Perjeta coverage in Ontario and medical oncologist in Toronto

cg4

Hi,

I am currently living in Montreal. I was diagnosed with Stage IV breast cancer this February, with bone and liver mets. I've had 4 cycles of Epirubicin and Cyclophosphamide, currently on my 16th weekly Taxol/Herceptin treatment.

I really want to add Perjeta to my treatment. Unfortunately, I don't have insurance so I have to rely on the Quebec government, which so far has refused to cover Perjeta because of its cost.

I am thinking of moving to Toronto - I know Perjeta is covered there. Unfortunately, from what I've read, it's only covered if the person has never received chemotherapy.

My questions are:

- Could you recommend a Medical Oncologist in Toronto who has a lot of experience in treating Stage IV breast cancer?

- Do you know if Cancer Care Ontario ever makes an exception so that a patient can add Perjeta to her treatment, even if she's previously had chemotherapy?

Thank you so much!

Moderators

Hi cg4,

From the main Breastcancer.org site's pages on Paying for Your Care:

Genentech, the company that makes Perjeta, offers Access Solutions. Call 1-866-4-ACCESS (1-866-422-2377) for more information.

We hope this helps!

--The Mods

208sandy

Cg4 - I am in Ontario but not on Perjeta - why don't you email Princess Margaret, Mount Sinai or Sunnybrook (or all three) and ask them the question - they are all great cancer centres - I am not Her2+ so have no idea what is what and I am over 65 so my OHIP would be different than yours - not a good idea to move without detailed information - not sure but there may be a waiting period to get on OHIP - have you asked your onc to ask for "compassionate" from the drug company - my oncs have done that successfully here and when I was living in the US - wouldn't hurt to send an email or two to the Quebec Health Minister and perhaps a letter to the editor of say, the Montreal Gazette - I know that I saw a story on CTV a couple of months ago about a woman in Manitoba trying to get Perjeta.  Hope this helps, I am originally from Quebec (Montreal).

Oncearunneralwaysarunner

Regarding the waiting period for health coverage when moving to Ontario, it used to be a three month wait. When I moved from Quebec to Ontario about 7 years ago there was a three month period after I moved where I lived in Ontario but was still covered under Quebec's health coverage. This means that you don't go without medical care but you are only covered for what Quebec would cover during those first three months. 

I'm not sure if that rule is still in place but I wanted to share my experience so that you can either research the waiting period further or take it into consideration when making your decision or not to move. Wishing you all the best with your treatment.

cg4

Hi Moderators - thanks for the reply. I've already contacted Genentech a few months ago, I'll call them again.

208sandy - thanks for the suggestions - I will email those hospitals and see what they say. I'll also write a letter to the Health Minister and the Gazette. I was thinking of contacting CTV News also - I initially did not want to go public with this, but I really think Perjeta will make a huge difference in prolonging my life and other people who are HER2-positive.

Oncearunner - thanks for the info on the waiting period. I did read that I have to wait three months. Did you have to pay any expenses that Quebec didn't cover?

Thanks!

Oncearunneralwaysarunner

I fortunately did not need to see a doctor during that three month waiting period. This was well before I was diagnosed and I didn't have any other medical conditions that needed follow up. So I never got to "test out" the rules for the waiting period.

sauvez-la

I am hoping Perjeta will get on the list on June 1st.. 9 provinces out of 10 cover it ! I have a petition for the Health Minister.. https://secure.avaaz.org/fr/petition/GAETAN_BARRETTE_MINISTRE_DE_LA_SANTE_Ajout_du_Perjeta_a_la_liste_de_medicaments_couverts_pour_le_cancer_du_sein/edit

leggo

cg4, I think all the other provinces have approved it only in the situation you mentioned; metastatic having had no other previous chemo or biological agents. That's the last I heard in November of last year. I'd make a lot of phone calls before moving for that reason. I hope you can find a loophole. Hugs and best wishes.