Intervention by a multiple sclerosis (MS) specialist proved crucial for Kory Loos.
The 19-year-old North Delta resident was rejected for medical insurance coverage of a new treatment for MS. His story was published in the Sept. 1 issue of the Reporter.
Eleven days later, he got word that the insurer, Manulife, had a change of heart. His neurologist and MS specialist, Dr. Anthony Traboulsee, appealed to Manulife on his behalf, and the insurance company relented. Traboulsee is also director of the MS Clinic at UBC Hospital.
Kory’s family is ecstatic that the insurance company has changed its mind. Since talking to the Reporter in August, they have found that the drug Lemtrada is covered in five of Canada’s 10 provinces. In B.C., it is still being evaluated for coverage under PharmaCare.
Lemtrada, which has been used in Canada since 2014, is a monoclonal antibody (a protein) which works on the immune system. Kory will get five doses with the drug this month, and three more in a year’s time.
Traboulsee recommended the treatment as he believes it will repair the myelin in Kory’s spinal cord and brain and will have a positive effect far beyond the treatment cycle.
Initially, Traboulsee was going to wait until a scheduled MRI in late October to decide how to treat Kory without insurance coverage for the Lemtrada. Instead, he decided to appeal to Manulife, hoping that he could proceed with the treatment sooner if the insurer would approve the payment.
Studies show this course of treatment has the ability to improve the lives of a majority of relapsing-remitting multiple sclerosis (RRMS) patients.
Kory’s sister Kayla and mother Christa Fox had started a GoFundMe page to raise the $60,000 needed for Lemtrada, and had already raised about $7,300. They have now let donors know what has happened. If donors want their funds back, they can get them, however, any funds left will go towards covering other costs associated with the treatment, with the balance going to the MS Society.
Christa and Kayla are both active volunteers with the MS society. In fact, Christa heard about Manulife’s change of heart while volunteering at an MS golf tournament.
She has also started a petition to Delta North MLA Scott Hamilton asking that the B.C. government speed up the process for approving Lemtrada. She is hopeful it will get at least 1,000 signatures before she presents it to Hamilton.
The petition can be found at thepetitionsite.com/en-ca/506/409/770/get-bc-pharmacare-to-cover-lemtrada-now.
Christa says she wants to continue the fight for Lemtrada coverage on behalf of other families who can’t get coverage.
Kory is happy about getting the treatment much sooner than he had believed was possible. He hopes that there won’t be too many side effects, but is quite ready to be treated with such a promising drug.