Court quashes OHIP denial of out-of-country treatment for man with terminal cancer
An Ontario court has quashed a decision denying provincial coverage for out-of-country cancer treatment to a 37-year-old man with Stage 4 melanoma. Alex Shved’s oncologist had applied to the Ontario Health Insurance Plan to fund tumour-infiltrating lymphocyte therapy for him in the United States, but that was denied both in an original decision and in […]
An Ontario court has overturned a decision denying coverage for out-of-country cancer treatment to a 37-year-old man with Stage 4 melanoma. The Ontario Health Insurance Plan denied funding for tumour-infiltrating lymphocyte therapy in the United States, but the Divisional Court ordered a judicial review, which has now set a deadline for OHIP to issue a new decision.
The judges, in a split decision, ruled that OHIP's denial is a life-or-death matter for the patient, finding its reasoning for denial "problematic." They suggest that approving the request might complicate future negotiations with the drug manufacturer over pricing for publicly funded treatment in Ontario, but the denial lacks a solid basis.
One dissenting judge agreed with the other two but wanted to further direct OHIP to recommend funding and expedite its decision based on that recommendation.
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- Court quashes OHIP denial of out-of-country treatment for man with terminal cancer winnipegfreepress.com
