Ont. cancer drug ruling being reviewed

Evidence that led experts to deny a young mother an expensive breast cancer drug is being reviewed, Ontario health officials said Wednesday as critics called for the government to show some compassion.

Diane McArthur, who heads Ontario's public drug program, said she has asked experts to look for any additional evidence that might change the province's guideline for Herceptin.

The province's health insurance recently rejected Jill Anzarut's request for the drug, which costs about $40,000, because her tumour was deemed too small.

"If new evidence comes forward, we'll make sure that it's reviewed," McArthur said.

That doesn't necessarily mean the guideline or Anzarut's situation will change, she added.

Many are calling for the province to set aside its rules and take a more human approach to Anzarut's case.

"Women facing these kinds of very scary and frightening health issues like breast cancer don't want a rule book thrown at them, they want some compassion from the minister of health," NDP Leader Andrea Horwath said.

Health Minister Deb Matthews said she will not interfere in the decision.

"I will not instruct (the Committee to Evaluate Drugs) what to do. I can't do that," Matthews told reporters.

"What I can do is educate myself on exactly what that evidence is as best as a lay person can do," she added.

Anzarut, a 35-year-old mother of two, said dealing with her diagnosis and the resulting bureaucracy has been "overwhelming."

"I understand Deb Matthews is deferring to medical experts, but why do [Ontario's] have a different opinion than everybody else's, and different from my oncologist's?" she said Wednesday.

Anzarut's tumour is a half-centimetre in diameter, but Ontario's health insurance will only cover the drug for tumours larger than one centimetre.

That's because the guideline is based on clinical trials, and nearly all were conducted on women with larger tumours, said Dr. Carol Sawka, vice-president of clinical programs and quality initiatives for Cancer Care Ontario.

The standard of care is to provide the drug to the population included in the clinical trial, said Sawka, who is among the experts advising the government on the issue.

Some other provinces, including British Columbia, Alberta and Saskatchewan, cover the drug for smaller tumours.

Christine Elliot, the Conservative health critic, said the government should investigate why other provinces are providing the drug to patients in Anzarut's situation.

"If there are experts out there that say Herceptin works on smaller tumours as well as larger tumours, I think it's incumbent on the minister of health to make inquiries," Elliot said.

The province stands to save money by treating cancer sooner, before it develops any further, she said.

"What is the cost to the system of a young mother with advancing breast cancer and an inability to work, an inability to care for her children," she said.

"That's going to cost the health-care system a lot more in the long run."

Anzarut's oncologist made an exceptional access request to the ministry this weekend in the hopes of securing the drug for his patient.

In the meantime, Anzarut is undergoing chemotherapy and had her first treatment on Wednesday.

Studies show Herceptin, when combined with chemotherapy, can drastically reduce recurrence rates for women with Anzarut's type of cancer.