August 11, 2001

A1 BREAKING NEWS
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Health
Ottawa ruling gives boost to private health care
Patients to be charged for “critical” cancer test

LISA PRIEST
INVESTIGATIONS UNIT

Health Canada appears to be creating an opening for private health care by giving a Vancouver-based company permission to expand the world's hottest new diagnostic tool for paying patients, The Globe and Mail has learned.

International PET Diagnostics Inc. was told it can expand its clinical trials on FDG, a drug injected in those who undergo positron-emission tomography scans, often for suspected cancer, said its executive vice-president, John Smith.

“What Health Canada has said to us is that we have no difficulty with you going across the country establishing other PET-scan facilities,” Mr. Smith said yesterday.

The company, which operates a PET scanner in Vancouver, is working on plans to expand to Montreal, Toronto and Calgary, where patients would get PET scans on a pay-as-you-go basis.

The company will also use the new machines to conduct a clinical trial to determine the “safety and efficacy of FDG,” Mr. Smith said, but it hasn't been resolved whether patients who are participating in the clinical trial will be charged.

Patients face paying $2,500 out of pocket to gain access to Canada's only private PET scanner in Vancouver.

A lucky few can gain access to a machine at no cost on a restricted basis in hospitals in Hamilton, Sherbrooke and Edmonton.

“We think it's unacceptable that a parallel, private medical test is being offered in Canada,” Mr. Laberge said. “It's very worrisome to see the federal government getting into private health care.”

The move has some wondering how federal Health Minister Allan Rock can justify investigating operators of private MRI scanners for potentially violating the Canada Health Act while his department gives permission for a drug that allows the expansion of private PET scans. His spokeswoman, Catherine Lappe, could not be reached for comment yesterday.

But Health Canada spokeswoman Roslyn Tremblay said PET scans are not covered under most provincial health plans as they are “not considered medically necessary because the technology is not a standard diagnostic tool.”

The PET scanner uses radioactive isotope tracers, such as glucose, to highlight cancer. it is used about 90 per cent of the time in such cases.

In no way is it a medical frill, said Sandy McEwan, president of the Canadian Association of Nuclear Medicine. “FDG has been used by millions of people around the world. There's no evidence of toxicity; it's an entirely safe pharmaceutical,” Dr. McEwan said.

The radiopharmaceutical, known medically as fluorodeoxyglucose, is approved for use in the United States. In the U.S., as many as 39 million people aged 65 and older, and others who qualify under Medicare can access the high-tech tool at no cost to diagnose certain cancers and other conditions.

The Institute for Clinical Evaluative Sciences in Ontario, a government-funded body that tracks the use of health-care services, said that 23,590 potential patients, including those with melanoma, Hodgkin's and Non-Hodgkin's lymphoma and cancers of the lung, colon, head, neck and breast, could have benefited from a PET scan in fiscal 1999-2000.

Similar studies on its usefulness have been done in British Columbia and Alberta, said Dr. McEwan, noting that another paper on its safety and efficacy is expected to come out soon in Quebec.

If extrapolated to the entire population, Dr. McEwan estimated that at least 100,000 Canadians, the vast majority with suspected cancer, could benefit each year from PET scans. Mr. Laberge said that not only does the technology save lives because it can detect cancer earlier, it also saves money by reducing the odds of too much or too little radiation therapy, chemotherapy and surgery. That's because unlike the MRI or CT scan, the PET scanner sees molecular changes in cells.

There are at least eight PET scanners across Canada in hospitals and universities, including the private machine in Vancouver.

“It is a critical diagnostic tool. We're talking about cancer, which will determine the survival of individuals. It is key,” said Mr. Laberge. “It helps saves lives, there's no question about that. And it saves money, as well.”

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