Joni Denroche staying positive after insurance fails to cover needed treatment

A Whistler woman is raising funds for cancer treatment after learning her insurance won't cover the bill.

Joni Denroche has been fighting Stage 4 metastatic melanoma for 13 years, undergoing dozens of surgeries in that time.

But after the recent discovery of a brain tumor and subsequent successful resection, Denroche was told her insurance company wouldn't cover the cost of a potentially lifesaving drug.

"I'd say it's disappointing, because it makes it harder for an individual who's going through stressful and difficult times to stay positive, and that's a huge part of healing, is having a positive outlook, feeling supported and loved," Denroche said.

"You don't necessarily expect a big company to love you, but you do expect them to be honest."

The drug, Yervoy (or ipilimumab), is manufactured by Bristol-Myers Squibb, and carries an $80,000 price tag.

Though Yervoy has been approved by Health Canada since 2012, it's the addition of another drug, Nivo, to Denroche's treatment plan that is affecting her coverage.

Denroche waited six weeks after her surgery, hoping her insurance would come through, before purchasing Yervoy on a credit card.

In the preceding six weeks, the 54-year-old wife and mother of two found herself lost in a sea of "political and bureaucratic chaos," trying, and failing, to get straight answers from all parties involved.

"Obviously the shock of being told you have a brain tumor is significant, but you get through that, and I try and stay positive. I know that there's hope," Denroche said. "But when I have knowledge that there's a drug out there that specifically attacks melanoma cells, or teaches your body to attack the cells and change them, that there's a 50-per-cent success rate, but I can't afford it, it's huge."

Her neighbour, she added, has been in remission for more than a year after taking Yervoy.

Neither the insurance company nor the drug's manufacturer responded to interview requests.

There are multiple steps involved with cancer drug approval in Canada, explained Pamela Gole, communications manager with BC Cancer.

"It starts with Health Canada, and their role is safety, efficacy, quality, proposed practitioner and consumer information, then the next step is the Pan Canadian Oncology Drug Review ... that's about cost effectiveness and comparative clinical effectiveness," Gole said.

Following that, the drugs go to the Canadian Association of Provincial Cancer agencies, which provides implementation advice to the provinces, before going to the Pan Canadian Pharmaceutical Alliance, which deals with funding negotiations (where Denroche's needed combo of Yervoy/Nivo currently sits).

"So each province does make its own funding decision, and the issue of affordability must be considered," Gole said.

BC Cancer spends about $350 million dollars per year on its life support/drug budget, Gole noted—up from $70 million just 10 years ago.

"We have to look at the sustainability for the whole system ... it's not about cost, it's about the effectiveness of the drug and the approval for that indication," she said.

"(In this case) right now there is no decision on BC Cancer's plate to make about funding that, because it's still at the national level."

Denroche describes herself as a private person, only going public when she has something positive to share, like when she did Sigge's P'ayakentsut 50-kilometre in memory of two friends (see Pique, Feb. 18, 2016).

And even after 13 years of battling cancer, Denroche remains a portrait of positivity. At the very least, she hopes to start a broader conversation about access to cancer medication.

"I don't think it's right. I think that we need to, as a larger community, like as a province, come forward and say, if this is a drug that has been approved for seven years ... you need to make sure it comes through," she said. "I think the main message is, no matter how difficult things get in life, there is always hope. And there is always a brighter side. I'm just waiting for it to come, that's all."

A GoFundMe for Denroche's treatment had amassed more than $27,000 as of June 18. Find it at ca.gofundme.com/Melanoma-Cancer-Treatment-for-Whistler-Mom.

On Aug. 5, proceeds from Lucia Gelato sales at the Whistler Farmers' Market will go towards Denroche's treatment. Other fundraisers are also in the works. Check back with Pique for more.