Auditor General Report Finds Cancer Patients in Ontario Face Delays and Safety Issues Related to Take-Home Cancer Treatments

CanCertainty Coalition and Canadian Cancer Society call for equity for all cancer patients

TORONTO, Dec. 6, 2017 /CNW/ - In its Annual Report released today, the Auditor General of Ontario found cancer patients who need take-home cancer treatments are facing administrative delays in starting treatments and safety issues.

Specifically, the Value-for-Money Audit of Cancer Treatment Services found patients are getting inadequate support for the proper and safe use of take-home drugs. When patients don't have sufficient safety information and there is a lack of pharmacist experience dispensing cancer drugs, it can lead to dispensing errors, a lack of toxicity management or safe handling, inaccurate advice and insufficient information or follow-up regarding side-effects.

In Ontario, take-home cancer treatments are not funded equitably and patients must apply for funding through special funding programs. The Auditor General's report said the processes for Exceptional Access Program and Trillium Drug Program need improvement. These complex programs create undue stress and anxiety for patients who are already shocked and stressed, as well as significant delays starting their life-saving treatments.

"The Ministry of Health and Long-Term Care has known about consequences of a two-tiered cancer system for years. There have been numerous reports, roundtables and calls for change from patients, physicians and the cancer community at large, yet little has changed," says Deb Maskens, kidney cancer patient and co-founder of the CanCertainty Coalition, the united voice of 35 Canadian cancer organizations. "For the sake of cancer patients, change needs to happen now."

The CanCertainty Coalition, the Canadian Cancer Society, physicians and patients across the province have been calling for Ontario to truly put patients first and create a comprehensive cancer system that enables all patients to access approved cancer drugs safely without delays, administrative hurdles or financial hardship.

"In Ontario, patients who need take-home cancer treatments face an antiquated system of paperwork, stress and delays," says Kelly Gorman, senior manager, public issues at the Canadian Cancer Society, Ontario. "We need change now because cancer patients cannot wait any longer."

The report surveyed oncologists in Ontario and found each spent an average of 3.5 hours per week on paperwork for Exceptional Access Program (EAP) requests, the equivalent of 182 hours per oncologist per year.

"Not only is the current dual system wasting money, but it wastes physicians' time. We're buried in administration instead of focusing on patients," says Dr. Sandeep Sehdev, medical oncologist at the Ottawa Hospital Cancer Centre. "But looking to provinces in Western Canada, it's clear both financial efficiency and patient safety can be improved when all cancer medicines are under the same program and infrastructure."

Many requests for access under EAP are initially denied, only to be approved after a second submission, which wastes more time and delays treatment, which can have dangerous consequences.

"Under the current system, I've spent more time and energy to get the medication that is saving my life than imaginable," says Sharon Dennis, a Niagara Falls resident living with leukemia. "I'm already dealing with a serious cancer, but then to be facing the mountains of forms and month-long delays is unbearably stressful."

The evolution of cancer treatment
In the past, all cancer drugs were administered by IV in hospital. But now, half of all prescribed cancer drugs are taken at home by pill or injection. Take-home cancer treatments have become a regular part of today's cancer treatments and should be recognized equally within our provincial health care systems. Most cancer patients today will require a take-home cancer drug.ⁱ

Patients requiring IV treatment in hospital can start that medication as soon as needed and don't face any financial or administrative burdens, provided the drug is included on the provincial formulary.

However, when take-home cancer treatments are prescribed, patients in Ontario who are under 65 and over 24 (starting January 2, 2018) must apply to a variety of funding assistance programs and ultimately many pay a significant deductible or co-pay. To qualify for assistance programs, patients and their families must submit significant amounts of personal and financial information for their entire household. Patients often face weeks of stressful delay in starting their cancer treatment until the paperwork and approvals are resolved.

Canada's Western provinces treat take-home cancer drugs and hospital-administered cancer drugs on a universal basis, regardless of age, income or postal code. Nova Scotia announced plans in its 2017 budget to address this issue. Ontario needs to catch up.

About the CanCertainty Coalition
The CanCertainty Coalition is the united voice of 35 Canadian patient groups, cancer health charities, and caregiver organizations from across the country, joining together with oncologists and cancer care professionals to significantly improve the affordability and accessibility of take-home cancer treatments.  For more information and to view our list of members, visit www.CanCertainty.com.

About the Canadian Cancer Society
The Canadian Cancer Society is a national, community-based organization whose mission is to eradicate cancer and enhance the quality of life of people living with cancer. Thanks to our donors and volunteers, CCS has the most impact, against the most cancers, in the most communities in Canada. For more information, visit www.cancer.ca or call our toll-free bilingual Cancer Information Service at 1-888-939-3333 (TTY 1-866-786-3934).

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i} Naipaul R, Beca J, Gavura S.  Shifting trends: An analysis of IV and take-home cancer drug use and public spending in Ontario. J Popul Ther Clin Pharmacol, 2016; 23 (suppl 1): e11.

SOURCE CanCertainty Coalition