Ottawa residents who rely on the Ontario Health Insurance Plan should know that the province has changed the rules on when it will pay for drugs outside the country, after a court fight over one man's request for cancer treatment in the United States.
The court case
Alex Shved is a 37-year-old father of two young children. He took the province to court over OHIP rejections of his request for treatment. His oncologist asked OHIP to fund tumour-infiltrating lymphocyte therapy, known as TIL therapy, in Florida, at an approximate cost of US$600,000. OHIP denied that request.
The Divisional Court quashed the denial. The ruling was reported on September 23, 2026, and the court ordered OHIP to issue a new decision by the end of the following week.
In its reasons, the court said OHIP's executive officer must do more than assert prejudice to "the system" when refusing to recommend potentially life-saving treatment. The court's wording was blunt about what is at stake for Shved: without the treatment, it said, he will likely die soon.
The court also had a piece of context to weigh. A version of TIL therapy called lifileucel was approved for sale by Health Canada the previous year.
What OHIP did next
The court's order did not end the matter. Following that ruling, OHIP rejected Shved's request for a third time.
The reasons for the third rejection are not set out in the information available so far, and it is not yet known what Shved and his family will do next.
The rule change
Health Minister Sylvia Jones announced that the province has amended its regulations. The clarification is that drugs will only be funded out of country if they are already funded within Ontario but access is temporarily unavailable or delayed.
In practical terms, that is a narrow door. A drug that Ontario does not fund at all is not covered by the out-of-country route under the clarified wording.
The announcement does not say how many past or pending requests the change would affect. It also does not say whether Shved's therapy would qualify under the new wording. Those details have not been announced.
Is there still a path for Shved?
Jones also says the government is exploring a "mutually satisfactory resolution" in Shved's individual case. No terms, timeline or amount have been made public, and it is not clear what a resolution would look like or whether it would involve funding the Florida treatment.
That leaves two things sitting side by side. The province has tightened the language of its general rule, while saying it is looking for a way to settle one specific case that went to court and won.
What to watch
Two questions remain open. The first is whether the government and Shved reach the resolution Jones describes. The second is how the amended regulation is applied to future requests for treatment outside Canada, particularly for therapies that Health Canada has approved but that Ontario does not yet fund.
For now, the court's message about the standard OHIP must meet when refusing potentially life-saving treatment stands as part of the record, alongside a regulation that now spells out a narrower route for out-of-country drug funding.
Sources: Global News, CP24
