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Cancer patients in Ontario pay more out of pocket compared to other provinces

By: Yona Harvey, Local Journalism Initiative Reporter

A cancer diagnosis for an Ontario resident has a significantly higher price tag and out-of-pocket expenses than residents of other provinces such as British Columbia or Alberta.

“They are facing hundreds, if not thousands of dollars of out-of-pocket expenses,” said Stephen Piazza, manager of advocacy for the Canadian Cancer Society (CCS). “It shouldn’t be this way.”

“In British Columbia or Alberta, (if you were) prescribed take-home cancer medications, it would be 100 per cent covered. In Ontario, it’s not,” Piazza said.

Ontario has been slow to adopt new forms of treatment, with more than 50 per cent of new cancer medications developed in a take-home format, according to him.

“We need to look at advances made and really have OHIP (Ontario Health Insurance Plan) and support programs match those advancements,” he said.

Piazza explained that the further you move away from (in-hospital) treatment, the fewer supports are available. This could include expenses such as the cost of new cancer drugs, transportation, accommodation, child-care support (for siblings of young cancer patients), home renovations and at-home hospital beds.  

Loss of income will also be a significant factor. “If a child becomes ill, you’ll have two parents that might be needing to take time off work to take that child to hospital,” said Sarah Chisholm, a financial advisor from O’Farrell Financial Services in Kemptville.

“For a lot of patients, they’re left navigating a patchwork of support systems in a really complex landscape,” said Piazza. 

Chisholm said, “It’s great that we have universal health care, but the reality is that it doesn’t cover everything. You’re lucky if you’re under 25 or over 65 because some of your prescription drugs are covered.”

Even if one has work insurance, the average cost of take-home cancer medication is over $6,000, Piazza said. With deductibles, caps and co-payments, out-of-pocket expenses can skyrocket over eight to 16 months of a typical treatment. 

In surveys done by CCS recently, 49 per cent of cancer patients and caregivers were concerned about their financial situation. Parents of young children with cancer have the highest out-of-pocket expenses.

The Canadian Cancer Society provides services such as life-saving impactful research, support services and advocacy to help shape public policy to benefit people diagnosed with cancer.

“We are calling on the government to address this gap for take-home cancer medications because this does not exist in other provinces,” Piazza said.

Piazza also encourages people who are able and willing to speak out about their unique needs and situations to “help sway government and influence change.”

On a brighter note, Piazza said that Ontario has among the highest cancer survival rate in the world. “We need to focus and build on this success to make sure Ontarians can access this high-quality care without financial hardship,” he added.

Critical Illness Insurance

One of the ways to avoid financial hardship during treatment is to have critical illness insurance. Matthew Thomas, a Sun Life financial advisor from Smiths Falls, said that “not enough people know about it.” 

“If a client is diagnosed with one of 26 critical illnesses, (one can take out) a lump sum — minimum of $25,000, tax free — to be paid out within 30 days of being diagnosed,” Thomas said.

“They have the choice to spend that money any way they want — (to buy) new, experimental drug, they can go to the United States, they can go anywhere in the world (for treatment).”

The statistics are grim: one out of two people will be diagnosed with critical illness before they’re 65, according to Thomas.

“The chances of dying versus coming down with a critical illness? You’re more likely to come down with a critical illness,” added Chisholm. 

For more information, call the cancer information helpline at 1-888-939-3333 or visit www.cancer.ca/en/?region=on.

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