Canadian Health Care

Hi Elizabeth!  Yes, it's a vaccine that hopefully trains your immune system to seek & destroy cells expressing the protein mammaglobin-A, which is over-expressed in 80% of breast cancers.  My latest & greatest tumor was tested for the protein, and it passed the test.  I have two more rounds of shots to go through, each four weeks apart.  It's a Phase I trial so the primary purpose is to test safety.  The secondary purpose is an immune response.  I hope both purposes are met!

Thanks, E., for explaining how they hope the vaccine will work. It makes perfect sense. And it's definitely the stuff that dreams are made of. Words cannot convey my gratitude for what you are doing. I certainly understand the wear and tear involved in traveling. Plus it hasn't been that long since you finished chemo so it's an enormous effort on your part.

Ironic, isn't it, that the Canadian thread is open to everyone while the recently deceased American thread was open only to Americans. It apparently has been replaced by a thread for conservatives only. Free speech is a wonderful thing. LOL. 

Mich - I travel from the mid-atlantic region to St. Louis, MO, a distance of about 850 miles one-way.  It's only a two hour plane trip, though, so it's not too bad if you can get a direct flight. 

Rico - Crazy ironic, isn't it?  Maybe we should start a new thread in the Canadian forum - Canadians & Friends? 

It's an act of desperation.  :-)   The trials in my area either involved chemo or some other agent that didn't make any sense to me. 

I will keep you all posted!

Lindsea, I've been enjoying your comments about the Canadian medical and drug systems and keep meaning to join in the discussion, but you say it so well. A very small point, not all provinces pay for Medical plans through taxation - in BC we pay a monthly medical insurance premium, (those with a low income can receive premium assistance) but almost everyone pays something.

About drug formularies, I had to take Neupogen shots with my chemo. Did you know Neupogen is not on the list in British Columbia? I didn't. I was able to pay for the first two sets of shots through my extended health insurance until my annual prescription drug amount was maxed. I assumed then that the amount would bring down the deductable on the gov't "Fair Pharmacare plan and I would be covered there, but it didn't, because it isn't an approved drug.

So I have no drug coverage for the rest of the year. I was not going to pay the full cost for the next two sessions, (over $1700 each), so I arranged to have my onc apply for a special authorization for the use of the shots and applied to the drug company "Victory Program" for help with the cost and they covered the amount of my deductable on the gov't plan. Whew.

Hi Kathy -- Great to hear from you!  I knew BC had a different way of handling the drug situation.  In fact a few years ago, the Ontario gov't brought in a new Health Premium tax to help pay for rising costs, I guess similar to your medical insurance premium.  But it turns out to be not enough (surprise, surprise!!).

As for neupogen -- my supplemental insurance (no maximum) paid for it (12 shots @ $200 per tx) but if it hadn't, I would have been given a home care card which the pharmacy would have accepted.  Ontario also had a special Trillium Fund to help cover drug costs for those who have difficulty paying for expensive medicines.  And drugs administered in hospital are also covered by OHIP (Ont. Health Insurance Plan).

I'm wondering how many Ontarians get neulasta instead of neupogen?  Neulasta would probably be administered in hospital (the day after tx) and perhaps that is why most of us are presribed neupogen which is administered at home.   Just wondering.....

BTW, Kathy, have you completed your tx?  Will you be going on Tamoxifen or an AI?  Will either of those be covered?   Wishing you well.

Linda

There are some of us slipping through the cracks with supplemental insurance, or those without.  I unfortunately went on gov't Disability without being employed (i.e., job with benefits) and the Ontario Drug Benefit Plan doesn't cover Tykerb.  I think it was just last year that a woman battled and won to get Xeloda covered.  Soooo, finding out that Tykerb isn't covered has given me patience to see if I can finally get on a clinical trial that will offer it (or TDM1).  The ON plan is slow to pick up drugs that are approved by the feds and provinces to use. 

Luah, you ARE a brave one!  The visiting nurse gave me the first 2 or 3 shots of neupogen, then taught my DH how to do it.  He practiced on a few oranges (natch!!) and then practiced on me!!  He was truly wonderful throughout but when he gave me the final shot, he said "Thank goodness this is the last one".  I asked him if it was really hard for him and he replied that every time he gave me the shot, he was so afraid of hurting me.    Awwwww, made me cry!

Is this a fairly new trend...getting neulasta or neupogen in Canada?  My onc just told me that it would be considered if I had issues.  

PiP -- I think many oncs choose to automatically prescribe it as a preventative.  Cynically speaking (!), because it's given outside of hospital, it's better for the hospital's budget than it would be if the patient had to be admitted with fever and life-threatening infections etc. due to a dangerously low WBC.

Yan - I salute you!  And so does my DH .

They never tested my blood until it was time for my next tx.  And it was never low enough then to warrant extra tx or to postpone chemo.  How do they know if you need it?  Do they test you between chemos now?

PiP -- I wasn't prescribed neupogen until after my second tx.  After the first tx, and just before second, my WBC count was borderline low, so after the second tx I was prescribed neupogen (x 10).  But when WBC count was taken just before third tx, it was still kind of low, so my onc upped it to x 12.  it definitely kept me from getting any infections -- as if the SEs from Taxotere aren't enough to handle

Everybody's different!  But I am curious to know why some oncs prefer neulasta over neupogen???

Yeah, they ordered the shot after the WBC on the day of chemo plummeted (didn't test between the tx's). She got the Neulasta next day.

Sharon - now they do the bloodwork 1.5-2 hours before the chemo.

It's my understanding that neupogen or neulasta is required/prescribed for dose dense scheduling - and it's sometimes prescribed to women on a triweekly schedule when their WBC fails to recover.  In the U.S., it seems to be used quite widely (which is nice for the drug maker), but frankly, I don't think it makes sense to prescribe automatically - after all, it is another drug with some unpleasant side effects  and it's expensive.