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Hello Everyone, Today's Globe & Mail reports that a new private clinic will open in Toronto offering patients access to cancer drugs that are not currently funded by the province. These drugs include Herceptin, lauded as a breakthrough therapy for the treatment of certain types of breast cancer and Velcade, a chemotherapy drug that is provided to patients with advanced multiple myeloma. In Ontario, drugs are one of the fastest growing components in overall health care spending, representing 10 percent of public health expenditures. The Ministry of Health and Long-Term Care spends more than $3 billion annually on drugs out of its $35.7 billion budget. Cardiovascular and antilipemic drugs account for a third of total drug expenditures in treating patients with heart and cardiovascular problems. A key factor driving this huge cost is that today we have newer, often better and generally more expensive drugs available to patients. We also have an aging population, as well as greater patient and provider awareness of new drug treatments. Increasingly, research will develop new drugs that may be beneficial for individual patients, but could also be extraordinarily expensive to the system. The Ministry approaches new drug coverage by weighing the effectiveness of the drug and its cost. University Health Network supports this evidence-based approach to providing drugs. In cancer chemotherapy, this approach has been pioneered by Cancer Care Ontario which is known around the world for its rigorous evaluation of evidence in making recommendations to government. Some Ontarians are currently traveling outside of the province to the U.S. to obtain treatment that may be useful and paying out-of-pocket for medications. What this new clinic is seeking to do is offer access to these new drugs here in Ontario. These issues are complex with no easy answers. Many health care economists believe the escalating cost of new cancer treatments and other drugs will inevitably force difficult ethical questions on policy-makers. We respect and support the role of physicians in advocating for what is best for their patients. We respect and support the Ministry's insistence on an evidence-based approach to public funding of pharmaceuticals. I believe it's time for society to have a debate on this important issue. It will ultimately shape the future of our health system and define our expectations for publicly funded health care. Bob