benefits outweigh costs in universal healthcare business case.pdfVIP

American Journal of Medicine and Medical Sciences 2014, 4(4): 126-138 DOI: 10.5923/j.ajmms05 Benefits Outweigh Costs in Universal Healthcare: Business Case for Reimbursement of Take-home Cancer Medicines in Ontario and Atlantic Canada D. Wayne Taylor The Cameron Institute, Cambridge, Ontario N3H 5N4, Canada Abstract Cancer has the fastest growing prevalence of any non-communicable disease in Canada. Oral and other take-home cancer drugs have been a major game-changer allowing cancer patients to live longer while staying at home without the stressful ordeal of IV chemotherapy. The Canada Health Act only provides for government reimbursement for IV cancer drugs administered in a hospital or cancer centre. In Ontario and Atlantic Canada, patients must personally pay some or all of the cost of medications that are taken at home, even if they are considered the standard of care as part of internationally accepted treatment protocols. A sensitivity analysis was conducted for Ontario on the pool of 9,588 financially vulnerable new cancer patients assuming different levels of oral drug penetration and different drug costs. The last dollar scenario, where the Province steps in after private insurance has paid its share, for a year’s worth of oral cancer drugs for new cancer cases would produce a budget impact of $28 million. For first-dollar coverage the budget impact would be $58.5 million. On an on-going, annualized, first-dollar basis, covering all cancer cases, full coverage would yield a budgetary impact of $93.8 million. Universal funding of oral cancer drugs will save the healthcare system money overall; provide better, more meaningful data; provide better quality of life for cancer patients; provide better purchaser negotiati