Ian Barrett
New Brunswick is setting aside $500,000 to pay for treatment for an unproven therapy, developed by Paolo Zamboni of Italy, for multiple-sclerosis sufferers. It should not be spending scarce health dollars courting unknown risks in clinics outside Canada.
Constructive approaches do exist. Newfoundland and Labrador has set aside $320,000 for an "observational study" of 30 patients, some of whom receive the treatment abroad. Saskatchewan is committing $5-million to run its own clinical trial. The University of New York at Buffalo has established to its satisfaction the safety of the treatment in a small, 10-patient trial, and is proceeding with a 20-patient preliminary treatment study.
As yet, the parameters of New Brunswick's program have not been determined; the program has just been announced in a Throne Speech. The Health Ministry is promising to do due diligence on any providers of Dr. Zamboni's treatment, in which balloon angioplasty is used to unblock clogged veins. No such treatment is currently provided in Canada. The costs of such due diligence seem likely to be exorbitant. And it is hard to envision how providers working outside a clinical-trial setting can pass muster.
The death of Mahir Mostic last month, after treatment in Costa Rica, shows the risks. But Dr. Zamboni's treatment has not been proved a dangerous failure. Dr. Zamboni himself does not approve of the method by which the treatment on Mr. Mostic was reportedly done - opening veins with a stent, which can cause deadly blood clots.
Canada has a high rate of multiple sclerosis, and it should feel obliged to test Dr. Zamboni's theory of vein blockages. Preliminary (non-treatment) studies are under way in several provinces, but are moving too slowly for the worst-off patients, who experience problems with vision and movement. It does little good to exhort them not to go abroad. They weigh the unknown risks against their suffering, and then they go.
In all the circumstances, the most responsible course of action from government is to treat as part of a study, or failing that, to study those treated. But it is not to pay for treatment outside Canada that falls beneath the standard of care.