Court quashes OHIP denial of out-of-country treatment for man with terminal cancer
The Ontario government's health insurance program, OHIP, has been ordered by a court to reconsider its decision to deny coverage for out-of-country cancer treatment for a terminally ill man. Alex Shved, a 37-year-old with Stage 4 melanoma, sought funding for tumour-infiltrating lymphocyte therapy in the United States, but his request was initially declined and then again denied upon reconsideration.
The court, in a 2-1 decision, ruled that OHIP's denial was problematic and life-threatening for Shved. The main concern for OHIP seemed to be the potential impact on future negotiations with the drug manufacturer regarding pricing for publicly funded treatment in Ontario. However, the court did not provide a clear basis for this concern.
One dissenting judge suggested that OHIP's executive officer should recommend funding and expedite the decision based on this recommendation.
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