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Provincial drug disparity a roadblock to cancer research

From Wednesday's Globe and Mail

For the first time, Canada is unable to participate in a key clinical trial because patients are not getting the best known treatment ...Read the full article

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  1. Timothy Nessus from Somewhere..., Canada writes: BULL.... Here we go again!!! This sort of government-sponsored nonsense really gets my motor going!!!!

    For the umpteen time, there are CREDIBLE, VERIFIABLE, DOCUMENTED evidence that MANY alternative treatements against CANCER work. They are WAAAAY SAFER, CHEAPER and EFFECTIVE that MANY conventional therapies.

    Take Avastin for example, the best we can hope for the drug is to slow the disease down. That's IT! It will NEVER be a cure.

    Then WHY????

    Why is the government NOT sponsoring research into alternative medications and, YES, devices???

    Such research would be a TON cheaper to do and the effectiveness of the medication would be gauged on STRICT EVIDENCE, and THEN, whichever drug/device survives the process would be manufactured by GENERIC PHARMACEUTICAL companies and HENCE, people would be getting DIRT CHEAP, EFFECTIVE, CANCER CURES. YES, CURES!

    But NOOOOO.... we have to spend bazillion of dollars feeding the Big Pharma's greed.


    Meanwhile, people continue to die.

    Ladies and gentlement, welcome to Canada. Welcome to Globalization.
  2. Stude Ham from Outremont, Canada writes: if harper moves in on calgary's desire to defuse federal powers then health care across canada will become even worse than this story of provincial fragmentation reveals. here's hoping the voters understand the hidden agenda.
  3. D H from Canada writes: Cancer drugs can cost up to $1,500 a week (prostate cancer). It's more cost effective to society to use the best drugs than to seek cheaper alternatives. Even though a death might seemingly lower medical costs, in the long run this turns out to be false. Just got to wonder which politicians actually use our system.

    One thing that actually bothers me in the coverage of drugs is exactly why their costs are rising faster, sometimes up to three times, the inflation rate. The financial reports by the provincial medicare boards (i.e. RAMQ in Québec) are available to the public. Guess most reporters can't stand the math.
  4. M. I. AM from Guelph, Canada writes: The buck stops here. I am tired of hearing that this political party or that one should pay for all cancer treatment no matter the cost. Since the multi-billion dollar Pharmaceutical companies claim the reason there is such a horrendous mark-up in the price of drugs like Avastin you would think they should be happy to supply these drugs for free in order to prove it is effective in the treatment of cancer.
  5. REYNELDA O'TOOLE from HALIFAX, Canada writes: I am a person that has had breast Cancer & Colon Cancer & I am so ashamed that our wonderful country has messed up our 'Health Care' system & we now have a 'Sick Care' system.....we were always a model for the US, now we are the horses rear...verrrry sad!!
    Shame on you so called Politicians......Rubbish!!
  6. Chris Edwards from Greater Sudbury, Canada writes: Most of us have lost a loved one to cancer, and know that this disease is much more than a health condition - there is a great deal of emotion wrapped up in the struggle, moreso than any other disease. There is a difficult but necessary question to ask however - at what cost? Do we rob limited resources from treatments or research that may actually save lives to pay for those which offer another few months of pain and suffering? How much of a hit are taxpayers willing to take? How much are people willing to pay out of their own pockets? Doctors paint this as black and white - that's their job. But it isn't so easy.
  7. Jimmy K from Toronto, Canada writes: What ever happened to those grand plans about developing a national pharmacare program?!?
  8. David Michaelson from Georgetown, Canada writes: $36,000 to prolong the suffering of a termanilly ill patient for another 5 months does not seem to be an effective use of resources. If it was cure, then it would be worth it, but it is not. In Canada we treat our pets more humanely than our relatives.
  9. H K from Winnipeg, Canada writes: We ARE a third-world country when it comes to health care. Everything in the system, from the diagnostic equipment to lab testing methods to knowledgable specialists, are throwbacks from the dark ages and yet we spend more and more public funds on it without any country-wide returns. The US is light years ahead of us in all of these areas - a result of three decades of government-managed health care. The sad part of it all is that we have a burgeoning medical technology research industry right here in Canada that has NO domestic market; they sell medical their advances to other countries. In addition, doctors are persecuted if they deliver patient-directed care using alternative, state of the art or innovative methods.
  10. Gardiner Westbound from Canada writes: Interestingly Newfoundland, which is financed by Ontario and Alberta, pays for Avastin but Ontario doesn't.

    Is there anybody out there who doubts Avastin would be instantly approved if a senior Ontario government politician's family member needed it?
  11. S M from Vancouver, Canada writes: Why should $36000 be too much to give colorectal patients an extra few months of life? I would much prefer that my tax dollars go to a family that can benefit from a few extra precious months of time with a loved one than sending bumbling poloticians to international meetings, making Canada look like a joke. How much did Ambrose's trip cost? How much did Harper's trip cost? Did we actually pay for Arbour's fact finding mission? How many families could have celebrated just one more Christmas, Chanukah, Kwanzaa, Japanese New Year, Diwali, Ramadan? I find it extremely disgusting, and un-Canadian, that people place a dollar value on life, even if it is for a few months.
  12. Wayne Spitzer from Faywood, United States writes: Drugs are often of value not only for treating a disease, but also for telling us about how the disease works. The information we get by testing a treatment, may tell us what we need to know in order to make a better treatment. It may be that a cure for cancer will not be realized by a single sudden break through, but rather incrementally, one small step at a time.
  13. J T from Canada writes: #8 has it right. That's ALL we should be focussing on instead of the politics and other fluff in the story. $36,000 PER PATIENT to prolong life 5 months - YOU DECIDE - it's your tax money. and by the way $36,000 is probably equal to 36 cataract surgeries...
  14. somegal from Ontario from Canada writes: The article leaves me confused on a number of points:

    1. Why don't researchers in Canada obtain a grant (or two) to cover the cost of the drugs? If not, then why not?

    2. Why is the drug completely unavailable in provinces that don't cover it? I have private drug insurance. Just because something is not covered by the government does not normally mean I can't get it. Why is it seemingly different for cancer drugs? This leads me to wonder about my next point...

    3. How are American patients getting the drug? They don't have national drug coverage there. So we look at how they're getting it and replicate that here. In other words, they probably are using a combination of grants, private health insurance, and medicare. Why do they think we can't do that here? Anyone in a province that isn't covering it would rely on grants and insurance, and anyone in the other provinces would rely on health care. What's the big deal?
  15. Alistair McLaughlin from Ottawa, Canada writes: I see #1 Timothy Nessus is sold on alternative medicine. That's nice. You go to your local traditional naturopathic practitioner for 'detoxification' consisting of snake oil injections and seaweed wraps. If I get sick, I'm going with western (read 'modern, science-based') treatment as opposed to voo doo traditional therapies based on mythology and old wives tails. I think your yin is seriously out of balance with your yang.
  16. Johnny Chinook from Calgary, Canada writes: The US healthcare system is GARBAGE. I know from experience. No one down there except the very rich would be given this drug because they wouldn't be able to afford it. I guess if you want to live 5 more months and leave your family without a home, hundreds of thousands of dollars of debt, and devastation then please move down south. Even with medical insurance it sucks there. I was paying more there in medical insurance premiums and visiting the doctor when my children were sick ($10,000 a year), $5000 for a 10 minute ear tube operation on my son, than I do here in Canada being taxed. If you add it up with a family the USA IS TAXED MORE THAN CANADA. When you're living there you're always worried about having an emergency, because you'll be waiting all day at the hospital (worse than Canada), plus you'll get a $5000/day bill from the hospital.
  17. truly concerned from help me out, Canada writes: I am confused (as usual). Is it fair to assume from this argument that Avastin is available free of charge to all US citizens. I would guess that it currently isn't, that it is only available to those that can afford it or have medical coverage that will pay for it. So if it is simply available in the US - Why is Canada different? Why must it be paid for by the Federal Government and be the standard of care in all povinces in order to be considered 'universally applied'? Why can't it just be made available to those who choose and have the means to afford it? Why isn't this standard operating procedure for all drugs so that we are not shut out of these such trials? Is it a fear that the drug will be shown to work and then it will have to be funded?

    Someone please help me out here
  18. Normand LaBine from Winnipeg, Canada writes: I agree with the Provinces. $12,000 per month for one drug and only a 6 month extension on life. Cancer research is witchcraft. The root causes aren't being addressed because the Pharmas can't sell pills. The body has been proven over and over again to recover itself. What do people need to do to A) Avoid these canckers that for Cancerous tissue, AND B) What types of synthetics research needs to be done to replace the broken plumbing.

    Oh no, more pills, more injections, more big hospital-based machines, the sexy stuff. The simple stuff has no sizzle and no profits. The Provinces are right! $72,000 for a life that worth millions if allowed to life fully. Put the money where real solutions and mysteriously evasive, simple science can restore the person to a healthy life.

    If this keeps up, we'll have to have a pill to take out a sliver, and another for a callous, and more for mosqitoe bites (Oh yeah we're there now, aren't we?)

    I hope the Provinces push their Health Science labs to get balance back into Health Delivery. This Pill Dependency is causing even DUI legislation to fail. Some pill-dependent folks need to drive to their drugstore and may cause accidents. Replacing the parts, even while waiting for a donor seems a more wholesome and safer solution all around.
  19. Bill NotGates from Canada writes: I have worked for BIG Pharma, and the fact is research costs big money. Cancer, while it will hit about 1/3 of us in our life, is not as common as Asthma. Hence, you find that the research costs and returns per Cancer treatments are much lower based on volume 'THANK GOD'. The problem is that Pharma has to charge way more to treat Cancer in its various forms and capture back its research cost, make a profit and fund the breakthroughs of the future. A cure, or complete control is in the future and we can only get to it with research, and it costs money! To the person that mentioned 36K for 5 months not worth it, ask the person that is suffering from Cancer, maybe that 5 months is worth more than that.
  20. Iain Scott from Calgary, Canada writes: #6 and #8 have a point that should not be ignored. This issue is exacerbated by the business model used by the pharmaceutical companies. While claiming that they need huge markups in order to conduct research, in fact a much larger percentage of their revenues is spent on marketing - in some cases over half. Health care in the U.S. is completely dollar driven, and is consequently obscenely expensive - as those who used to work for Ford or GM can attest. Perhaps the researchers conducting this trial would like to try including some of those from the one-thrid of the U.S. population that have no health coverage at all, and are therefore using neither Avastin or Erbitux, they are simply using nothing and dying.
  21. Timothy Nessus from Somewhere..., Canada writes: I wasn't planning on posting a second time, but since there are so many disbelievers in alternative treatements, I will post a single, sientific bibliography reference as a proof of concept and comment briefly:

    Cesium Therapy in Cancer Patients
    Pharmacology Biochemlstry & Behawor, Vol 21, Sup#, i, pp 11-13, 1984 © Ankho International Inc Pnnted Ill the U S A
    Life Science Universal Medical Center, Sutte 306
    4501 Connecticut Avenue, Washington, DC 20008

    In summary, 50, terminally ill cancer patients that EXHAUSTED ALL 'standard' treatement (i.e. sent home to die) were treated with Cesium Chloride (NOT RADIOACTIVE), vitamines, minerals and... gasp!.. a diet!

    Do you know what happened???? 50% of the patients RECOVERED. And, please remember, these were people given for DEAD by the 'conventional' medicine.

    Also, this study was done in a clinical environment and was followed-up for 3 YEARS.

    And this is not even the tip of the iceberg. If you look at the SCIENTIFIC litearture (not your local mumbo-yumbo scam artist) you will find A TON of it.

    So, there you have it. IT IS NOT a fantasy. IT IS SERIOUS, SCIENTIFIC R&D!
  22. Dan Stevens from Winnipeg, Canada writes: #14, to address your comments

    1) Grants (by which I assume you mean government money, as there aren't many private granting agencies) are not easy things to come by in Canadian heath research, and those few available grant dollars will never be allocated to supplement a trial that is otherwise being run by another body. You can check out the grant application process on the CIHR (Canadian Institute of Health Research) webpage if you don't believe me.

    2) As Canadians, we are congenitally enslaved to the concept of a 'one-tier' health care system, no matter how demonstrably unfeasable it is. This is why you can't just go out and buy an unapproved drug, even if you have insurance or are wealthy. There is an exception for oral medications, but Avastin (like most cancer drugs) is administered intravenously, requiring a nurse, supervising physician, chemotherapy unit, etc etc. In Ontario it's against the law for a chemotherapy unit to administer drugs that you bought yourself, with the exception of one private infusion clinic in Toronto.

    3) American patients, by and large, have the drug covered by their private insurance. These insurance companies are under different cost-effectiveness pressures than provincial governments are, and therefore will fund different drugs. In this particular trial there is no 'grant' paying for the Avastin.
  23. Don Gravenor from Memphis, United States writes: Hello. I'll add my 2 cents worth, as I think this is an interesting topic.
    Dr. Wong is absolutely right; giving avastin in first and second line treatment of metastatic colon cancer is the US standard of care.
    Calling it non-cost effective is simply a fancy way of saying that the provincial government finds the price too high. The pricing of pharmaceutical agents is a complex topic, but these drugs are in fact extremely expensive to develop, and the company needs adequate compensation to continue to work on new agents.
    Most Americans do have access to avastin (given with other drugs). Once a drug is FDA approved, most insurers will cover it. Uninsured patients can generally obtain treatments without charge via hospital outpatient departments.
    As for participating in clinical trials, most provinces which don't fund avastin will be shut out of this as well as other (eg lung cancer) trials resulting in more overall frustration, and inferior care.
  24. goofy fathead from Canada writes: well now,theres a great example of backwards liberal priorities. the federal governments have wasted billions in foreign aid to place most canadians could care less about, huge welfare cheques to immigrants that dwarf the pensions of our vets, money into stupid campaigns like kyoto, and wasting billions on a completely backwards and uncanadian firearms registry, instead of distributing that money to provinces or national health care where it could make a real difference and save the lives of real canadians. way to go ya bleedin heart commies.
  25. M K from Canada writes: I would pay extra taxes each year if I know that it would extend the lives of those dying of colorectal cancer. It's not just for the patients, but for their loved ones who have so many more moments that they can cherish together. People like #13 make me laugh. You hide behind internet anonymity and whine about your precious tax money now but if placed in front of a dying man or woman with their children in their arms you would buckle in a second and dole out any amount of cash you could.
  26. It's me Again from St. Stephen, Canada writes: I have a proposal. Everybody's life is worth (say) $200,000 you can elect any treatment or drug regimen until that amount is exhausted. After that you pay or die. This applies to all ages. You are free to trade your credit if you so desire. Result: controlled health care costs, private insurance for extended plans, a balanced objective health plan that ensures everyone is responsible for their own health.
  27. Festina Lente from Tampa Bay, United States writes: To Johnny Chinook from Calgary who states medical coverage in US is garbage: True we pay two to three times the cost of health care and the only people who are on waiting lists are uninsured or foreigners without insurance. Any informed Canadian would certainly have insurance. Another problem with US health care in the vast number of schemes that appeal to rich, poor and in-between. For me, of modest means, I have the best of schemes...that of the US government of entitlements for services rendered in WW11: Medicare and Tricare for life...also for my spouse! I am most grateful for that. Shame that only Alberta can provide the best of health care in Canada and shame that Canadians cannot participate in a most important research program. Malcolm McCallum in Florida.
  28. Mark M from Toronto, Canada writes: A couple of points here -
    1. we shouldn't be talking averages. some patients have dramatic turnarounds. some don't respond at all. so should we be offering everyone the chance to be one of those where they have a dramatic turnaround? by the way, #8 - you're response is a bit chilling to me. the reason for cancer treatment is that patients can go into remission at any time. Or maybe we shouldn't treat any cancer patients? and the more we work with these therapies, the better an more effectively they get used.
    2. what do you want - tax cuts or better health care? we have a huge federal surplus and none of it is going to health care. why not? oh right. tax cuts. Read #16 to find out how that works out.
  29. Patrick Connors from Antigonish, Canada writes: Number 13...maybe I am reading you wrong but you seem to be saying that $36,000 for 36 cataracts operations is money better spent than $36 000 to prolong a life. Well, being the son of a cancer patient and the grandson of a blind man I'd ask you to think about what you said. I know, and I think my grandfather would agree with me, that money would much better be spent prolonging a life rather than spending that money on giving someone their vision.

    Now, maybe these drugs aren't the most cost effective. Maybe there is something better, I don't know, I'm no expert.

    All I'm saying to #13 is that life is more important than vision.
  30. still grieving from Canada writes: My father died two weeks ago today from colorectal cancer. At the start of his two year battle with this horrendus disease I was one of the few who thought, 'what's a few more months?' Now I think if $36,000 would have provided me with another Christmas with my Dad, or another six months of memories, who is the average Canadian taxpayer to say that it's not worth it.

    I whole heartedly believe that more funds need to go into the reasons why so many people need this treatment in the first place - the Government needs to find the causes behind so many new cases of Cancer each year so this sort of tragedy that has befallen my family, and so many others in this country can be avoided.

    But for those people who have unfortunately been given this diagnosis, as a country, we should be able to provide them and their families with the best possible care available... whether it is a cure or an extension of a few more months to spend with your family.
  31. Mike M from Toronto, Canada writes: This is a great example of the biggest problem with our health care system. People complain that in the US if a family member gets ill, well you may have to mortgage your house for them to get treatment. That sucks, I agree.

    It's much better in Canada isn't it? We don't get the option to mortgage our house to pay for their treatment - it's unavailable at whatever cost we are willing to pay and if the best treatment out there is too expensive for our system, well too bad.

    Count me among those that would prefer to mortgage my house to pay for the potential for a lengthier stay with a relative. To those who say they wouldn't - think about that next time you sit down with your loved ones. Nothing says I love you like, 'I wouldn't mortgage my house to live another 5 months, potentially much longer, with you.'
  32. S Lucht from British Columbia, Canada writes: #21: Are you serious? You've chosen a 22-year-old 'study' involving a tiny number of patients in a non-randomized, unblinded trial as evidence of the value of unconventional medicine.

    The patients had a multitude of different cancers. The abtract doesn't define 'terminal' or 'recovery', and 25% of the patients died within 2 weeks of starting treatment. Also, a host of other elements ('vitamins, minerals, chelating agents and salts of selenium, potassium and magnesium') were administered--how can you possibly say what, if anything, actually worked?
  33. Terry H from Moncton, Canada writes: Good post #1. I think we all have a scary feeling that the government would sooner see someone die than to cough up extra money to save their lives. I have a theory also. I think it is a secret prime minister conspiracy they pass along to each other. The more elderly and sick people who die, the less the government has to pay out in medical costs and old age pension cheques. Alternative medicine works, I think the Chinese and Asians have proven that over the last few thousand years. But alas, our government will continue to suck up to big pharmaceutical companies and big business, where a lot of their donation and lobbyist money comes from. Sickening really. And post #26 should go back to sleep, or back to the USA.
  34. Raymond Baden from Calgary., Canada writes: There's a problem with people who are generally only used to living in a 'first world country', for the most part, they're extremely whiny, if not outright irritating to deal with. I've lived in a third world country for some years, and trust me, Dr. Wong, or whatever the guy's name is should really just shut up because 'cancer treatment' isn't even an option there. The burden of so called 'first world citizens', we're all a bunch of spoiled people who have trouble understanding just how great we have it. Oh, and no offence, but $36k is not worth 4.7 months, a year-ok, perfectly reasonable, but not under five months. There's compassion, and then there's being a bunch of bleeding heart money-wasters(notice how I do not use the term 'liberal', because not many -L-iberals, are -l-iberals).
  35. Emma Hawthorne from Canada writes: Canadians should not hesistate to contact US research centres to take part in drug trials there. For example, Thunder Bay residents have taken part in Mayo Clinic cancer trials for decades. And, when Canadians head for the border, the embarrassed Canadian healthcare system wakes up and raises treatment levels to compare with the US!
  36. Timothy Nessus from Somewhere..., Canada writes: "Are you serious? You've chosen a 22-year-old "study" involving a tiny number of patients in a non-randomized, unblinded trial as evidence of the value of unconventional medicine."

    YES, it is common practice in medicine to test "unproven" medications on terminal patients WITHOUT making them randomized and/or blind. This is the STANDARD for such proofs. This is NOT Phase I, II or III studies for your average New Chemical Entity.

    "The patients had a multitude of different cancers. "

    THAT'S the POINT. IT worked WITHOUT any regards with the TYPE of cancers.

    "The abtract doesn't define "terminal" or "recovery","

    I duuno how about being ALIVE 3 YEARS after being declared DEAD?? will this do?

    "and 25% of the patients died within 2 weeks of starting treatment. "

    And this should be a surprise because? These patients were TERMINAL. Burned and poisoned with radio and chemo therapy. According to the traditional medicine they should ALL be dead by the end of the study.

    "Also, a host of other elements ("vitamins, minerals, chelating agents and salts of selenium, potassium and magnesium") were administered--how can you possibly say what, if anything, actually worked?"

    Well, alternative means non-traditional. This is, a HOLISTIC approach. The traditional scientific METHOD (to change ONE parameter at the time) DOES NOT apply since the COCTEL is much more powerful than each individual component. And, as to "if anyting", how about discussing this with to 50% of patients that SURVIVED for 3 years???

    And how about the fact that for ALL the patients that autopsies were done there were NO signs of tumor????? How about THAT?

    Also, this is NOT the only study. There are a TON of them. Check the litearture!
    Also, this is NOT the ONLY protocol, substance or method. There are a TON of them. Just check the literature!
  37. Ross g from edmonton, Canada writes: There are already cures for cancer. They are not widely known because they drug companies will not profit from them so there is almost no research done to verify that they are effective. Some medical doctors know about them but doctors are only allowed to provide care that is approved by the CMA and can be sensored or have their liscence stripped for delving into what is consdiered by the CMA alternative medicine.
    The 2 treatments that come to mind are treatments with glyconutrients and treatment with massive doses of digestive enzymes. (not pancreatic) Enzymes are what power all the transformative processes in the body. Glyconutrients allow propper cellular comunication in the body and allow the body to function to it's potoential. A human body normally has cancer cells showing up in it and the immune system identifies these cells and deals with them. When the immune system is not longer able to do this then a problem (cancer) develops. Glyconutrients help the immune system to function closer to the level it is capable of and in that way heals the body. I suspect there will be some agressive flames to my posting this. Not sure why people react to something working that the medical community is not embracing.
  38. W D from London, Canada writes: No 1 - good post!

    I do believe that the reason government won't fund preventative measures for cancer is that they are very dependent on funds from the big pharmas for their political agendas, and let's face it, curing cancer is not a winning proposition for Drug companies....
    Curing people would mean no longer being able to make enormous amounts of money pushing their drugs and other supposed "life saviours" onto a desperate public - Healthy people are not good for business!

    Just think of the concept of Pharma companies spending research dollars to keep people alive, but not healthier, and you understand what I mean: you now have a permanent audience who always needs to come back for more drugs or treatment because they, more often than not, do not get well, or trade in one set of problems for another..It is so desperately sad, but will not change until there is a fundamental shift in people's perception and how does one accomplish that?? That is really what I want to know...

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