‘I want to live’: Whitby woman struggling to pay for life-saving cancer treatment after being denied OHIP coverage

A Whitby woman receiving treatment for Stage 4 Metastatic Breast Cancer is struggling to pay for a new life-saving drug after being denied coverage by OHIP. She is calling for change so other women don’t fall into what she calls a loophole.

Gabriela Fiorini was first diagnosed with breast cancer in 2013 before it metastasized in 2021.

“It came to the liver, the lungs, and the bones. And I started treatment immediately and then all of a sudden they discovered that it went to my brain too,” she explained.

The 62-year-old, who came to Canada from Argentina 30 years ago and volunteers to help newcomers, is HER2 positive and there are few treatment options. She was put on a drug called Kadcyla but stopped in Nov. 2022 after it was discovered the treatment wasn’t working.

Shortly after, her oncologist informed her of a new drug called Enhertu that had just been approved in Ontario. Studies show it has had greater success and offers what every cancer patient desperately needs, hope. So far Fiorini has had seven treatments of the drug and she says they are working.

“Markers have reduced a lot … the CT scans are stable and some reducing or shrinking,” said Fiorini.

The treatment is expensive with each one costing almost $6,000. Fiorini needs 12 treatments and even with a 20 per cent compassionate fee reduction from the drugmaker AstraZeneca, the total cost to her is $72,000. But because Fironi was first on Kadcyla, she doesn’t qualify for OHIP coverage of Enhertu.

“I want to keep on living. I’m not ready to give up. I want to keep on fighting.”

A fellow cancer patient has up a GoFundMe page, which has raised close to $22,000 but the money has run out and Fiorini has been paying for the treatment out of her savings and credit. She has five more treatments to go but needs an additional $30,000 to finish. 

In desperation, Fiorini has written letters to each party leader at Queen’s Park and her MPP to try and find out why she isn’t covered. Her MPP responded indicating her letter would be sent to someone else, but she hasn’t heard anything since.

“It’s not only me, it’s all these people disqualified.  We’ve asked for a revision of this criteria but so far haven’t heard anything,” said Fiorini.

CityNews reached out to the Minister of Health’s office and learned there is a complex algorithm for funding cancer drugs. Each one goes through rigorous trials before being approved and then covered.

According to the Ministry, Enhertu’s trials did not include patients who received Kadcyla, so that is why Fiorini is not eligible to be covered by OHIP.

AstraZeneca confirmed to CityNews it has submitted more data that is currently being reviewed by Health Canada, however, that could take months.

One in eight women will be diagnosed with breast cancer during their lifetime in Canada and between 20 and 30 percent of them with early-stage breast cancer will develop Stage 4 cancer. The median survival rate for them is three years.

“I know it’s much better and new drugs are appearing all the time and yes, every time you have a new treatment you have hope,” said Fiorini.