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Help Suzanne Aucoin
Jan. 31, 2007 - The St. Catharines Standard
St. Catharines Standard (ON)
Front, Wednesday, January 31, 2007, p. A1
Province apologizes and reimburses cancer treatment costs
Victory for Suzanne
'They put her through the wringer'
PETER DOWNS; Monique Beech
Cancer fighter Suzanne Aucoin has earned a major victory.
Ontario's government watchdog has sided in Aucoin's favour, calling the
Health Ministry's bungled treatment of her case "cruel" and misguided.
The St. Catharines woman will get back all of the money - about $56,000 -
she spent from her own pocket on a colorectal cancer drug after being
wrongly rejected for out-of-country coverage by the province's Health
Ministry.
The government will also reimburse approximately $19,000 she spent on legal
costs.
And the Health Ministry will launch a review of its out-of-country
drug-coverage program to ensure more patients don't get the same runaround
Aucoin received.
Health Minister George Smitherman announced the steps late Tuesday after
receiving a highly critical report by Ontario Ombudsman Andre Marin.
"They put her through the wringer for absolutely no good reason," Marin told
The Standard Tuesday night. "What attracted my attention was the bad
treatment that was given to the complainant - the kind of misery that she
was put through."
Aucoin, 36, said she's pleased the protracted battle against the government
is finally over so she can concentrate on her health.
"I will never be able to get back the full year I spent dealing with this
when I should have been just dealing with cancer," Aucoin said before going
out to celebrate over dinner with her parents, Norm and Janet.
Diagnosed with terminal colon cancer three years ago, Aucoin was told by her
Hamilton oncologist that her best chance to prolong her life lay with an
intravenous drug called Erbitux, which is not commercially available in
Ontario.
Aucoin applied to OHIP to pay for her to receive the expensive medication at
a clinic in West Seneca, N.Y., through OHIP's out-of-country coverage
program, but was turned down.
Desperate to fight the cancer that had already migrated from her colon to
her liver and lungs, Aucoin decided to pay for Erbitux with thousands of
dollars friends and supporters have raised for her.
She spent $31,065 for the drug at the clinic in West Seneca from October to
December 2005. She paid a further $21,116 for Erbitux at Hamilton's cancer
centre through a federal special access agreement.
Aucoin was paying about $10,000 US per month less at the West Seneca clinic
than OHIP was paying for other Ontario patients to get Erbitux at Buffalo's
Roswell Park Cancer Institute.
OHIP subsequently agreed to pay for Aucoin to begin receiving the treatment
last March, provided she went to the more expensive Roswell Park.
After a daylong hearing in Toronto in September, Ontario's Health Services
Appeal and Review Board rejected Aucoin's appeal for reimbursement of her
medical costs in November.
The ombudsman's office contacted her the following day and launched a formal
investigation into why her initial application for out-of-country-coverage
was rejected.
The investigation revealed a badly flawed process that is extremely
complicated for sick patients and their physicians to understand and
navigate, Marin said.
"There's a whole cloak-and-dagger (approach) by the Ministry of Health," he
said. "It's as if they hand a dying cancer patient a Rubik's Cube and
they've got to figure it out themselves. It's a real cruel game."
He said ministry bureaucrats mishandled Aucoin's application for coverage
from the outset and continued to botch it all the way along.
"This case is stunning in many ways, not the least for the many missteps and
miscommunications by ministry officials," he said.
"They misunderstood her application from the beginning and then they sent
her an unintelligible form letter to explain (her rejection)."
In a rejection letter Aucoin received in October 2005, a Health Ministry
official maintained the application couldn't be approved because the drug
was already available in Canada and was considered experimental.
The health official was wrong -while Erbitux had been approved for use by
Health Canada in September 2005, it has not been made commercially available
in any province or territory.
The rejection letter contained a second error, turning Aucoin down for
another cancer drug called Avastin, when, in fact, she was trying to get
access to Erbitux.
"This idea of sending out a form letter to a Stage 4 cancer patient, it's a
calamity," Marin said.
He maintained ministry officials displayed a "slavish adherence to rules at
the expense of common sense."
Based on Marin's recommendations, Smitherman announced the government will
take immediate steps to give physicians better access to information about
the out-of-country health-coverage program.
Other recommendations made by the ombudsman will be implemented in the
spring, including a move to give patients better reasons for OHIP decisions
on out-of-county funding applications.
Smitherman was not available for comment Tuesday night, but his press
secretary said the government will move quickly over the next few months to
review the program and make improvements.
The report "was fairly clear in this area. It could have worked better. It
could have been more clear," said David Spencer.
Late Tuesday afternoon, Aucoin received a phone call from deputy health
minister Ron Satsford apologizing on the ministry's behalf.
"As much as the money is important, accountability is important," Aucoin
said.
"It would have been nice if Mr. Smitherman had called directly."
St. Catharines MPP Jim Bradley said he's pleased the ministry accepted the
ombudsman's recommendations and apologized to Aucoin.
"It's not simply offering a cheque and begrudging it," he said.
"It's very important that they recognize what the ombudsman has said and
what the circumstances are. I think it was most appropriate that an apology
is offered Suzanne Aucoin."
Bradley said Aucoin's victory will help others in similar situations.
"Suzanne is not only obtaining the funding that she sought for her own
costs, but will be instrumental in improving (care) for others."
Marin marvelled at Aucoin's tenacity and determination to fight for her own
rights and the rights of other cancer patients.
"Suzanne Aucoin is like the modern-day Erin Brockovich. She fought city hall
and won," he said.
The Toronto-based Cancer Advocacy Coalition of Canada is calling on the
ministry to move forward quickly with improvements recommended by the
ombudsman.
"There are many more cancer patients who don't have the energy and the fight
of Suzanne Aucoin," said Colleen Savage, the coalition's president and chief
executive officer.
"There are other patients being tortured by the processes of OHIP."
Savage questioned why the Health Ministry didn't act sooner to reimburse
Aucoin's expenses and improve the out-of-country health coverage program.
"The ministry has known about Suzanne Aucoin's case for about a year and a
half, and they did nothing about it until they were kicked by the
ombudsman," she said.
"Why did they make her go through all of this?"
Aucoin, who's on leave from her job as a chaplain at Denis Morris High
School, said she couldn't have mounted her fight without the network of
family, friends and supporters who have been following her story.
"It's nice to finally have some good news," she said. "Now I can focus on
being well and research (into treatments)."
pdowns@stcatharinesstandard.ca
Box(es):
Making changes
Based on recommendations of Ontario Ombudsman Andre Marin, the Ministry of
Health announced Tuesday it will:
Reimburse St. Catharines cancer patient Suzanne Aucoin the full amount she
paid for Erbitux - approximately $56,000 - after being wrongly rejected by
OHIP for out-of-country drug coverage.
Reimburse Aucoin approximately $19,000 she paid in legal fees to argue her
case before the Ontario Health Services Appeal and Review Board.
Apologize to Aucoin for the way her case was mismanaged.
Review the government's out-of-country health-coverage program.
Provide physicians with better access to information about the
out-of-country health coverage program.
Review the need to provide more information to patients and physicians about
funding for particular treatments to ensure decisions about funding are
consistent and based on evidence.
Provide patients and physicians higher-quality explanations when requests
for out-of-country health coverage are denied.
Suzanne's story on the web
The Standard's ongoing series following Suzanne Aucoin's fight with colon
cancer can be read online. For previous stories in the series, go to The
Standard's website (www.stcatharinesstandard.ca) and follow the link on the
left-hand side to Suzanne's Story.
Suzanne Aucoin also posts regular updates and information on her website:
www.helpsuzanne.com
Illustration(s):
Suzanne Aucoin received word Tuesday that she will get back all of the money
- about $56,000 - she spent on a colorectal cancer drug. Aucoin is shown
with her mother, Janet, and father, Norm, inside their St. Catharines home.
staff photo by Bob Tymczyszyn
Category: Front Page
Uniform subject(s): Diseases, therapy and prevention
Length: Long, 1205 words
© 2007 St. Catharines Standard (ON). All rights reserved.
St. Catharines Standard (ON)
Front, Wednesday, January 31, 2007, p. A1
Province apologizes and reimburses cancer treatment costs
Victory for Suzanne
'They put her through the wringer'
PETER DOWNS; Monique Beech
Cancer fighter Suzanne Aucoin has earned a major victory.
Ontario's government watchdog has sided in Aucoin's favour, calling the
Health Ministry's bungled treatment of her case "cruel" and misguided.
The St. Catharines woman will get back all of the money - about $56,000 -
she spent from her own pocket on a colorectal cancer drug after being
wrongly rejected for out-of-country coverage by the province's Health
Ministry.
The government will also reimburse approximately $19,000 she spent on legal
costs.
And the Health Ministry will launch a review of its out-of-country
drug-coverage program to ensure more patients don't get the same runaround
Aucoin received.
Health Minister George Smitherman announced the steps late Tuesday after
receiving a highly critical report by Ontario Ombudsman Andre Marin.
"They put her through the wringer for absolutely no good reason," Marin told
The Standard Tuesday night. "What attracted my attention was the bad
treatment that was given to the complainant - the kind of misery that she
was put through."
Aucoin, 36, said she's pleased the protracted battle against the government
is finally over so she can concentrate on her health.
"I will never be able to get back the full year I spent dealing with this
when I should have been just dealing with cancer," Aucoin said before going
out to celebrate over dinner with her parents, Norm and Janet.
Diagnosed with terminal colon cancer three years ago, Aucoin was told by her
Hamilton oncologist that her best chance to prolong her life lay with an
intravenous drug called Erbitux, which is not commercially available in
Ontario.
Aucoin applied to OHIP to pay for her to receive the expensive medication at
a clinic in West Seneca, N.Y., through OHIP's out-of-country coverage
program, but was turned down.
Desperate to fight the cancer that had already migrated from her colon to
her liver and lungs, Aucoin decided to pay for Erbitux with thousands of
dollars friends and supporters have raised for her.
She spent $31,065 for the drug at the clinic in West Seneca from October to
December 2005. She paid a further $21,116 for Erbitux at Hamilton's cancer
centre through a federal special access agreement.
Aucoin was paying about $10,000 US per month less at the West Seneca clinic
than OHIP was paying for other Ontario patients to get Erbitux at Buffalo's
Roswell Park Cancer Institute.
OHIP subsequently agreed to pay for Aucoin to begin receiving the treatment
last March, provided she went to the more expensive Roswell Park.
After a daylong hearing in Toronto in September, Ontario's Health Services
Appeal and Review Board rejected Aucoin's appeal for reimbursement of her
medical costs in November.
The ombudsman's office contacted her the following day and launched a formal
investigation into why her initial application for out-of-country-coverage
was rejected.
The investigation revealed a badly flawed process that is extremely
complicated for sick patients and their physicians to understand and
navigate, Marin said.
"There's a whole cloak-and-dagger (approach) by the Ministry of Health," he
said. "It's as if they hand a dying cancer patient a Rubik's Cube and
they've got to figure it out themselves. It's a real cruel game."
He said ministry bureaucrats mishandled Aucoin's application for coverage
from the outset and continued to botch it all the way along.
"This case is stunning in many ways, not the least for the many missteps and
miscommunications by ministry officials," he said.
"They misunderstood her application from the beginning and then they sent
her an unintelligible form letter to explain (her rejection)."
In a rejection letter Aucoin received in October 2005, a Health Ministry
official maintained the application couldn't be approved because the drug
was already available in Canada and was considered experimental.
The health official was wrong -while Erbitux had been approved for use by
Health Canada in September 2005, it has not been made commercially available
in any province or territory.
The rejection letter contained a second error, turning Aucoin down for
another cancer drug called Avastin, when, in fact, she was trying to get
access to Erbitux.
"This idea of sending out a form letter to a Stage 4 cancer patient, it's a
calamity," Marin said.
He maintained ministry officials displayed a "slavish adherence to rules at
the expense of common sense."
Based on Marin's recommendations, Smitherman announced the government will
take immediate steps to give physicians better access to information about
the out-of-country health-coverage program.
Other recommendations made by the ombudsman will be implemented in the
spring, including a move to give patients better reasons for OHIP decisions
on out-of-county funding applications.
Smitherman was not available for comment Tuesday night, but his press
secretary said the government will move quickly over the next few months to
review the program and make improvements.
The report "was fairly clear in this area. It could have worked better. It
could have been more clear," said David Spencer.
Late Tuesday afternoon, Aucoin received a phone call from deputy health
minister Ron Satsford apologizing on the ministry's behalf.
"As much as the money is important, accountability is important," Aucoin
said.
"It would have been nice if Mr. Smitherman had called directly."
St. Catharines MPP Jim Bradley said he's pleased the ministry accepted the
ombudsman's recommendations and apologized to Aucoin.
"It's not simply offering a cheque and begrudging it," he said.
"It's very important that they recognize what the ombudsman has said and
what the circumstances are. I think it was most appropriate that an apology
is offered Suzanne Aucoin."
Bradley said Aucoin's victory will help others in similar situations.
"Suzanne is not only obtaining the funding that she sought for her own
costs, but will be instrumental in improving (care) for others."
Marin marvelled at Aucoin's tenacity and determination to fight for her own
rights and the rights of other cancer patients.
"Suzanne Aucoin is like the modern-day Erin Brockovich. She fought city hall
and won," he said.
The Toronto-based Cancer Advocacy Coalition of Canada is calling on the
ministry to move forward quickly with improvements recommended by the
ombudsman.
"There are many more cancer patients who don't have the energy and the fight
of Suzanne Aucoin," said Colleen Savage, the coalition's president and chief
executive officer.
"There are other patients being tortured by the processes of OHIP."
Savage questioned why the Health Ministry didn't act sooner to reimburse
Aucoin's expenses and improve the out-of-country health coverage program.
"The ministry has known about Suzanne Aucoin's case for about a year and a
half, and they did nothing about it until they were kicked by the
ombudsman," she said.
"Why did they make her go through all of this?"
Aucoin, who's on leave from her job as a chaplain at Denis Morris High
School, said she couldn't have mounted her fight without the network of
family, friends and supporters who have been following her story.
"It's nice to finally have some good news," she said. "Now I can focus on
being well and research (into treatments)."
pdowns@stcatharinesstandard.ca
Box(es):
Making changes
Based on recommendations of Ontario Ombudsman Andre Marin, the Ministry of
Health announced Tuesday it will:
Reimburse St. Catharines cancer patient Suzanne Aucoin the full amount she
paid for Erbitux - approximately $56,000 - after being wrongly rejected by
OHIP for out-of-country drug coverage.
Reimburse Aucoin approximately $19,000 she paid in legal fees to argue her
case before the Ontario Health Services Appeal and Review Board.
Apologize to Aucoin for the way her case was mismanaged.
Review the government's out-of-country health-coverage program.
Provide physicians with better access to information about the
out-of-country health coverage program.
Review the need to provide more information to patients and physicians about
funding for particular treatments to ensure decisions about funding are
consistent and based on evidence.
Provide patients and physicians higher-quality explanations when requests
for out-of-country health coverage are denied.
Suzanne's story on the web
The Standard's ongoing series following Suzanne Aucoin's fight with colon
cancer can be read online. For previous stories in the series, go to The
Standard's website (www.stcatharinesstandard.ca) and follow the link on the
left-hand side to Suzanne's Story.
Suzanne Aucoin also posts regular updates and information on her website:
www.helpsuzanne.com
Illustration(s):
Suzanne Aucoin received word Tuesday that she will get back all of the money
- about $56,000 - she spent on a colorectal cancer drug. Aucoin is shown
with her mother, Janet, and father, Norm, inside their St. Catharines home.
staff photo by Bob Tymczyszyn
Category: Front Page
Uniform subject(s): Diseases, therapy and prevention
Length: Long, 1205 words
© 2007 St. Catharines Standard (ON). All rights reserved.