Why is Ontario’s Provincial Parliament so out of touch about biologic medications? These medications — especially Remicade (infliximab) — account for a significant and fast-growing chunk of Ontario’s health expenditures*, so a rational discussion of how to balance their costs with the benefits to patients who need these drugs to stay alive would be something worth having. But there is little evidence that our politicians have any awareness of how serious an issue this is, both for patients and for taxpayers/citizens at large.
To put things in perspective, Remicade has been available in Canada on a non-experimental basis since 2001. Its patent protection would have expired in the US and EU in 2011 and everywhere else in 2014, though lobbying by its manufacturer extended the patent until 2015. We are not talking about a new and untested medicine here — Remicade is recognized as the standard first-line treatment of severe Crohn’s disease according to the Canadian Association of Gastroenterology. Newer studies also support the use of Remicade as a first-line treatment for severe Crohn’s. And private health insurance companies in Canada are discussing what to do in a few years when biosimilar versions of Remicade and other biologics are expected to be approved for use in our country.
But, these days, coverage of the funding of biologics in Parliament is limited to praising the efforts of private citizens running candy sales — it makes my blood boil! Just to be clear, the only mention of biologics in the current session of Parliament — on May 16th, 2013 — was as follows:
Oakville MPP Kevin Flynn calls Remicade a new drug when praising Robbie’s Rainbow
Hansard transcript of the video (my bolding):
Mr. Kevin Daniel Flynn: . . . . Crohn’s is a destructive disease that eats away sections of the intestinal lining of your digestive tract. Robbie has been battling Crohn’s disease since he was six years old. Traditional treatment, in his case, was not successful, but a new drug called Remicade has helped Robbie fight back.
It has now become Robbie’s mission to help other children struggling with severe Crohn’s disease receive the biologic drug treatments they desperately need but sometimes can’t afford. So Robbie and his mother, Kate, created Robbie’s Rainbow. It’s a charitable organization that’s dedicated to improving the health and quality of life of children who are living with Crohn’s disease and ulcerative colitis. . . .
Robbie’s Rainbow is a registered children’s charity devoted to raising funds so that kids with Crohn’s can afford biologic therapies. According to its founders, it was “established in January 2010, when [6-year-old] Robbie witnessed a child denied treatment. The child’s family lacked the financial resources to access critical drug care.” The charity has raised enough money since then to help pay for medications for around 20 kids.
I do not intend to pick on Robbie’s Rainbow, because it fills a real gap in health care coverage in Ontario — a gap that I hope will be closed very soon. But private organizations that raise funds to pay for medicines that should be covered by provincial plans are only a band-aid solution — they do nothing to fix the underlying policy problems that caused the funding gap in the first place. And while funding medications for 20 kids is commendable, fixing our broken policies could help a lot more families.
Our politicians need to step up and help out the hundreds of Ontarians who are currently falling through the cracks in biologic reimbursement.
Want to help? You can write to your MPP about the need for the Exceptional Access Program’s guidelines for patient eligibility for biologics to be brought in line with the best medical evidence, as determined by specialists in the diseases the biologics are used to treat (more info).
* I’m still looking for more recent stats.