Archive for September 19th, 2009

Ontario Making Cancer and Cardiac PET Scans Available

Saturday, September 19th, 2009

July 23, 2009 12:00 PM

McGuinty Government Makes Diagnostic Exam A Publicly Insured Health Service

Ontario is making positron emission tomography (PET) scanning a publicly insured health service available to cancer and cardiac patients under conditions where PET scans have been proven to be clinically effective.

PET scanning is a nuclear medicine diagnostic imaging exam.  PET scanning can provide information on both the location and the extent of the metabolic activity of abnormal tissues such as cancer and it has the potential to identify the areas of abnormal metabolic activity that is not always found through the use of MRIs or CT scans.  For the services that will be insured, PET is useful in determining the stage or extent of some cancers to aid in treatment decisions. PET has also been determined to be useful in making treatment decisions in certain advanced heart conditions.

Ontario’s decision has been informed by advice received from Ombudsman Andre Marin. The Ministry of Health and Long-Term Care will ensure that resources are in place to continue clinical evaluations for additional health indications where PET scanning may prove beneficial. In addition, the ministry is committed to assessing and evaluating future technologies in an expeditious and transparent manner. For individuals with indications for which PET scans are not currently funded, physicians will continue to be able to make a request through the PET Access Program, where each application for funding is considered on a case-by-case basis. The ministry will work towards making this process and the decision-making behind it more transparent, and ensure that resources are available to process applications in a timely manner.

QUICK FACTS

  • The government is making PET scanning available as an insured service this fall, for certain evidence-based health indications, based on results from the Ontario studies of its effectiveness on patient outcomes.
  • By October 2009, insured PET scans will be performed in Ottawa, London, Toronto, Hamilton and Thunder Bay.
  • Ontario has established one of the largest PET infrastructures in Canada with 10 PET scanners at nine centres.

CONTACTS

  • For public inquiries call ServiceOntario, INFOline
    1-866-532-3161
    null(Toll-free in Ontario only)
  • Neala Barton
    Minister’s Office
    416-327-4388
    media@nullmoh.gov.on.ca

“PET scans have been shown to be highly effective in determining treatment of certain diseases where it can help ensure patients receive the best possible health outcome. I’m grateful to the Ombudsman for his advice and the members of the Ontario PET steering committee for their dedication and willingness to put patients first and to support Ontario’s efforts to ensure that we only pay for new health technologies that work and improve better patient care.”

 – David Caplan
Health and Long-Term Care Minister

“We’re making PET scanning available to Ontarians based on the evidence of its effectiveness. I applaud the Ontario Government for supporting past and future evaluations of new technologies before widespread introduction.”

 – Dr. William (Bill) Evans
Chair, Ontario PET Steering Committee

“I am gratified that the Ministry of Health and Long-Term Care has taken my concerns about patient access to PET scanning in 2009 seriously and acted.”

 – André Marin
Ontario Ombudsman

“Today’s announcement is a step in the right direction and will benefit cancer and cardiac patients who meet the clinically proven indications for PET scans. In addition, the OANM looks forward to working with government in order to appropriately increase PET access for those patients requiring this procedure in the future.”

 – Dr. Christopher O’Brien
President, Ontario Association of Nuclear Medicine (OANM)

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Ontario Ombudsman comments on province’s PET scan announcement

Saturday, September 19th, 2009

Ontario Ombudsman André Marin today welcomed the government’s announcement that it will make positron emission tomography (PET) scanning a publicly insured health service for some cancer and cardiac patients.

The announcement is based in part on the Ombudsman’s advice, following his investigation into the government’s PET scan program evaluation process.

Mr. Marin launched his investigation in September 2007 after receiving numerous complaints from doctors and patients that the evaluation had gone on too long and Ontario was lagging behind other provinces in the provision of publicly funded PET scans.  It has been seven years since the government decided to conduct clinical trials to determine whether it should fund PET scans for specific indications.

The investigation was conducted by the Special Ombudsman Response Team (SORT) and involved in-depth research into PET scan technology, the accessibility of PET scans in other provinces and interviews with about 50 physicians as well as patients and other stakeholders.  It was completed in December 2008.

At that time, the Ombudsman provided a copy of his preliminary report to the Deputy Minister of Health and Long-Term Care for a response, as required under the Ombudsman Act.  After a number of meetings with senior Ministry officials, the Ombudsman determined that the issue could be resolved without need for a published report.

“Our investigation determined that this is a very complex issue, nowhere near as black-and-white as it is sometimes made out to be,” Mr. Marin said.  “It quickly became clear to us why the evaluation process had taken so long.  However, that was no justification for not taking action, which we urged the Ministry to do.  I recommended that PET scans be expedited for those patients who already qualified for them under the cancer and cardiac registries.  I’m gratified that the Ministry has taken my advice and finally moved forward.”

The announcement notes that PET scans will be available for cancer and cardiac patients under specific conditions where they have proven to be clinically effective.  Patients with conditions that are not covered may still be eligible for PET through the PET Access Program.  The Ministry has assured the Ombudsman that requests through the PET Access Program will be processed in a timely manner.

“As a result of our recommendations, physicians will now be made aware of the avenues available to get approval to have patients who are not covered under the new regulations provided with PET scans,” Mr. Marin said.  “That is a safety net that should catch those who fall through the cracks of today’s announcement.  This existed before, but the Ministry did very little to let doctors know about it until several years into the evaluations.  The Ministry has indicated that future technology assessments will be more open and transparent, which is encouraging.  I’m convinced that this resolution is a much-needed step forward by the government that will benefit many people in need.”

While it is relatively unusual for the Ombudsman to choose not to publish a report, he has chosen this course a number of times in recent years.  In 2007, a cancer patient was reimbursed $76,000 in medical costs and the province’s out-of-country program was overhauled in the wake of an Ombudsman investigation, without need for a published report.  That same year, mental health services for the children of Ontario-based soldiers were increased by the province after the Ombudsman’s investigation quickly resolved the issue, also without a published report.  The Ombudsman also resolves thousands of individual complaints every year.

Mr. Marin noted that, as with all SORT investigations, his team will continue to monitor the province’s progress on the PET scan issue, with the potential to re-investigate if evidence warrants.
“I also recommended to the Ministry that it establish a process so that when the next new technology comes along, it will be assessed as quickly as possible.  Bearing in mind what they can mean to people with life-threatening conditions, these kinds of assessments should be properly researched, planned and implemented – and the Ministry should be accountable throughout.”

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For further information, please contact:

Sara McMillen
Communications Officer
Tel: 416-646-8008
smcmillen@nullombudsman.on.ca

or

Elena Yunusov
Communications Officer
Tel: 416-586-3521
eyunusov@nullombudsman.on.ca

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