Cancer Care Ontario proposal could put pressure on employers
Gord Hart, Partner, Employee Benefits & Pensions

A Cancer Care Ontario recommendation that Ontario cancer patients be allowed to pay for unfunded, intravenous drugs and infusion costs in public hospitals could put pressure on employers and their insurers to cover the cost of these expensive treatments.

Currently the only options for patients who have been prescribed one of these unfunded IV drugs are to go to a single private clinic in Toronto or to go to the U.S. In either case, the patients pay substantially more than they would if the drug was available in an Ontario hospital.

If the government accepts the proposal contained in a working paper sent to the Ontario government at the end of July, cancer patients would pay for drugs they receive in provincial hospitals -- something that has long been seen as a violation of the Canada Health Act as it could be construed as paying for a medically necessary service.

However, legal analysis undertaken by Borden Ladner Gervais LLP before the working group was struck concluded that there was no legal impediment to a hospital providing unfunded IV drugs for private payment.

"If going forward people are going to have to use their life-savings to pay for these drugs, plan sponsors and insurers will have to make some hard decisions," says Christine Than, a pharmacist at the pharmacy benefit management company Emergis.

THE NEXT STEP IS YOURS. TAKE THE FIRST STEP ON THE RIGHT PATH.

CALL US TODAY!