An Oshawa, Ont., mother is urging the province to help cover the cost of her son’s expensive prescription formula.
Andrea Gangel’s 14-month-old son Steven was diagnosed with a cow’s milk protein allergy and soy intolerance when he was just a baby, which meant he couldn’t keep down regular formula.
The only thing he could stomach was a prescription elemental formula called Neocate. It costs $68 a can and Steven consumes one a day.
READ MORE: Alberta rolls out coverage for special Neocate baby formula
“He was just irritable. He couldn’t sleep he was just in so much pain,” said Gangel.
“He was a completely different baby when he started Neocate.”
For the first year, Neocate was covered by the province’s Trillium Drug Program. But that coverage stopped when Steven turned one year old.
READ MORE: Insurance company refuses to pay for life-saving formula for premature twins
“We went to the pharmacy and they said we can no longer fill it because he’s over a year old and that’s no longer his sole source of nutrition,” said Gangel.
According to an email Gangel received from the Ministry of Health and Long-Term Care, once patients start eating solid food Neocate becomes a supplement to their diet and therefore the child no longer eligible for coverage.
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Some insurance plans also don’t cover the prescription formula on the grounds that Neocate is a nutritional supplement and not a drug. That leaves mothers like Gangel picking up the monthly tab of over $2,000.
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She said she wrote letters to the Ontario government hoping it will follow in the footsteps of Alberta and Quebec, which now subsidize the expensive formula. Steven’s doctor also wrote a letter to the Ontario Drug Benefits Program saying the toddler’s “nutrition is inadequate without a dairy substitute.”
Unless the province makes an exception and covers the cost, Gangel said she fears she won’t be able to stay afloat trying to give her son the nutrients he needs to grow and thrive.
“When you’re a mom you do what you have to do, but it’s hard,” said Gangel.
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