How can you get OHIP to cover new drug for HER2+ people

Hello Betsy,

Wanted to share some information:

1.  There is a Perjeta/Herceptin/Taxotere thread on the breastcancer.org webpage.  I believe so far only American women are posting on it which makes sense since the drug has not yet been approved for use in Canada.  It is an inspiring thread!  You must read it!  It gives me hope for my mom.  The vast majority of women posting are getting amazing results with Perjeta, not all but most.  I don't know if we are allowed to post specific websites but I will say, just type Perjeta into a google search and go to the drug webpage.  There is a ton of info about the drug there that is very helpful.

2.  Got some more info about getting a non-Canadian approved drug in Canada.  I spoke with another rep from Roche Pharma yesterday.  She was very helpful and told me about the "special procedures" of getting Canada to approve use of a drug that isn't yet available for Canadians.  Your onc can advocate for you if he/she feels Perjeta will be essential to your treatment.  Your onc probably already knows about this but I wanted to share the process with you since I didn't know about it.  Go to the Health Canada website and look up the Special Access Programme (SAP).  Your onc must fill out the Special Access Request (SAR) form and submit it.  Then you basically wait for approval and cross your fingers that you get it.

3.  Payment for the drug.  Still unclear who pays for the drug if you get approved.  There was the sense that OHIP would cover it under the Special Access Programme but can't confirm that.  I asked the Genentech rep in the US how much the drug cost if we wanted to pay out of pocket.  She said it cost $5900/month.  You need to have your onc write the prescription in any event.

We have faxed my mom's onc our desire to explore Perjeta as an option for my mom's treatment.  She was out of the office until Monday.  I hope she is on board with us.  I will keep you posted.  By the way, one problem people in the US have been having is getting the drug approved for off label use.  The drug is indicated for 1st line treatment, which I think is a bit crazy considering most people with mets have been treated at least once.  That being said, a lot of women are getting it prescribed off label (meaning they are on their 4th or 5th line of chemo treatments and are still getting the drug).

Hope this helps...will keep you posted:)

Lilah