Four years ago, Bill Lake, a retired engineer from Battersea, Ontario, was diagnosed with advanced colorectal cancer, and doctors gave him at most a year to live. Faced with despair, he began making a to-do list for the last time in his life, wanting only to spend more time with his family. In 2022, the Ontario government began funding Keytruda for the treatment of this rare type of colorectal cancer. By the end of the year, Lake had the opportunity to use this immunotherapy drug. This drug had previously shown breakthroughs in patients with melanoma and lung cancer, extending the lifespan of people who previously only had a few months to live by several years.
After receiving treatment, Lake’s tumour shrank significantly, and he has now returned to beekeeping and remains in remission. “This medicine has given us hope again,” Lake’s wife said with emotion. Keytruda, approved by Health Canada in 2015, is considered a breakthrough cancer drug. Its immune mechanism doesn’t directly kill cancer cells; instead, it releases the “brakes” on the body’s immune system, allowing the body to fight tumours on its own. Data shows that Keytruda has significantly improved the survival rate of patients with melanoma, lung cancer, and some colorectal cancers. Lake’s MSI-type colorectal cancer was the type that was sensitive to this drug. For Lake, whose traditional treatments had limited effectiveness, Keytruda almost changed his fate.
In 2023, Canada spent nearly 800 million Canadian dollars on Keytruda at list price, making it the highest-spending single drug in hospitals nationwide. Experts point out that Ontario’s cancer drug spending has increased from $500 million to $1.7 billion over the past decade, with an average annual growth rate of 15%, far exceeding the growth rate of the healthcare budget. Today, for every $10 that Canadian hospitals spend on cancer drugs, about $1 goes to Keytruda. “These figures are alarming for those managing the money,” said Mina Tadrous, a pharmaceutical policy researcher at the University of Toronto.
In 2023, Canada spent nearly 800 million Canadian dollars on Keytruda at list price, making it the highest-spending single drug in hospitals nationwide. Experts point out that Ontario’s cancer drug spending has increased from $500 million to $1.7 billion over the past decade, with an average annual growth rate of 15%, far exceeding the growth rate of the healthcare budget. Today, for every $10 that Canadian hospitals spend on cancer drugs, about $1 goes to Keytruda. “These figures are alarming for those managing the money,” said Mina Tadrous, a pharmaceutical policy researcher at the University of Toronto.
This practice is scientifically based; Merck’s initial clinical trials proved that weight measurement is also safe and effective. Some experts believe that fixed dosages lead to overuse and maximize corporate profits. Merck insists its dosages are scientifically sound, but the WHO analysis indicates that if weight-based dosing were adopted globally, $5 billion could be saved in lung cancer alone by 2040. Nevertheless, experts acknowledge that these cost-saving measures are merely a “stopgap measure.” As long as drug prices remain high, the pressure of expensive drugs on the public healthcare system will be difficult to alleviate.
Sitting at home, Lake couldn’t help but sigh when he learned that his two-year Keytruda treatment would cost over 400,000 Canadian dollars. He knew the drug was expensive, but he hadn’t expected the price to be this high. “He deserves it,” his wife Shari said with a smile. Lake also wrote the scientific name of Keytruda, “pembrolizumab,” in the inside of his notebook—”I have to remember how to spell this word,” he said with a laugh. “That’s why I’m still alive.”