Herceptin coverage extended – Ombudsman suspends investigation
Ontario Ombudsman André Marin today suspended his investigation into the province’s limited funding of Herceptin, after the Ministry of Health and Long-Term Care decided it would fund the drug for patients with breast cancer tumours of one centimetre in diameter or less.
TORONTO (May 12, 2011) – Ontario Ombudsman André Marin today suspended his investigation into the province’s limited funding of Herceptin, after the Ministry of Health and Long-Term Care decided it would fund the drug for patients with breast cancer tumours of one centimetre in diameter or less.
Mr. Marin announced his investigation March 18, and his Special Ombudsman Response Team (SORT) interviewed eight patients who were denied funding because their tumours were too small. SORT investigators also spoke with numerous officials in the Ministry and at Cancer Care Ontario, and reviewed funding in other provinces.
“I’m very pleased with the Ministry’s ongoing efforts to make drug funding decisions more fair and evidence-based,” Mr. Marin said. “We received excellent co-operation from the Ministry from the start of this investigation and its officials were very receptive to our questions and advice. I’m glad we were able to resolve this quickly for the patients affected.”
Although the investigation is suspended, Mr. Marin has asked the Ministry for regular updates on the implementation of its new Evidence Building Program. He will also continue to monitor developments and complaints on this issue.
More information is available on Cancer Care Ontario’s website (cancercare.on.ca), which notes today that Herceptin is the first drug to be funded through the Evidence Building Program. Effective immediately, Herceptin will be funded “to treat tumours of less than or equal to one centimetre in women who are node negative and HER2 positive,” the site states.
The case is the Ombudsman’s second investigation into limited funding of a cancer drug. In December 2009, in the wake of his September 2009 report A Vast Injustice, the Ministry lifted the 16-cycle cap on Avastin for colorectal cancer patients.
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