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← Return to CLL - newly diagnosed
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Blood Cancers & Disorders | Last Active: 1 hour ago | Replies (108)
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My experience at a big Ontario Cancer Centre is that they've never suggested chemo for my stage 4b prostate cancer, even though my meds cost above CA $6,000/month.
As far as I know, provincial health plans can't penalise doctors for recommending more-expensive treatments *or* reward them for saving money — they all bill the same — so I'm not sure what their motivation would be to push a patient towards a cheaper treatment if a better one is available.
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Access to a specific drug, or its pricing to the patient, likely depends on if the drug is in the drug formulary in the first place and what tier level it is in.
I had to switch Medicare Part D (drug) plans here in the U.S. to get my cancer drugs covered as my old plan didn’t include Venclexta or Gazyva. If I hadn't switched plans I likely would have to resort to chemo that is covered or pay for Venclexta or Gazyva out-of-pocket. These are both tier 5 drugs.