A woman dying of breast cancer who was forced to battle the medicare bureaucracy in her final months has succeeded in obtaining a drug she needed, helping dozens of other women in the process.
Months after her oncologist recommended it, Deborah Warkus, 50, finally acquired the drug capecitabine to be used with another medicine, lapatinib, which was to be her last chance at prolonging life.
Ontario’s decision to pay for the drug for all women like Ms. Warkus – who have metastatic breast cancer and whose disease has progressed despite chemotherapy – came on Jan. 5, several weeks after her case was publicized in The Globe and Mail.
“As it stands now, no one in Ontario will be denied that combination,” said Stephen Reingold, a senior medical oncologist at William Osler Health Centre’s Brampton and Etobicoke sites, who treats Ms. Warkus. “In that position, it’s the only option you’ve got left.”
In October, Dr. Reingold prescribed Ms. Warkus the combination, which more than 100 breast-cancer patients across the country have taken since it was approved by Health Canada about eight months ago.
At the time, Ontario’s Committee to Evaluate Drugs was studying the combination that GlaxoSmithKline Inc., maker of lapatinib, had submitted for review in July.
Until it was approved, Ms. Warkus was not able to obtain the capecitabine under the Ontario Drug Benefit program’s Exceptional Access Program, which provides free prescription drugs to some patients, including those on disability benefits such as Ms. Warkus.
That left the former accounting clerk, who lives in Brampton, in a medical Catch-22: She could not obtain capecitabine because the province’s drug approval body hadn’t signed off on funding its use in that combination, and the drug company couldn’t give her lapatinib unless she used it with capecitabine – the only combination for which lapatinib is approved by Health Canada.
The only other choice at that point was for Ms. Warkus to pay what she could not afford – an estimated $800 a month for capecitabine, which interferes with the growth of cancer cells.
Dr. Reingold said the case shows the need for a mechanism for patients with limited options and finances to obtain drugs in a timely manner. Ms. Warkus has not been able to tolerate other chemotherapy drugs, and lapatinib could help control her disease. [Lapatinib is a biological therapy that works by binding to part of a protein found inside breast-cancer cells.]
Her ex-husband, Georg Warkus, who has been organizing her care and advocating for the drug, said they were overwhelmed with the generous responses from the public over the Christmas holidays, offering to pay for her treatment.
And while they went to set up a trust fund for Ms. Warkus, in the end they didn’t need it because she was able to obtain the medicine.
Though she has received two rounds of the medicine, it’s too soon to say if it’s having an impact, but she and her family, which includes two children, are thankful she is doing all she can to prolong her life, Mr. Warkus said.
“It lightened both my heart as well as Deborah’s. It’s about time the government did turn around and take action for this very serious disease.”
