Wednesday, April 14, 1999
Red tape hobbles Parkinson's drugs
Pramipexole, Ropinirole not covered by drug plan
By MARY-JANE EGAN, Free Press Health Reporter
Parkinson's patients are being neglected in Ontario because two
promising drugs aren't covered under the
province's drug plan, says a frustrated London doctor.
Dr. Mandar Jog, director of London Health Sciences Centre's movement
disorder centre, said patients who could
benefit from the drugs Pramipexole and Ropinirole may go without because
they can't afford the annual $1,200 to
$2,000 cost.
Jog said patients who lack private drug insurance coverage must either
pay for the drugs or go through the
"bureaucratic maze" of a Section 8 application under the provincial drug
plan -- a step that leads to mountains of
paperwork and headaches for the doctor.
Costs of the drugs vary, depending on the dose required for particular
Parkinson's patients.
Health Ministry spokesperson Barry Wilson said the two drugs in question
were not recommended for coverage
by the ministry's drug quality and therapeutics committee -- an arm's
length expert panel that reviews drug
manufacturers' submissions for listing on the Ontario drug formulary.
Jog said the refusal by Ontario to cover the drugs raises troubling
questions about "equality of care." He asks:
"Why is Ontario one of the few provinces that doesn't cover these drugs,
which are proven to be effective for
certain Parkinson's patients?"
Wilson noted the province did cover 1,000 claims for the drugs in
question last year through the Section 8 process
in which doctors justify why coverage should be granted in a particular
case.
"It is a very tedious process," Jog said yesterday. "First, we have to
have tried approved drugs and prove that
they've failed and then the government will approve coverage for a brief
period -- and then you reapply. When you
have 150 patients, all with different drug renewal dates, you can
imagine the paperwork. All we want is what's best
for our patients -- and for patients where these drugs work, they should
be covered."
Wilson said since 1995, 11 new drugs for Parkinson's disease were added
to the formulary, bringing the total
number of covered Parkinson's drugs to 19.
Jog was adding his voice to that of the Parkinson Foundation of Canada,
which held a news conference yesterday
arguing the drugs should be covered by Ontario's drug plan.
Allan Ward, 68, of Ingersoll, has been taking Ropinirole since December
after getting approval through the Section
8 process. He said the drug helps control all his Parkinson's symptoms
and he is puzzled why it hasn't been
approved as part of the drug plan.
"Why Ontario is dragging its feet on this is beyond me," Ward said,
agreeing a Section 8 application causes
unnecessary work for the doctor.
Parkinson's is a chronic, debilitating neuromuscular disease affecting
more than 100,000 Canadians.
The disease makes it difficult for sufferers to control their movements,
often resulting in tremors, slow movement
and sudden, uncontrolled motions.
The disease gained widespread attention last year when Canadian actor
Michael J. Fox divulged he suffers from
the condition.
Jog said many patients respond favourably to Pramipexole and Ropinirole.
"But until the provincial government
makes them available, many Ontarians are going without.
"We don't have any hidden agenda here," Jog added. "We just want what's
best for patients."
--
Judith Richards, London, Ontario, Canada
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