Djeme-Mi Koumazock contacted her employer and union. While her union is helping her with her case, she’s been told the decision is policy. She’s now forced to pay out of pocket until she finds a solution.<\/p>\n
\u201cI need this medication to survive, I never would have thought they would hit me with a no,\u201d she said. \u201cI want to live.\u201d<\/p>\n
![\"A](\"https:\/\/www.newsbeep.com\/uk\/wp-content\/uploads\/2026\/07\/1784580073_547_default.jpg\")
Djeme-Mi Koumazock pictured with her partner, Jonathan Tekeu, and their four kids aged three, six, 12 and 13. (Bruno Gigu\u00e8re\/Radio-Canada)Gap in coverage<\/p>\n
In its refusal letter sent to Djeme-Mi Koumazock on June 19 and reviewed by CBC News, Canada Life wrote its program requires the review of \u201cfactors such as [the drug\u2019s] efficacy, safety, and cost effectiveness.\u201d<\/p>\n
It said following a review conducted by \u201cqualified health-care professionals at Canada Life,\u201d the PSHCP Prior Authorization Program determined the drug is excluded from coverage.<\/p>\n
In an emailed statement to CBC News, Canada Life said as plan sponsor, the Government of Canada determines what is covered under its benefits plan.\u00a0<\/p>\n
This includes any differences from what may be covered under Quebec\u2019s health insurance board, the R\u00e9gie de l\u2019assurance maladie du Qu\u00e9bec (RAMQ).\u00a0<\/p>\n
![\"A](\"https:\/\/www.newsbeep.com\/uk\/wp-content\/uploads\/2026\/07\/1784580074_843_default.jpg\")
Djeme-Mi Koumazock is now waiting for a response from Beneva \u2014 her partner\u2019s insurer \u2014 to which she has now been added as a beneficiary. She’s hoping they will help foot the bill. (Sylvain Roy Roussel\/CBC)<\/p>\n
In an emailed statement, a representative for the Treasury Board of Canada, which manages PSHCP policy, says the optional health-care plan offered to eligible public service employees, pensioners and dependants is designed to supplement provincial and territorial health insurance plans.<\/p>\n
But it says the PSHCP is not required to provide the same basic coverage as RAMQ.<\/p>\n
The Treasury Board confirmed Truqap is not an eligible prescription drug under its PSHCP prior authorization program.<\/p>\n
But Djeme-Mi Koumazock doesn\u2019t understand why this gap exists. She calls it \u201cinequity.\u201d\u00a0<\/p>\n
\u201cWhy, between two Quebecers, could one have access to this medication and not me?\u201d she asked.<\/p>\n
Woman\u2019s oncologist wants to give her time<\/p>\n
Djeme-Mi Koumazock\u2019s oncologist, Dr. Brigitte Poirier, says Truqap is a good option for her patient and that the efficacy of this treatment is proven by the literature.\u00a0<\/p>\n
Poirier, a surgical oncologist at CHU de Qu\u00e9bec-Universit\u00e9 Laval and head of its breast cancer centre, says it\u2019s about controlling the disease the best they can.\u00a0<\/p>\n
\u201cWhen the medication we are giving stops [working] \u2026 and we lose the control, we have to change the treatment,\u201d she said. \u201cIt\u2019s the thing we have to do now.\u201d<\/p>\n
![\"A](\"https:\/\/www.newsbeep.com\/uk\/wp-content\/uploads\/2026\/07\/1784580074_759_default.jpg\")
Djeme-Mi Koumazock\u2019s oncologist, Dr. Brigitte Poirier, says she wants to control the disease the best they can. (Sylvain Roy Roussel\/CBC)<\/p>\n
While there are other options for Djeme-Mi Koumazock, including chemotherapy and other anti-hormonal medications, \u201cwe want the best for our patients,\u201d Poirier said.<\/p>\n
\u201cIt\u2019s not easy for someone [who is] like 43 years old with young kids. We want to give them time.\u201d\u00a0<\/p>\n
Djeme-Mi Koumazock wants that too. It\u2019s part of why she and her partner decided to temporarily dip into their savings \u2014\u00a0 and retirement fund, if necessary \u2014\u00a0 so she can start the treatment as soon as it is available.<\/p>\n
Djeme-Mi Koumazock is now waiting for a response from Beneva \u2014 her partner\u2019s insurer \u2014 to which she has now been added as a beneficiary.\u00a0<\/p>\n
In an emailed statement from Beneva, it confirmed Truqap is part of its standard plan, since it applies the criteria established by RAMQ \u2014 therefore counting the medication as an exceptional drug.\u00a0\u00a0<\/p>\n
\u2018Very unlikely\u2019 2 insurers refuse coverage, says RAMQ<\/p>\n
Djeme-Mi Koumazock has called RAMQ numerous times and spoken with agents to request that the provincial agency step in.<\/p>\n
CBC News asked RAMQ if it would cover the cost of the medication if her partner\u2019s insurance also refuses to pay.\u00a0<\/p>\n
In an emailed statement, RAMQ did not answer if it would cover the medication, but pointed to the fact that private insurance, provided through an individual\u2019s partner, should be able to cover costs.<\/p>\n
\u201cIt\u2019s very unlikely that two different insurers refuse to reimburse a medication that RAMQ would accept to cover and, to our knowledge, a situation of this kind has never been brought to our attention,\u201d read the statement.<\/p>\n
Same problem for another Quebec woman\u00a0<\/p>\n
The process to get medication covered took Nathalie Samson from Saint-Philippe, Que., months when she was in the same situation as Djeme-Mi Koumazock earlier this year.\u00a0<\/p>\n
Diagnosed with metastatic breast cancer in 2022, she had been on medication for years in an effort to stop the progression of the Stage 4 disease.\u00a0<\/p>\n
But this past December, her body stopped responding and her care team referred her to try the drug Truqap.\u00a0\u00a0<\/p>\n
\u201cThis is when the battle started,\u201d said Michel Boulay, Samson\u2019s partner.\u00a0<\/p>\n
\u201cShe experienced a lot of stress, she was sick. This lasted four and a half months.\u201d\u00a0<\/p>\n
![\"A](\"https:\/\/www.newsbeep.com\/uk\/wp-content\/uploads\/2026\/07\/1784580075_405_default.jpg\")
Nathalie Samson and her partner, Michel Boulay, from Saint-Philippe, Que., went through a similar ordeal earlier this year. (Submitted by Nathalie Samson)<\/p>\n
As a federal employee, Samson was also denied coverage under the Canada Life plan.\u00a0<\/p>\n
Boulay requested Samson be brought onto his work insurance plan with Manulife in February. She was able to get coverage for Truqap through Manulife and AstraZeneca \u2014 the drug manufacturer.<\/p>\n
Around March, Samson’s cancer began to stabilize while she was still taking her old medication. But if things worsen, she says she now has the ability to start taking the new drug.\u00a0\u00a0<\/p>\n
![\"A](\"https:\/\/www.newsbeep.com\/uk\/wp-content\/uploads\/2026\/07\/1784580075_722_default.jpg\")
Djeme-Mi Koumazock calls the gap in coverage \u2018inequity.\u2019 (Sylvain Roy Roussel\/CBC)<\/p>\n