QUEBEC CITY: A Quebec mother living with advanced breast cancer is appealing for access to a life-extending medication after her health insurance provider declined coverage for a treatment costing up to C$12,000 (US$12,000) per month.
Forty-three-year-old Sophie Djeme-Mi Koumazock was diagnosed with metastatic breast cancer in 2025. After her existing treatment stopped working, her oncologist recommended Truqap, an oral targeted therapy considered suitable for her condition. Although the drug is not a cure, doctors believe it could help slow the progression of the disease and extend her life.
However, her hopes were dashed when she learned that the medication would not be covered under the Public Service Health Care Plan (PSHCP), the federal insurance program available to Canadian public servants and administered by Canada Life.
The decision came despite Quebec’s public health insurance program providing coverage for Truqap in certain exceptional cases. As a result, Djeme-Mi Koumazock has been forced to pay for the medication herself while seeking to overturn the ruling.
According to Canada Life, coverage decisions under the federal plan are based on assessments of a drug’s clinical effectiveness, safety and cost-effectiveness, and the Government of Canada determines which medications are included in the plan’s benefits.
The patient has sought assistance from both her employer and her union, which is supporting her appeal. She says the financial burden has added significant stress to an already difficult battle and hopes the coverage decision will be reconsidered.
The case has drawn attention to differences between provincial and federal drug insurance programs, raising concerns about gaps in access to expensive but potentially life-extending treatments for cancer patients.
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