Canada - chemo drugs not covered by OHIP ?

[elise]

Hi

I learned yesterday that the chemo drug that it looks like I'll be taking for 6 months is NOT covered by OHIP (government health insurance).

My oncologist thinks that my private healthcare will cover it.

Has anyone else had this issue in Canada???

Elise

[RixInPhx]

The primary chemo treatment for Stg 2 CRC is 5FU, or the pill version of it, Xeloda.
I can't imagine either of these not being covered by the gov't program.

Can you give us any info on what drug your onc is proposing?
If it's not one of the above, then it might have different conditions.

[triciah]

Check out our "Canuck" thread. But I suspect it's Xeloda that's not being covered. That's because it's a pill and only some provinces cover it.

Tricia

[String]

My understanding in talking to my doctor is that all drugs administered in the hospital are covered, but only some drugs taken outside are covered in Ontario by OHIP.

[kac]

I have been told the same things, if it is administered in the hospital it is paid for. Which kind of sucks for someone like me who has no extra insurance plan. So far it hasn't been an issue though.

[elise]

Thanks everyone. I have to say I'm kind of offended that the recommended treatment for my cancer (that happens to be taken at home - thus saving the province a crapload of money in hospital visits) ins't covered.

It is Xeloda. Thank goodness for additional insurance.

[prtza]

As a matter of interest, does OHIP pay for HIPEC?

[disco nap]

As a matter of interest, does OHIP pay for HIPEC?

Yes, under certain circumstances but I think most Ontarians have to go to Buffalo to get it.

[westie68]

Hi: I have to add to this discussion. I am paying $4000/month for my folfirinox treatment (oxaliplatin + irenotecan + 5FU). In this mix, only the 5FU is covered. If I were taking the pill form, Avastin is it, it wouldn't be covered. My private plan doesn't cover any of these either as they say that anything
administered in a hospital setting (in Ontario) has to be covered by OHIP/Cancer Care Ontario. I think the folfirinox treatment would be covered for me in BC. Not all stages of colon cancer are covered with folfox in Ontario and as I don't have colon cancer but rather gallbladder cancer it isn't covered for me.

Re HIPEC. As far as I know, OHIP definitely covers the HIPEC surgery in Calgary (but not the accommodation afterwards). The two surgeons there at the Tom Baker Cancer Centre were trained directly by Sugarbaker and are excellent, but they are pretty much concentrating on peritoneum cancer from ovarian cancer and appendix cancer. They've been on the national news and in the Globe and Mail. I know at least one woman from Ontario had her HIPEC surgery covered in either Buffalo or Detroit, can't remember which. I have the brochure from OHIP on the HIPEC surgery. Unfortunately I can't have the surgery.

[daughter07]

Re: OHIP and Xeloda. My Dad is currently taking Xeloda (inoperable Stage 4 CRC) - OHIP covers 100% of the cost. He lives in Ottawa and is treated at the Ottawa Hospital Cancer Clinic.

[tammylayne]

I live in Ontario and I took Xeloda last year and had to pay for it. My oncologist at the time said that it was about to be covered for COLON cancer, but NOT for rectal cancer. ???? Really?????

I should correct this...my private benefits covered it, not me personally. It was $1200 per cycle (2 weeks).

[elise]

Re: OHIP and Xeloda. My Dad is currently taking Xeloda (inoperable Stage 4 CRC) - OHIP covers 100% of the cost. He lives in Ottawa and is treated at the Ottawa Hospital Cancer Clinic.

I'm really intrigued by this. Could it be that stage 4 inoperable is treated differently than stage 2 post-op by our government healthcare?

[elise]

wow so for 6 months of treatment, someone with no additional insurance would be looking at around $21,000!

Even with my insurance, that is still about $500/month.

[RixInPhx]

With no insurance, the maker of Xeloda (Genentech) bends over backward with discounts and grants.
Because there's no expense for infusion or pump involved, it can be cheaper for the uninsured american patient to go with subsidized Xeloda than with 5-FU.