An Open Letter to Brian Gallant and Victor Boudreau

When I last visited with Victor Boudreau, it was concerning a little girl (Kamie Babineau) who lives near Moncton that needed a life-saving treatment that is very similar to the treatment that Morgan needs. In fact, the only difference is the enzyme that each of these kids need. It’s simple really – unbelievably simple. Kids suffering from MPS lack an enzyme in their blood that breaks down cellular waste. The cellular waste that doesn’t get broken down needs to find a place to go so it stores itself in the bones, tissues, organs, and muscles of our kids fighting the disease.

The treatment our kids receive to help fight off the ravages of MPS is a synthetic version of the enzyme they are missing in the blood. Basically, our kids are missing this enzyme and we are giving it back to them. The enzyme treatment breaks down all of the cellular waste that is building up in the body and helps patients lead a more normal and healthier life.

It really is that simple, and it’s why Minister Boudreau approved access to the drug Kamie needed within days of receiving her application.

When we met at that time, Mr. Boudreau told me that one of the main reasons that he was so passionate about the work we are doing was because of a quote that tops my website, and a quote I work to live my life by. It’s a quote by Margaret Mead that read “Never doubt that a small group of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has.”

Mr. Boudreau told me he saw this on my website and it struck a cord with him. He told me that Premier Gallant often uses this quote during cabinet meetings, telling his team that they have the opportunity to be that small group of committed citizens, and to always work to change the world in everything they do.

When he saw this on my website, Minister Boudreau told us that he went directly to the Premier with Kamie’s application for treatment and told him they needed to do something, and fast.

And it was fast – days. In a matter of days, Kamie’s application for treatment was approved. A short while later, she began her life-saving treatments and is thriving today. Thriving because the treatment works. Her life had been saved.

During that same meeting, I told Mr. Boudreau about Morgan Doucet. I told him there was another boy needing a very similar treatment and that he needed it fast. The treatment had been approved by Health Canada 8 months earlier and the Ministry of Health wouldn’t accept the physician’s application for reimbursement for Morgan. At that time, the Ministry said they “didn’t know what to do with the file.” Mr. Boudreau told me he would take the application and he would get back to me very quickly.
In reality, The Ministry of Health DID know what to do with Morgan’s file because they have been part of a larger collective in the country – a collective of all of the pharmaceutical managers throughout the country who made an agreement that they wouldn’t approve payment for the drug Morgan needed. Why? Cost. It’s an expensive drug and the Provinces wanted to work together to bring the cost of this treatment down. They discussed the drug together, made a commitment that “nobody would be the first to approve” and began work to bring the cost of the drug down.

In theory, brining the cost of pharmaceuticals down in this country is a good thing. I’m all for getting the best price on things, especially expensive things. But not at the expense of the people who have to suffer while the bureaucrats play hardball with the pharmaceutical industry.

I’ve had conversations with different provinces about this issue over the course of the past 2 years. They stand by their approach to this drug, even when told that it’s putting our kids in the middle of a battle that they want no part of, even when told that our kids are dying while they try to get the best deal possible for their respective Provinces.

Unfortunately for Minister Boudreau, he didn’t discover this until he took Morgan’s application and promised to get back to us quickly. Days turned into weeks, which turned into months. A battery of tests were ordered on Morgan and the Province worked to delay a decision on Morgan’s treatment by adding new tests after the original batches were complete.

When a decision on Morgans treatment was deemed “imminent”, the Ministry of Health ordered Morgan to undergo a sleep study, knowing full well that the New Brunswick didn’t have the capabilities to conduct such tests in the Province and that Morgan would have to fly to the Hospital for Sick Children in Toronto to have the tests done.

This is when I started to move from frustrated to upset. Why? Because the Ministry was well aware that the test Morgan required would take months to complete due to a wait list at Sick Kids in Toronto. Add to that the stress and burden placed on Morgan and his family by leaving their home, boarding an airplane, and finding their way around a huge city (something they have never done before).

But it wasn’t the delay which was incredulous to me, it was the test that was ordered with the clear intention of delaying things further for Morgan. They wanted a sleep study, even though Morgan has never had difficulty with his sleeping. Ever.

With some perseverance, we were able to remove the sleep study from the tests the Ministry ordered for Morgan. After that removal, the Province denied Morgan’s application. I immediately asked how we could appeal the ruling. I asked the Ministry, the Minister, and the Premier in multiple emails and phone calls. I was ignored each and every time.

Which brings us to where we are today. I relayed all of this to Minister Boudreau when we met yesterday and he told me he would take another look at Morgan’s file. He told me he would look at things after I told him the pharmaceutical managers have agreed to work together to deny access for our kids as they wage war on Big Pharma. He told me he would look into things after I told him the review process was flawed and set up to fail from the very beginning. He told me this after I told him that Saskatchewan saw through this flawed system and took it upon themselves to initiate their own proper, thorough, and transparent review. A review free of bias from Ministry officials. A review meant to provide REAL feedback.

During that meeting, however, I couldn’t help but wonder where the Minister’s gusto for being part of the small group of citizens working to change the world together went. If this wasn’t the time to step forward and take a stand, make a statement on behalf of a young child, then when? We know this treatment works. We know because we have 33 Canadian children receiving the treatment throughout the country. We know because the International and Canadian experts have all said it should be used in our kids as soon as possible.

And I know because I see it working each and every day, with every patient I visit, with every drop of drug that gets dripped into their body. Their lives are changed – saved – and we can see it in everything they do.

Saskatchewan took the lead and moved away from this review process. They did this because it is the right thing to do by patients.

So I again implore Victor Boudreau and Premier Brian Gallant to be part of that small group of citizens working to change the world. Take it upon yourselves to be the true leaders your Province needs you to be. I’m not asking for immediate access to treatment, just the commitment to a new, thorough, and transparent review of Morgan’s file. A review completed by the real experts out there, free of bias and bureaucratic interference.

Morgan deserves that opportunity, and it’s incumbent on your offices to be sure that he gets that chance. Please be part of the change you purport to stand for and don’t hide behind the excuses being handed to you by the bureaucrats.  The government has nothing to lose by ordering a new review, but Morgan has EVERYTHING to lose if they don’t.

This shouldn’t be about cost, about the Provinces of Canada vs. Big Pharma. It should be about Morgan, and I ask you humbly to refocus things on that little boy. In the end, it WILL change his world.

I stand by my offer to bring in Dr. Paul Harmatz to talk with you about this disease, this treatment, and this case.  He’s the best in the world when it comes to this disease.  If your government is open, transparent, and about the change you want to see in this world, a good first step toward showing this would be to talk with Dr. Harmatz and get the real information you need.

I’ll be in Fredericton this week and hope we can discuss while I’m there.

 

 

 

 

LIFE-SAVING TREATMENT DENIED FOR AILING NEW BRUNSWICK CHILD

FOR IMMEDIATE RELEASE

PDF Version – www.theisaacfoundation.com/nbtreatment.pdf

Ministry of Health Denies Funding; Premier and Minister of Health Refuse to Allow Appeal; Treatment Already Being Funded in Saskatchewan, Ontario and Quebec

The New Brunswick Ministry of Health has denied funding for a life-saving treatment required by an ailing 10-year old Baie-Sainte-Anne child. Morgan Doucet suffers from MPS IVA (Morquio Syndrome) and requires the life-saving treatment immediately in order to halt further progression of his devastating disease. The Isaac Foundation and The Canadian Society for Mucopolysaccharide & Related Diseases (Canadian MPS Society) are calling on Health Minister Victor Boudreau and Premier Brian Gallant to take action, review and reverse the decision, and ensure that treatment begins immediately.

Without access to therapy, Morgan faces a long and painful decline and death at a young age. The Isaac Foundation met with Minister Boudreau on December 9, 2015 but the Minister declined to make any commitments regarding an appeal for Morgan. The family has publicly given permission for the Minister to comment on Morgan’s application and condition so that the Minister can be forthcoming with the public about why he isn’t allowing an appeal.

Sufferers of Morquio Syndrome lack an enzyme in their blood that breaks down cellular waste in the body. This waste builds up in the bones, tissues, organs, and muscles of affected individuals and leads to many devastating symptoms including heart and airway disease, corneal clouding, stiffening of the joints, shortened stature, and premature death. The treatment being denied to Morgan dramatically slows or halts the disease, improves pulmonary function, walking ability, and gives patients the chance at a normal life. It is currently being funded in Saskatchewan and for patients in Ontario and Quebec.

Andrew McFadyen, Executive Director of The Isaac Foundation, an advocacy, research, and family support organization that specializes in MPS related diseases, is disappointed by the decision and is urging an immediate reversal to save the Morgan’s life. “The decision to deny this life-saving treatment for Morgan is outrageous, heartless, and cruel. This therapy has been recommended by a Canadian Expert Panel comprising of MPS experts from BC, Alberta, Saskatchewan, Ontario, and Quebec, and International Treatment Guidelines for Morquio Syndrome highlight this treatment as the gold standard of care for affected patients. To prevent this child from receiving the care he requires is needless and callous, and shows a reckless disregard for what our Canadian Health Care System purports to stand for.” He adds, “The Ministry is telling this family to enter a long-term palliative approach to care for their child instead of ensuring that disease progression is halted now. They are allowing him to die, instead of taking leadership and doing the responsible and ethical thing by providing him with the help he needs. It’s shamefully disgraceful.”

McFadyen is puzzled as to why access for treatment was denied, especially considering the weight of available evidence and Canadian and International expert guidelines urging it’s approval. In addition, the Province already provides access to patients suffering from every other form of MPS requiring the same kind of treatment. He expects it comes down to financial considerations due to the high cost of the drug, coupled with a recent negative recommendation from the Common Drug Review (CDR), that has clouded the judgment of decision makers at the Ministry.

Jamie Myrah, Executive Director of the Canadian MPS Society, a national patient association that serves those affected by MPS and related lysosomal diseases, notes that there were serious issues with the initial review that denied Morgan the treatment he needs.   “The initial review was done by a reviewer who has never used this treatment, using the flawed CDR report as the basis for his decision. This recently happened with three children in Saskatchewan. However, when the Minister realized the review for those files was flawed, he ordered a new review using real experts dealing with this disease and this treatment. He chose International experts to take a second look at the files and those experts came back with a decision to treat. We feel the Premier should also take a second look at Morgan’s file. We’re not asking for much – just a second look at this decision. Morgan’s life depends on it and I would hope the Premier and the Minister of Health would want to ensure they get things right.”

McFadyen also questions the process used by the New Brunswick Ministry of Health in making their decision, noting the family first requested access in October of 2014. He notes that in March of 2015, the file was finally sent to Ontario for review by one individual alone, with no opportunity allowed for a rigorous discussion with the rest of the MPS Experts throughout Canada –experts that deal with the disease on a daily basis and some of whom have seen first-hand how well other children receiving the treatment are doing. “The only thing stopping this child from beginning his treatment is the lack of funding by the Province. It’s incredulous to me that one individual gets to pick and choose who does or doesn’t get access to the life-saving treatment they need, especially considering the fact that a precedent has been set with other children in this province and in other provinces across the country receiving access to similar medications. One individual is making life-altering decisions on behalf of this Ministry and the people of New Brunswick, and it’s led to Morgan’s life being left in peril.”

Myrah adds, “We know this treatment works and the Province knows that ERT’s for MPS diseases are currently the only chance patients have of living longer, healthier lives. We recognize that the CDR gave this treatment a negative recommendation, but it did so for all the other MPS ERT’s as well; yet every province in the country – including New Brunswick – still ensures access for those patients. While ERT treatment for MPS is expensive, it is often just as expensive – if not more expensive – to not treat these kids. It simply doesn’t make sense to make these children suffer a slow and painful decline when we could stop or dramatically slow the progression of the disease with the treatment being requested.”

Both Myrah and McFadyen are hopeful that a review and a reversal of this decision can take place immediately, and they are urging the Health Minister and the Premier to take action now. Says McFadyen, “Brian Gallant’s government has the opportunity to do the right thing and ensure that Morgan receives the treatment he so desperately needs. It’s the role of government to protect and ensure fair and equitable access to Health Care for all people in New Brunswick, regardless of whether they are impacted by a rare disease or not. This family needs to concentrate on treating their children’s disease, not wading through a bureaucratic maze of paperwork and pinning their hopes on the appeals process or the recommendation of one person alone –a person who has never used this therapy or seen it’s effectiveness – at the Ministry of Health. We strongly call on this government to take action and save the life of this little boy now. He can’t afford to wait.”

# # #

For more information about this topic, or to schedule an interview with Andrew McFadyen, please call Andrew at 613-328-9136 or email Andrew at mcfadyena@me.com. The Isaac Foundation can also arrange interviews with parents of patients currently receiving this treatment in Canada.

 BACKROUNDER  

While not a cure for Morquio Syndrome, the necessary Enzyme-Replacement Therapy (ERT) is designed to provide patients with a synthetic version of the enzyme they are lacking by infusing small doses into the patient’s bloodstream on a weekly basis. The treatment slows down or halts progression of the disease in patients, improves endurance, walking distance, breathing problems, and provides other benefits to sufferers that dramatically improve their quality and length of life. International experts and a Canadian Panel of Genetics Specialists have all recommended Vimizim as the front-line treatment for Morquio Syndrome. Vimizim was approved by Health Canada in July 2014, and is currently being reimbursed for use by patients in Saskatchewan, Ontario, and Quebec. Recently, the National Institute for Health and Care Excellence (NICE) recommended reimbursement for all 88 patients suffering from Morquio Syndrome throughout the UK.

Baie Sainte Anne Boy Needs Drug To Manage Rare Disease

December 9, 2015

A young Baie Sainte Anne boy’s plight made it to the floor of the provincial legislature this morning.

Morgan Doucet, 10, is currently the only person in New Brunswick suffering from morquio syndrome.

On Wednesday morning, Southwest Miramichi-Bay du Vin MLA Jake Stewart called on the province reverse its decision not to fund a Health Canada approved treatment for Doucet’s illness.

According to the U.S. National Library of Medicine, morquio syndrome is an inherited disease of metabolism in which the body is missing or doesn’t have enough of a substance needed to break down long chains of sugar molecules called glycosaminoglycans (formerly called mucopolysaccharides).

Symptoms include:

– Abnormal development of bones, including the spine
– Bell-shaped chest with ribs flared out at the bottom
– Coarse facial features
– Hypermobile joints
– Knock-knees
– Large head (macrocephaly)
-Short stature with a particularly short trunk
– Widely spaced teeth

While Stewart didn’t name the treatment in question, the only Health Canada approved drug for the disease is Vimizim, which was approved last year.

Annual treatment can cost upwards of $100,000.

Stewart said Doucet needs treatment.

“Recently access to this lifesaving medication for Morgan Doucet was denied by the minister of health and the department, even though it is the gold standard of care as recommended by the international treatment guidelines, has been recommended by the Canadian Expert Panel on Morquio Syndrome and has been prescribed by Morgan’s genetic specialist at the IWK ” Stewart said in the legislature.

He accused the government of overruling the experts and said there is no process for appeal.

Health Minister Victor Boudreau said he could not discuss the specifics of the case on the floor of the legislature, citing privacy rules, but said their is a process in place for situations like Doucet’s.

“Because we do not have the level of expertise on these rare diseases and rare drugs here in the province of New Brunswick we rely on the province of Ontario and this is a process that was put in place by the member for Rothesay, the former minister,” Boudreau said.

He explained that the file is sent to experts in Ontario and they get back to the New Brunswick government with a recommendation.
But Stewart wasn’t happy with that reply.

“The drug that Morgan requires is currently being funded by Saskatchewan, Ontario and Quebec and in most developed countries.  Morgan’s application was denied by a single reviewer from Ontario, a reviewer who no longer practices medicine and has never used this treatment,” Stewart said.

He also said Saskatchewan found flaws with the review process and with that reviewer. He said that province now deals directly with the experts on specific diseases.

“I ask the minister of health and the premier, will they show the same leadership and do the right thing by ordering a new review of Morgan’s file and provide immediate access to this life saving treatment while that review is taking place?” Stewart asked.

Boudreau said these are very tough situations.

“Everybody in this legislature has a heart and understands that these decisions are difficult to make,” Boudreau said.

“I can tell you that across the country, and in New Brunswick, some cases get approved, some cases don’t. We follow a process, Mr. Speaker. I am not an expert, and we don’t even have those experts within our department or within our province,” he added, saying the process was followed.

This Is Not OK – When Answers Aren’t Really Answers

To me, this is the most difficult part to accept. No appeal? No opportunity to ensure the decision was rendered correctly before we condemn this little boy to a life of pain and suffering…to death? Prisoners on death row – prisoners there for the heinous crimes they have committed – have multiple opportunities to appeal their decided fate. Before that, their fates get decided by collections of people, people who have the opportunity to hear all viewpoints, all expert testimony, everything. They exhaust all avenues in making death sentence rulings, and then we allow those prisoners the opportunity to appeal and fight their fate. Not so for this little boy, it appears, and that will never be OK with me.  ~Andrew McFadyen, Executive Director, The Isaac Foundation

Late last night, I boarded a plane to Fredericton with hopes of meeting with the Minister of Health, Victor Boudreau, about 10-year-old Morgan Doucet.  Recently, the Minister denied access to the life-saving medication that Morgan needs immediate access to, thereby condemning Morgan to a life of pain and suffering, and immediately signalling that Morgan’s care should enter a palliative approach to his disease.

This is NOT OK, for a whole host of reasons, not least of which is that we CAN help Morgan, we can stop his disease progression, and we can do it quickly with access to the treatment he needs.

This is not OK because the treatment Morgan needs has been approved by Health Canada for almost 2 years now, and it’s being used to help save the lives of  33 patients throughout the country, while being fully reimbursed for use in patients in Saskatchewan, Ontario, and Quebec.  It’s also funded in most developed countries throughout the world – including the UK – where they recently took steps to fund every patient that needs access immediately.

This is not OK because Morgan’s review was done by one person alone, a person who has never used this treatment before and a person who isn’t  a practicing physician anymore.  He’s a bureaucrat, paid by the government of Ontario to review files and render life and death decisions about kids – life and death decisions that come without rigorous debate and input from the true experts in the field.

This is not OK because the overwhelming evidence and recommendations by those true experts in the field all conclude that this drug works and should be given to patients immediately in order to stave off the ravages of the disease.  It has been prescribed by Morgan’s genetics specialist, it has been recommended for use in patients by the Canadian Expert Opinion on Morquio Syndrome and it is recommended as the front line treatment for Morquio Syndrome in the International Treatment Guidelines for Morquio Syndrome.  In fact, it’s considered the gold standard of care for patients suffering from this disease, and it’s inhumane and unethical to deny patients the help they need when they need it most.

This is not OK because we are allowing those bureaucrats and politicians to overrule and contradict medical experts, clinicians, and researchers, regarding best practice and treatment for this little boy suffering from this devastating disease.  In essence, the Minister and his bureaucrats are making clinical decisions where they are not qualified to do so.

And this is not OK because denying life-saving treatment to dying kids is not what our Health Care System is supposed to stand for, it’s not the principles that our country and our Medicare Act were founded on, and it’s not who we want to be as a Canadian People.

With all this on my mind, I took the late flight here for an arrival in New Brunswick in the middle of the night.  I came  to Question Period this morning to hear MLA Jake Stewart ask the hard questions of the Minister that he’s been avoiding answering.  Jake was poignant, thoughtful, and strong in his belief that Morgan should receive access to this drug.  After all, the Liberals themselves said last year that they “can – and MUST – do better” for our kids suffering from rare diseases.

With three questions asked, Minister Boudreau decided not to provide proper answers.  He started by saying there is a process, and that process includes a CDR report and they won’t fund drugs until that process is complete (it is, and was completed a long time ago).  He neglected to mention that no MPS drugs ever get the blessing of the CDR panel, yet New Brunswick is paying for every other drug for MPS diseases that are currently on the market.  He neglected to point out that the only patient with MPS in this province that isn’t receiving the life saving drug they need is Morgan.  He neglected to say that this has less to do with what the experts say and more to do with the cost of the drug, something that should never be a hinderance to proper care in this country.

Minister Boudreau commented on the process used – Morgan’s file was sent to a reviewer in Ontario to make a decision whether to treat or not.  One reviewer.  With no avenue for appeal after any decision is rendered.  He didn’t comment on that in Question Period, but after the decision was delivered I asked the Ministry of Health how we can appeal the ruling.  I was ignored.  I asked the Minister of Health 7 times for a meeting or information about how we can appeal the ruling.  I was ignored.  And I asked the Premier multiple times for a meeting to discuss an appeal.  As you all know, I received a note telling me that he was unable to meet, with apologies “for the inconveniences this may cause.”

To me, this is the most difficult part to accept.  No appeal?  No opportunity to ensure the decision was rendered correctly before we condemn this little boy to a life of pain and suffering…to death?  Prisoners on death row – prisoners there for the heinous crimes they have committed – have multiple opportunities to appeal their decided fate.  Before that, their fates get decided by collections of people, people who have the opportunity to hear all viewpoints, all expert testimony, everything.  They exhaust all avenues in making death sentence rulings, and then we allow those prisoners the opportunity to appeal and fight their fate.  Not so for this little boy, it appears, and that will never be OK with me.

As I was typing this entry, Minister Boudreau dropped over to meet with me to discuss Morgan and his plea for help.  I am thankful that he did, as I was able to present everything I’ve written above.  He made a commitment to take a look at this case but truly believes in the process put in place.  In his words, he will make not promises or commitments, but he will look at things and get back to me.

Knowing this, I implore Minister Boudreau to take a real look at this case and seek a new review of Morgan’s application.  I asked Minister Boudreau to seek outside opinions from a panel of 3 or 5 International and Canadian experts that deal front-line with this disease and this treatment each and every day.  I asked Minister Boudreau to allow a rigorous discussion on all available evidence that exists on this drug and the impact it has on patients, and I asked for expediency because it’s unethical to make a child and his family wait.

I asked this to allow for a transparent and fair process for Morgan.  His life depends on it and it’s the right thing to do.  And in the end, if the Minister doesn’t want to listen to and seek feed back from clinical expert opinion, patient reported outcomes, peer-reviewed published journals, etc., then who will he listen to?  The opinion of 1 person who has never used this treatment and didn’t engage with those experts to help make his decision on Morgan’s fate?

If that’s the case, it’ NOT OK.

I’ll be here for a short while and will be putting out a PR tomorrow morning so that media can cover this story if they choose.  Thank you for all of your support over the past little while – our last entry was seen over 20,000 times in a few short days.  Sharing Morgan’s story is helpful, and staying ready to fight means the world to us.

I’ll update with any news as it develops.

This Is Not OK – When Answers Aren't Really Answers

To me, this is the most difficult part to accept. No appeal? No opportunity to ensure the decision was rendered correctly before we condemn this little boy to a life of pain and suffering…to death? Prisoners on death row – prisoners there for the heinous crimes they have committed – have multiple opportunities to appeal their decided fate. Before that, their fates get decided by collections of people, people who have the opportunity to hear all viewpoints, all expert testimony, everything. They exhaust all avenues in making death sentence rulings, and then we allow those prisoners the opportunity to appeal and fight their fate. Not so for this little boy, it appears, and that will never be OK with me.  ~Andrew McFadyen, Executive Director, The Isaac Foundation

Late last night, I boarded a plane to Fredericton with hopes of meeting with the Minister of Health, Victor Boudreau, about 10-year-old Morgan Doucet.  Recently, the Minister denied access to the life-saving medication that Morgan needs immediate access to, thereby condemning Morgan to a life of pain and suffering, and immediately signalling that Morgan’s care should enter a palliative approach to his disease.

This is NOT OK, for a whole host of reasons, not least of which is that we CAN help Morgan, we can stop his disease progression, and we can do it quickly with access to the treatment he needs.

This is not OK because the treatment Morgan needs has been approved by Health Canada for almost 2 years now, and it’s being used to help save the lives of  33 patients throughout the country, while being fully reimbursed for use in patients in Saskatchewan, Ontario, and Quebec.  It’s also funded in most developed countries throughout the world – including the UK – where they recently took steps to fund every patient that needs access immediately.

This is not OK because Morgan’s review was done by one person alone, a person who has never used this treatment before and a person who isn’t  a practicing physician anymore.  He’s a bureaucrat, paid by the government of Ontario to review files and render life and death decisions about kids – life and death decisions that come without rigorous debate and input from the true experts in the field.

This is not OK because the overwhelming evidence and recommendations by those true experts in the field all conclude that this drug works and should be given to patients immediately in order to stave off the ravages of the disease.  It has been prescribed by Morgan’s genetics specialist, it has been recommended for use in patients by the Canadian Expert Opinion on Morquio Syndrome and it is recommended as the front line treatment for Morquio Syndrome in the International Treatment Guidelines for Morquio Syndrome.  In fact, it’s considered the gold standard of care for patients suffering from this disease, and it’s inhumane and unethical to deny patients the help they need when they need it most.

This is not OK because we are allowing those bureaucrats and politicians to overrule and contradict medical experts, clinicians, and researchers, regarding best practice and treatment for this little boy suffering from this devastating disease.  In essence, the Minister and his bureaucrats are making clinical decisions where they are not qualified to do so.

And this is not OK because denying life-saving treatment to dying kids is not what our Health Care System is supposed to stand for, it’s not the principles that our country and our Medicare Act were founded on, and it’s not who we want to be as a Canadian People.

With all this on my mind, I took the late flight here for an arrival in New Brunswick in the middle of the night.  I came  to Question Period this morning to hear MLA Jake Stewart ask the hard questions of the Minister that he’s been avoiding answering.  Jake was poignant, thoughtful, and strong in his belief that Morgan should receive access to this drug.  After all, the Liberals themselves said last year that they “can – and MUST – do better” for our kids suffering from rare diseases.

With three questions asked, Minister Boudreau decided not to provide proper answers.  He started by saying there is a process, and that process includes a CDR report and they won’t fund drugs until that process is complete (it is, and was completed a long time ago).  He neglected to mention that no MPS drugs ever get the blessing of the CDR panel, yet New Brunswick is paying for every other drug for MPS diseases that are currently on the market.  He neglected to point out that the only patient with MPS in this province that isn’t receiving the life saving drug they need is Morgan.  He neglected to say that this has less to do with what the experts say and more to do with the cost of the drug, something that should never be a hinderance to proper care in this country.

Minister Boudreau commented on the process used – Morgan’s file was sent to a reviewer in Ontario to make a decision whether to treat or not.  One reviewer.  With no avenue for appeal after any decision is rendered.  He didn’t comment on that in Question Period, but after the decision was delivered I asked the Ministry of Health how we can appeal the ruling.  I was ignored.  I asked the Minister of Health 7 times for a meeting or information about how we can appeal the ruling.  I was ignored.  And I asked the Premier multiple times for a meeting to discuss an appeal.  As you all know, I received a note telling me that he was unable to meet, with apologies “for the inconveniences this may cause.”

To me, this is the most difficult part to accept.  No appeal?  No opportunity to ensure the decision was rendered correctly before we condemn this little boy to a life of pain and suffering…to death?  Prisoners on death row – prisoners there for the heinous crimes they have committed – have multiple opportunities to appeal their decided fate.  Before that, their fates get decided by collections of people, people who have the opportunity to hear all viewpoints, all expert testimony, everything.  They exhaust all avenues in making death sentence rulings, and then we allow those prisoners the opportunity to appeal and fight their fate.  Not so for this little boy, it appears, and that will never be OK with me.

As I was typing this entry, Minister Boudreau dropped over to meet with me to discuss Morgan and his plea for help.  I am thankful that he did, as I was able to present everything I’ve written above.  He made a commitment to take a look at this case but truly believes in the process put in place.  In his words, he will make not promises or commitments, but he will look at things and get back to me.

Knowing this, I implore Minister Boudreau to take a real look at this case and seek a new review of Morgan’s application.  I asked Minister Boudreau to seek outside opinions from a panel of 3 or 5 International and Canadian experts that deal front-line with this disease and this treatment each and every day.  I asked Minister Boudreau to allow a rigorous discussion on all available evidence that exists on this drug and the impact it has on patients, and I asked for expediency because it’s unethical to make a child and his family wait.

I asked this to allow for a transparent and fair process for Morgan.  His life depends on it and it’s the right thing to do.  And in the end, if the Minister doesn’t want to listen to and seek feed back from clinical expert opinion, patient reported outcomes, peer-reviewed published journals, etc., then who will he listen to?  The opinion of 1 person who has never used this treatment and didn’t engage with those experts to help make his decision on Morgan’s fate?

If that’s the case, it’ NOT OK.

I’ll be here for a short while and will be putting out a PR tomorrow morning so that media can cover this story if they choose.  Thank you for all of your support over the past little while – our last entry was seen over 20,000 times in a few short days.  Sharing Morgan’s story is helpful, and staying ready to fight means the world to us.

I’ll update with any news as it develops.

To Change The World – Treatment Approved in New Brunswick!


Never 
doubt that a small group
 of thoughtful, committed citizens can change the world; indeed, it’s the only thing that ever has. – Margaret Mead

The quote above is one that we have displayed prominently on our website, and they are words we live by.  Existing in the world of rare diseases requires one to have such a mindset – to make a difference in the world of rare diseases, you have to begin with a small group of people.  Here in Canada, Isaac is one of just thirteen individuals that suffer from MPS VI.  In the broader family of MPS, we’re still talking less than 250 people battling the disease country-wide.  That’s 250 people out of 35 million (or just .0007% of our population, for our mathematician supporters!)  In essence, we’re a small group.  But we think big, and truly believe that we can change the world for our kids.

I have this quote on our website for many reasons – one of them being to remind myself that things are possible, even when we’re facing odds that most people would bet against.  Little did I know, that quote would help a government approve a treatment for a little girl who desperately needs it.  Little did I know, that quote would help save her life.

The photo above is of Kamie Babineau, a beautiful little girl from a town near Moncton New Brunswick.  Kamie’s mom, Parise, connected with me in December 2014, worried that her daughter was suffering from MPS VI – the same disease that Isaac has. The same disease that Jasper and Aleena and Violet have.  The same disease we’ve worked tirelessly to find a cure for, the one we’ve had to battle governments to provide life-saving treatment for.  Parise was obviously worried for her daughter – she sent me a photo of Kamie and one of Aleena that she found in a newspaper report and felt they shared the same features.  One glance at Kamie’s photo told me she was on the right track, but confirmatory tests needed to be done before we could begin the process of setting up treatment for her.  Confirmation of MPS VI was given at the end of January, and an application for reimbursement for treatment went into the government of New Brunswick in early March.

If you’ve been following our blog, you’ve seen how difficult it is to access treatment for MPS VI in Canada.  It’s expensive (the third most expensive drug in the world, according to this website and many others like it,) and governments are reluctant to cover the cost of the treatment for our kids.  Reluctant, even though it’s life-saving.  Reluctant, even though it gives our kids the chance at a healthy life.  Reluctant, even though it staves off the ravages of the disease, slows down or halts its progression.  Reluctant, even though the cost of not treating the disease is sometimes far more costly than treating it when you take into account the costs associated with managing the multi-systemic failures that ensue in children without access to therapy.  If you need some reminders on how difficult it is for our kids to get access to treatment in this country, have a look through this collection of news articles and stories.  To summarize – it’s difficult, and treatment is rarely approved without a fight.

DSC_0144I had been told that New Brunswick would be especially difficult to deal with.  Indeed, I had already reached out to the Province a few months earlier upon learning that a boy with MPS IVA needed access to treatment and the provincial bureaucrats wouldn’t accept the application for funding because they didn’t have a process in place to review the application.  I called and stated my concerns and frustration that an application wouldn’t even be accepted for this child, let alone reviewed and denied.  I was told to wait until the bureaurcratic process of a CDR Review was completed and that they would not consider any request for treatment until that time (that review gets completed in 2 days from now!)  So, I was prepared for a difficult start to accessing treatment for Kamie, and I wasn’t wrong when I began the process a few weeks ago.

I again called the bureaucratic branch at the Ministry of Health in New Brunswick that looks after pharmaceuticals, and talked to the same person I had talked with many months earlier.  I patiently explained the situation.  I had previously sent an email with background information (it wasn’t read until I was on the phone with them), and explained that there were already 9 other children in Canada receiving the same treatment that Kamie desperately needed.  I offered to provide all the resources they could ever need to produce a review of the application, including the International Treatment Guidelines (which assert that treatment should begin immediately after diagnosis for best outcomes and that the primary way to deal with this disease is to provide the treatment we were seeking), and the recent 10 Year Resurvey Data (which shows the incredible outcomes for patients with access to treatment over a 10 year period).  I also sent in a full folio of MPS VI and other articles showing the benefits that treatment brings to kids suffering from this disease.  I offered to connect them with the leading MPS VI experts throughout North America to help them with the data.  I expressed and provided ample evidence to show that symptoms that appear prior to treatment beginning cannot be reversed.  Many of these symptoms are devastating, and I expressed that we were racing against time to stave off such symptoms and provide Kamie with the quality of life that she deserved, not the quality of life that a disease untreated would leave her with.  At the end of our conversation, I asked how the application would be reviewed and when an expected decision would be rendered.  I was told, quite bluntly, that they had “no idea.”

This isn’t uncommon when dealing with this disease and applications for reimbursement of treatment.  When a disease affects .0007% of a population, we can’t expect governments to know everything about the disease and the process that would be used to review applications for treatment.  However, what should be expected is that these types of situations are taken seriously.  What should be expected would be for the bureaucrats to spring into action, figure out what review process was needed to deal with the situation, with an immediate and expeditious review undertaken.  This is not what happened, unfortunately.  Two weeks passed with the same update – they had no idea how they would review the file.  In fairness, they did express their hope that it would be approved, but couldn’t figure out exactly how to initiate the file set before them.

DSC_0201From here, my impatience got the better of me.  But it’s an impatience that stems from necessity – necessity to get treatment initiated immediately, the knowledge that Kamie’s disease is progressive and unrelenting, the hope that she can get the help she needs before her body is further deteriorated by MPS.  This impatience is where the story changes for the better.

I placed a call into the Minster of Health, Mr. Victor Boudreau.  I’ve been fortunate to work with may of the Ministers throughout the country, and I hoped he would take the time to get back to me, hear my concerns, and put a plan in place to look after Kamie’s application.  Mr. Boudreau had his staff look into the issue.  We connected numerous times over email, and I provided him with details about the frustratingly slow action being taken by the Ministry.  What ensued thereafter is something I’ve not seen in this country, from any official dealing with treatment for MPS VI – a determined effort to review the application for funding, and a promise for a prompt resolution/decision for the family.

We scheduled a direct meeting with Mr. Boudreau at his constituency office in Moncton.  I hopped on a plane, met with Parise and her husband, and planned out how we were going to handle the meeting.  In previous fights for treatment for other kids, we learned to be prepared for anything, and we learned to show governments that we would do anything to help save our children.  We were prepared to let Mr. Boudreau know that we weren’t going to go away, that we would do everything necessary to help save Kamie.  We were in this for the long haul because treatment for Kamie was our only Hope for her future.

At the meeting, Mr. Boudreau began by telling Parise that cabinet had approved treatment for Kamie.  Just like that, her life was changed.  Just like that, her life was saved.  In two days – two days! – the application was reviewed by Mr. Boudreau’s team, a presentation was put to the government’s cabinet, and an approval was passed.  Quick action by Mr. Boudreau changed the lives of this family forever, and I’m incredibly indebted to him for it.

How does this story relate to the quote above?  The Minister told us that he was on The Isaac Foundation website to research the disease, our organization, and read about the work we’ve been doing for kids across this country.  Displayed prominently at the top of our page is Margaret Mead’s quote, he told us.  Minister Boudreau informed us that Premier Gallant, the leader of the government in New Brunswick, uses that quote all the time around the cabinet table.  He uses it to inspire his government to do what is right for people.  He told us that he took that quote from the website when presenting Kamie’s case to the Premier and told him that his government could be the “small group of people” in this situation.  They could be the ones to change the world, even if just for one family.

In all my dealings with governments, bureaucrats, and politicians over the past decade, I have rarely been as impressed as I was with Minister Boudreau on Monday morning.  He saw a problem, saw a need for prompt action, saw the need to help a family in need, and went about doing everything he could do to make things better.  While I’m sure it’s too early for him to understand what his actions, his passion, and commitment to make a difference really means, I know from experience that he will look back on this and see this as part of the legacy he’s left behind, part of the good he was able to do while in office.  Saving someone’s life will remain with you forever and, usually, change who you are for the rest of your life.  Just ask Heather Forsyth, leader of the Wildrose party in Alberta, the person who worked tirelessly to save the life of Aleena Sadownyk.  Just ask Elizabeth Witmer, the person who did everything in her power to save my son Isaac’s life.  I hope Minister Boudreau looks back on this with pride, and I hope his family can learn just how much of a difference he made to the life of a little girl this week.

I know this entry is long, but before I sign off I want to leave you with the other quote I live my life by, one that guides me wherever I go, whenever I get the chance to meet with families battling a rare disease like we are.  It comes from my favourite book, To Kill A Mockingbird, from a character whom I wish I could be more like in this world – Atticus Finch.  In this novel, Atticus works hard to teach his children about courage.  He leads by example, and hopes his children realize that they can make a difference in this world if they truly believe in what they are doing, no matter what the consequences may be for themselves.  Atticus tells his daughter that:

“Courage is not a man with a gun in his hand. It’s knowing you’re licked before you begin but you begin anyway and you see it through no matter what. You rarely win, but sometimes you do.”

In many ways, this is exactly what we face when we’re dealing with rare diseases and treatment for our kids.  The initial diagnosis is devastating for families.  Knowing a treatment exists provides hope, so much hope during those dark days.  Families are devastated again when they find out that governments deny access to those treatments – take that hope away – solely based on financial considerations.  Expensive treatments aren’t the fault of patients and families, but they bare the consequences.  Oftentimes, we fight with grace and courage to get the access to treatment we need, against all odds.  Rarely do we win, but sometimes we do.  We did yesterday, with the help of Minister Boudreau, and I can’t thank him enough.

So – where do we go from here?  Well, there is another child suffering from MPS in his Province who needs access to treatment.  He’s the same boy I called the Province about many months ago without success.  Perhaps the application we tried to submit many months ago can now be reviewed, and hopefully Mr. Boudreau can do what he can to assist.  With help, perhaps the little boy in need can now get the help he deserves.  I know I’ll keep trying to make it happen, and I hope to be met halfway by the Government of New Brunswick.

Thanks for hanging in to the end of this entry.  It’s a long one, but one of the most important ones we’ve ever logged.

Till next time,

A.

Foundation Poster