed that those with higher drug co-payments were seventy percent likelier to end their treatment and forty-two percent likelier to skip doses.

Why should a living person on the planet need to spend large amounts of money to fight for their life? There is no right to give a person the opportunity to choose survival chance at the price of financial hardship or saved money by guaranteeing death. There is no right for cancer treatments to be as costly as an expensive Ontario university education. (Whose costs also need to decrease) Is cancer not enough of a stressful challenge without worrying about the inability to pay for treatment? Life-and-death situations should not become debt-or-death situations. A person at meetings at the Canadian Cancer Society battled cancer at a young age. I know those that know those fighting cancer. Last year when I did a Daffodil Days campaign at my high school and travelled across the school to collect signatures to an "I'm donating for" wall, many had personal connections to cancer. Is this what I want them and those they know with cancer to face? Not at all. 45% of males and 41% of females. (As I am religious, I will use the following term -) God-forbid my dread that those close to me or those close to those close to me join the statistics, how will they pay? The second-last situation I want to see them in is to consider selling their assets or anticipating social insurance simply for the right to fight for their life or not having enough in the first place to fight for it. (What is the last situation, you wonder? Death itself.) It is almost a situation where one is convicted of a crime and must bribe large amounts of money to receive a trial. Is this what we call free healthcare? The right to healthcare? The right to treatment? I disagree.

In the dread of being another person watching a person we know enter hardship in the face of survival, another doctor addressing patients' financial concerns with empty solutions, or a cancer patient ourselves wishing we relocated to another province earlier enough, what do we do? I believe there is hope. A coalition of thirty non-profit organizations, CanCertainty, are calling to provincial governments to cover take-at-home medications. The Canadian Cancer Society's Ontario Division posted a petition to Ontario MPPs (provincial politicians) on its Ontario Division Take Action webpage. Media coverage is spreading on the issue. We have the power to address our politicians. We have the power to not give up in turning around Debt-or-Death to fulfilling of one of CanCertainty's slogans: "Cancer isn't fair, but access to treatment should be." 
CanCertainty image
One of CanCertainty's slogans: "Cancer isn't fair, but access to treatment should be."
Taken from http://www.cancertaintyforall.ca/social_media_resources

- FA

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