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PROVINCIAL DRUG INSURANCE
Information compiled by the Canadian Hemophilia Society
during the summer of 2009 and updated during the fall of 2014
(Last partia l update: Apri l 02, 2015)
Pag e | 2
PROVINCIAL DRUG INSURANCE
Each Canadian province is responsible for providing healthcare services and administers the
manner in which they are dispensed. Each province also has its own drug insurance program
and a list of covered medications.
Canadian residents with a congenital bleeding disorder receive different levels of coverage,
depending on their province of residence, as well as their social and financial situations.
This document focuses on differences between the provincial plans and how this affects
reimbursement for the drugs most commonly used by people with bleeding disorders.
TABLE OF CONTENTS
PROVINCIAL DRUG COVERAGE ………………………………………………………………….….….……………….... 3 Table listing each province’s plan and who is entitled to coverage
DESMOPRESSIN AND ANTI-FIBRINOLYTICS ON PROVINCIAL GOVERNEMENT FORMULARIES ……………………………………………………………………………………………10 Coverage levels for the prescription drugs most frequently used by people with bleeding disorders.
ANTI-RETROVIRAL DRUG PLANS …………………………………………………………………………………..……. 11 List of each province’s specific programs for HIV antiretroviral drugs.
PROVINCIAL DRUG COVERAGE AND CHRONIC HEPATITIS C MEDICATION ……….…………….….13
Pag e | 3
PROVINCINAL DRUG COVERAGE
Province or territory
Drug plan Eligibility criteria What the patient
must pay Where to get more information
and subscribe
British Columbia
BC PharmaCare
All BC residents who have valid MSP coverage and have filed an income tax return for the relevant taxation year (FairPharmacare), or qualify for one of the specific coverage programs (e.g. Social services recipients, medically dependent children).
Depends on the type of coverage you are eligible for. People enrolled in the Fair PharmaCare program pay a deductible based on annual income; once the deductible is reached, the program pays 70% of eligible costs for the rest of the year up to a family maximum. After the maximum is reached, the program pays 100% of eligible costs.
PharmaCare: 1-800-663-7100
Web site: www.health.gov.bc.ca/pharmacare
Alberta
Alberta Publicly-funded
supplementary drug benefit
programs (through
Alberta Blue Cross)
All Alberta residents registered with the Alberta Health Care Insurance Plan have access to this coverage. Most residents are covered by the Non-Group Prescription Drug Coverage (for residents under 65 years of age and their dependents).
Depends on the type of coverage you are eligible for. E.g.: To obtain the non-group coverage, you have to pay 30% of each prescription up to $25. A premium of about $64 per month (about $44 at the subsidized rate) is charged. Other types of coverage are available for seniors, persons in palliative care, etc.
Alberta Health Care: 1-780-427-1432
For Prescription Drug Program Inquiries, call Alberta Blue Cross
Customer Services: 1-800-661-6995
Web site: www.health.alberta.ca/services/ben
efits-supplementary.html
Saskatchewan Saskatchewan
Drug Plan
Saskatchewan residents who pay high prescription costs in relation to their income (at least 3.4%). There is special coverage for low-income individuals and families, people who receive social assistance, and people requiring emergency assistance or receiving palliative care.
The amount of money to be paid depends on the specific coverage program.
Saskatchewan Health Drug Plan & Extended Benefits Branch:
1-800-667-7581
Web sites: www.health.gov.sk.ca
www.health.gov.sk.ca/prescription-drugs
Manitoba Manitoba
Pharmacare Program
If your prescription costs are not covered by another provincial
A deductible based on your income. Once that amount is
Pharmacare: 1-800-297-8099
Pag e | 4
Province or territory
Drug plan Eligibility criteria What the patient
must pay Where to get more information
and subscribe
or federal program and if your eligible prescription drug costs exceed your Pharmacare deductible.
reached, Pharmacare pays 100% of your prescription.
Web sites: www.gov.mb.ca/health/index.html
www.gov.mb.ca/health/pharmacare/index.html
Ontario
Trillium An individual or a family not 100% covered for their prescription drug costs by private coverage and not eligible for the ODB Program.
A deductible of approximately 4% of your annual income. Once your drug cost exceeds this deductible, Trillium will pay for your medication (you may pay about $2 per prescription).
ServiceOntario INFOline: 1-866-532-3161
To get a Trillium application package call:
1-800-575-5386
or visit: www.health.gov.on.ca/en/public/pro
grams/drugs/opdp_forms.aspx
Web sites: www.health.gov.on.ca/en/
www.health.gov.on.ca/en/public/programs/drugs/programs/odb/opdp_tri
llium.aspx www.health.gov.on.ca/en/public/programs/drugs/programs/odb/odb.asp
x
Ontario Drug Benefit
Program
People of 65 years or older; people receiving special care (long-term care homes, home care program, etc.) or social assistance (Ontario Works, Ontario Disability Support Program).
For seniors with an annual income of $16,018 or more or senior couples with a combined yearly net income of $24,175 or more, a deductible of $100. Once your drugs exceed this amount, you will pay up to $6.11 per prescription. For others subscribers, $2 per prescription.
Quebec RAMQ
People who are not eligible for private insurance drug coverage and their children. Persons of 65 years of age and older are automatically part of the plan.
An annual premium which varies from $0 to $611 per adult, depending on net family income.
RAMQ: 1-800-561-9749
Web sites: www.ramq.gouv.qc.ca/en/Pages/ho
me.aspx
www.ramq.gouv.qc.ca/en/citizens/prescription-drug-
insurance/Pages/prescription-drug-insurance.aspx
Pag e | 5
Province or territory
Drug plan Eligibility criteria What the patient
must pay Where to get more information
and subscribe
New Brunswick
New Brunswick Drug Plan
People who have an active Medicare card and either do not have existing drug coverage (through a private plan or a government program) or have existing drug coverage but it does not cover a specific drug that is included in the drug plan formulary or the resident has reached their yearly or lifetime maximum for drug coverage. Beginning April 1, 2015, all New Brunswickers will be required to have prescription drug insurance and those not insured by a private plan will join the New Brunswick Drug Plan.
A monthly or quarterly premium calculated based on family income (between $67 and $167 per month in phase one), plus 30% of the cost of each prescription up to a maximum of $30.
Beginning April 1, 2015, premiums and co-pays will be subsidized based on income and are expected to be lower.
Drug Plan information line: 1-855-540-7325
Web sites: www2.gnb.ca/content/gnb/en/depar
tments/health.html
www2.gnb.ca/content/gnb/en/departments/health/MedicarePrescription
DrugPlan/NBDrugPlan.html
New Brunswick
Prescription Drug Program
People who are eligible for one of these categories: 1) Seniors with low
income 2) Adults in licensed
residential facilities
3) People registered by the Social Development Office
4) Special needs children
5) Children in government care
6) People with a specific disease
Depends on your type of coverage. For
example, seniors receiving the GIS have to pay $9.05
for each prescription up to a maximum of
$500 per year.
New Brunswick Prescription Drug Program Administration Office:
1-800-332-3692
Web site: www.gnb.ca/0051/0212/index-e.asp
Prince Edward Island
Prince Edward Island
Pharmacare Drug
Programs
People who qualify under one of these categories: 1) Children in
custody of Child Welfare
2) Seniors over 65 years
3) Low-income families
4) Persons eligible
Depends on your type of coverage. Eligible seniors pay $8.25 of each prescription plus the pharmacy professional fee. Eligible families only pay the pharmacy professional fee.
Drug Cost Assistance Program: 1-877-577-3737
Web sites: www.healthpei.ca/?lang=E
www.healthpei.ca/drugprograms
Pag e | 6
Province or territory
Drug plan Eligibility criteria What the patient
must pay Where to get more information
and subscribe
for Financial Assistance under the Social Assistance Act
5) Persons with specific medical or psychiatric conditions
6) Residents of private nursing homes
7) Persons whose eligible prescription drug costs are affecting their household’s ability to maintain life essentials.
Nova Scotia Nova Scotia Pharmacare
For all residents of Nova Scotia who do not have full drug coverage or are facing high prescription drug costs. Some coverage plans address the specific situations of people 65 years or older (with low income) and people in specific medical or financial situations.
Depends on your type of coverage. For Family Pharmacare, a deductible based on your income. Once that amount is reached, you have to pay a percentage of the amount of your prescriptions, up to a maximum amount.
Nova Scotia Pharmacare: 1-800-544-6191
Web site: novascotia.ca/dhw/pharmacare/nova
-scotians.asp
Newfoundland and Labrador
Newfoundland and Labrador Prescription
Drug Coverage
Families and individuals with low income or who receive income support; families and individuals with high drug costs (between 5 and 10% of annual income); seniors over the age of 65 who receive the Guaranteed Income Supplement; children in government care; people with specific medical conditions.
Depends on your type of coverage. For families with high drug costs and low income, the co-pay amount is calculated based on income and drug costs. Eligible seniors pay only for the professional services and not for the medication itself.
Newfoundland and Labrador Prescription Drug Coverage:
1-888-859-3535
Web sites: www.health.gov.nl.ca
www.health.gov.nl.ca/health/prescription/index.html
Yukon
Yukon Insured Health & Hearing Services
Yukon residents who: 1) are children
under 19 from low-income families; or
Depends on the type of coverage. For example, for the Chronic Disease Program, recipients
Yukon Health Services Branch: 1-800-661-0408
Web sites: www.hss.gov.yk.ca/healthservices.ph
Pag e | 7
Province or territory
Drug plan Eligibility criteria What the patient
must pay Where to get more information
and subscribe
2) have a chronic disease or a serious functional disability (including hemophilia and HIV/AIDS); or
3) are at least 65 years of age or aged 60 and married to a living Yukon resident who is at least 65 years of age
If you receive health insurance benefits through your employer or a third party insurance agency, claims must be submitted to these insurers first.
are required to pay the first $250 of eligible costs per year, to a maximum of $500 per family. For the Pharmacare Program for seniors, there is no deductible and the program will pay the total costs of the lowest priced generics of all prescription drugs listed in the Formulary, including the dispensing fee.
p
www.hss.gov.yk.ca/insured_services.php
Northwest Territories
Extended Health
Benefits (administered
by Alberta Blue Cross)
Non-Native and Métis residents of the NWT who are 60 years of age and over; or have specified disease conditions (including hemophilia, hepatitis, HIV and all HIV related diseases).
If you qualify for these benefits under any other insurance plan, you must claim from the other plan first.
The program provides up to 100 percent coverage for eligible prescription drug products as defined in the Health Canada NIHB drug benefit list, when the drug is prescribed by a health care professional and dispensed by a licensed pharmacist.
NWT Health Services Administration: 1-800-661-0830
Alberta Blue Cross: 1-800-661-6995
Web sites: www.hss.gov.nt.ca/
www.hss.gov.nt.ca/health/nwt-health-care-plan/extended-health-
benefits-specified-disease-conditions www.hss.gov.nt.ca/health/nwt-
health-care-plan/extended-health-benefits-seniors-program
Nunavut Extended
Health Benefits
People who are enrolled with the Nunavut Health Care Plan and are one of the following: 1) a non-beneficiary
65 years or older 2) a non-beneficiary
Nunavut resident with a chronic disease or illness (including HIV and all HIV related diseases)
3) any Nunavut resident who has used up or does
If you do not have other drug insurance, EHB will pay the full cost of approved prescription drugs listed in the NIHB formulary.
If you have other drug insurance, EHB will pay the cost of prescription drugs not covered by your other insurance plan, usually 20 per cent.
If a prescription drug is not covered by your
Nunavut Health Insurance Programs Office:
1-800-661-0833
Web sites: gov.nu.ca/health
gov.nu.ca/health/information/health-insurance-extended-health-benefits
Pag e | 8
Province or territory
Drug plan Eligibility criteria What the patient
must pay Where to get more information
and subscribe
not have other health care insurance options
If you have insurance through your work or any other insurance, you must use those insurance plans before claiming from Extended Health Benefits.
other insurance plan, EHB will pay the full cost of the prescription drug if you are given prior approval.
Important facts All provinces and territories provide a type of coverage. In most cases, such as in
Saskatchewan, Ontario and Newfoundland and Labrador, the deductible is so high that only
people facing extremely high drug costs in relation to their income are truly eligible. For
example, in Newfoundland and Labrador, people earning $40,000 must spend more than
$3,000 on medication each year to be eligible for public coverage. In Alberta, people need
to pay a premium of about $760/year plus 30% of prescription costs. Taking this into
consideration, some of these so-called “universal” plans might be best characterized as
“catastrophe insurance.”1
1 Blomqvist, Ake et Jing XU. 2003. «Pharmacare and Canada : Issues and Options». Health Canada. Online at http://dsp-
psd.pwgsc.gc.ca/Collection/H13-5-01-1E.pdf.
Pag e | 9
Where to find out more about provincial drug plans
The CATIE Web site provides details about all provincial and federal drug plans for people
with HIV or HCV:
www.catie.ca/en/treatment/access-hiv-and-hepatitis-c-drugs-federal-provincial-and-
territorial-drug-access-program
The Drug Coverage Web site offers information about drugs by type of affliction and some
information about the provincial and federal plans, with links to their respective Web sites:
www.drugcoverage.ca/en-ca/
Pag e | 1 0
DESMOPRESSIN AND ANTI-FIBRINOLYTICS ON PROVINCIAL GOVERNMENT
FORMULARIES
Octostim spray Octostim, liq.
inj. DDVAP inj. Cyklokapron
DIN 02237860 02024179 00873993 02064405
British Columbia Yes No Yes Yes
Alberta Yes No Yes Yes
Saskatchewan Yes, exceptional
status No
Yes, exceptional status
No
Manitoba Yes No Yes Yes
Ontario Yes No No No
Quebec Yes Yes Yes Yes
New Brunswick No No Yes Yes
Prince Edward Island No No No No
Nova Scotia Yes Yes No Yes *
Newfoundland and Labrador No No Yes Yes
Northwest Territories (non-insured health benefits)
No No Yes Yes
Yukon No No No Yes
Nunavut (Non-Insured Health Benefits)
No No Yes Yes
* Available for eligible Community Services Pharmacare and Family Pharmacare and Seniors Pharmacare programs persons. Amicar is discontinued since 2006.
This table reveals important differences of coverage of medication per province. At the time
of updating this research (summer 2014), only two provinces cover Octostim Liquid while
Cyklokapron is covered in ten provinces and territories. Quebec is the only province that
covers all these medications and Prince Edward Island is the only one that doesn’t cover any
of them.
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ANTI-RETROVIRAL DRUG PLANS
Given the high cost of anti-retroviral drugs, some provinces have established special programs to provide these medications. Other provinces provide coverage under their regular drug plans.
Province Eligible beneficiaries Eligible drug benefits Other eligible benefits
or program features
British Columbia All residents with HIV
AIDS
Specific anti-retrovirals provided through hospital
based programs (by the British Columbia Center
for Excellence in HIV/Aids).
No deductible or co-payment required.
Alberta All residents with HIV
AIDS
Anti-retrovirals listed on the Alberta Drug Benefit
List (the drugs are provided through Alberta
supplementary drug benefit programs).
No deductible or co-payment required.
Saskatchewan
All residents with HIV/ AIDS and eligible for the Drug Plan (The Special Support Program helps individuals whose drug
costs are high in relation to their income.)
All anti-retrovirals listed in the Saskatchewan
formulary
Normal deductibles and co-payments apply.
Manitoba
All residents with HIV/ AIDS and eligible for
Manitoba Pharmacare benefits
Anti-retroviral therapies listed in the Manitoba
Formulary.
Normal deductibles and co-payments apply.
Ontario
All residents with HIV/AIDS and eligible for
Trillium or an Ontario Drug Benefit program
(must be approved for the facilitated access
mechanism for HIV)
All residents with HIV/ AIDS (Special Drugs
Program)
Anti-retrovirals listed in the Ontario Drug Benefit
Formulary
Zidovudine and pentamidine
Typically, normal deductibles and co-
payments apply.
ODB Specific products used to treat ODB-eligible people with HIV/AIDS are reimbursed through the
Facilitated Access process under the Exceptional Access Program (EAP).
Under this process, approved physicians are exempt from the usual paperwork associated with the provision of
these products and no deductible or co-payment
is required.
Quebec All residents with
HIV/AIDS
Anti-retrovirals listed in the Liste de médicaments du Québec. A request for
Normal deductibles and co-payments apply.
Pag e | 1 2
Province Eligible beneficiaries Eligible drug benefits Other eligible benefits
or program features
special consideration of coverage can be made for
drugs not listed.
New Brunswick
HIV/AIDS patients registered and deemed
eligible for the NB Prescription Drug Program
- HIV/AIDS (Plan U)
Anti-retrovirals listed in the New Brunswick Prescription Drug
Formulary.
Individuals are required to pay a co-payment of 20%
of the costs for each prescription up to a
maximum of $20 to an annual family maximum of
$500. There is an annual registration fee of $50.
Prince Edward Island All residents with
HIV/AIDS
All anti-retroviral drug therapies provided by the PEI Pharmacare AIDS/HIV
program.
No deductible or co-payment required.
Nova Scotia
All residents with HIV/AIDS who have no
other means of obtaining funding for the drugs
Anti-retroviral drug therapy provided through hospital based programs.
Individuals must pay the dispensing fee ($10.42) for a 3-month supply of each
prescription.
Newfoundland and Labrador
All residents with HIV/AIDS and registered
for one of the five plans in the Prescription Drug
Program
All anti-retroviral drugs listed in the NFL and
Labrador Coverage Table.
Normal deductibles and co-payments apply.
Yukon
All residents with HIV/ AIDS (except persons covered by NIHB or
private plans)
Anti-retroviral drug therapies.
Annual maximum co-payment of $250 per
person or $500 per family; no co-payment for seniors
65 and over, or for children under 19 from
low-income families.
Northwest Territories All residents with
HIV/AIDS
Disease specific therapies listed in the NIHB
formulary.
Normal deductibles or co-payments apply.
Nunavut All residents with
HIV/AIDS
All anti-retroviral drugs listed in the NIHB
formulary.
No deductible or co-payment required.
Non-Insured Health Benefits for First Nations
and Inuit
Eligible First Nations people and Inuit
Anti-retroviral drugs listed in the NIHB formulary.
Normal deductibles and co-payments apply.
The information provided in this table is based on provincial and territorial government Web sites.
For more information about provincial and territorial anti-retroviral drug programs, and for a complete list of anti-retroviral drugs covered in each province, you can consult the document “Access and Coverage of Antiretroviral drugs across Canada”, which is published on the Toronto General Hospital Immunodeficiency Clinic’s Web site: www.hivclinic.ca/main/drugs_reimbuse_files/HIV%20medication%20coverage%20across%20Canada.pdf
Pag e | 1 3
PROVINCIAL DRUG COVERAGE AND CHRONIC HEPATITIS C MEDICATION
This table provides information about the drug coverage and eligible beneficiaries of
hepatitis C medication in every province.
Province Eligible Beneficiaries Eligible Drugs Other information
British Columbia British Columbia
Pharmacare beneficiaries
Interferon: alfa-2b,recomb. (Intron A), beta-1a (Rebif), beta-1b (Betaseron; Extavia)
Peginterferon alfa-2a (Pegasys)
Ribavirin/P-Interferon alfa-2a (Pegasys RBV)
Ribavirin/P-Interferon alfa-2b (Pegetron)
Boceprevir (Victrelis)
Boceprevir/Ribavirin/P-alfa-2b (Victrelis Triple)
Telaprevir (Incivek)
Simprevir (Galexos)
Ledipasvir/Sofosbuvir (Harvoni)
Sofosbuvir (Sovaldi)
Special Authority Request required
Visit the Pacific Hepatitis C Network’s Treatment
Information Project Web site for more information:
www.pacifichepc.org/hepctip/
Alberta Alberta Drug Plan
beneficiaries
Interferon: beta-1a (Rebif), beta-1b (Betaseron; Extavia)
Peginterferon alfa-2a (Pegasys)
Ribavirin/P-Interferon alfa-2a (Pegasys RBV)
Ribavirin/P-Interferon alfa-2b (Pegetron)
Boceprevir (Victrelis)
Boceprevir/Ribavirin/P-alfa-2b (Victrelis Triple)
Telaprevir (Incivek)
Ledipasvir/Sofosbuvir (Harvoni)
Sofosbuvir (Sovaldi)
Special Authorization Request required
Saskatchewan Saskatchewan Drug Plan
beneficiaries
Interferon: alfa-2b (Intron A), beta-1a (Rebif, Avonex), beta-1b (Betaseron; Extavia)
Boceprevir (Victrelis)
Boceprevir/Ribavirin/P-alfa-2b (Victrelis Triple)
Telaprevir (Incivek)
Ledipasvir/Sofosbuvir (Harvoni)
Sofosbuvir (Sovaldi)
Exception Drug Status approval application required
Manitoba Manitoba Pharmacare
beneficiaries Interferon alfa-2b (Intron, Intron A)
Exception Drug Status Program approval required
Pag e | 1 4
Province Eligible Beneficiaries Eligible Drugs Other information
Boceprevir (Victrelis)
Boceprevir/Ribavirin/P-alfa-2b (Victrelis Triple)
Ledipasvir/Sofosbuvir (Harvoni)
Sofosbuvir (Sovaldi)
Ontario
ODB and Trillium beneficiaries approved under the Exceptional
Access Program
Interferon alfa-2b (Intron)
Through Exceptional Access Program:
Ribavirin/P-Interferon alfa-2a (Pegasys RBV)
Ribavirin/P-Interferon alfa-2b (Pegetron)
Boceprevir (Victrelis)
Boceprevir/Ribavirin/P-alfa-2b (Victrelis Triple)
Telaprevir (Incivek)
Sofosbuvir (Sovaldi)
Ledipasvir/Sofosbuvir (Harvoni)
Medications classified as limited use; approval by
Exceptional Access Program (EAP) required
Quebec RAMQ beneficiaries
Ribavirin/P-Interferon alfa-2a (Pegasys RBV)
Ribavirin/P-Interferon alfa-2b (Pegetron)
Boceprevir (Victrelis)
Boceprevir/Ribavirin/P-alfa-2b (Victrelis Triple)
Telaprevir (Incivek)
Simprevir (Galexos) (under the Exceptional Medications Program for some groups of people with genotype 1 hepatitis C virus)
Sofosbuvir (Sovaldi) (under the Exceptional Medications Program for some groups of people with genotype 1 or 4 hepatitis C virus)
Prior approval required
New Brunswick
NB Prescription drug
plans beneficiaries not
registered under a
specific disease plan
Interferon: alfa-2b (Intron), beta-1a (Rebif; Avonex) beta-1b (Betaseron; Extavia)
Peginterferon alfa-2a (Pegasys)
Ribavirin/P-Interferon alfa-2a (Pegasys RBV)
Ribavirin/P-Interferon alfa-2b (Pegetron)
Ribavirin/ Interferon alfa-2b,recomb. (Rebetron)
Boceprevir (Victrelis)
Boceprevir/Ribavirin/P-alfa-2b (Victrelis Triple)
Special Authorization Request required
Pag e | 1 5
Province Eligible Beneficiaries Eligible Drugs Other information
Telaprevir (Incivek)
Ledipasvir/Sofosbuvir (Harvoni)
Sofosbuvir (Sovaldi)
Prince Edward Island
Persons diagnosed with hepatitis
Interferon alfa-2b (Intron A)
Peginterferon alfa-2a (Pegasys)
Ribavirin/P-Interferon alfa-2a
(Pegasys RBV)
Ribavirin/P-Interferon alfa-2b
(Pegetron)
Boceprevir (Victrelis)
Boceprevir/Ribavirin/P-alfa-2b
(Victrelis Triple)
Telaprevir (Incivek)
Paritaprevir/ritonavir/ombitasvir)
tablets; dasabuvir tablets (Holkira
Pak)
Available under the Hepatitis
Program; application required
Nova Scotia
Beneficiaries of Family Pharmacare, Seniors
Pharmacare and Community Services
Pharmacare
Interferon: alfa-2b (Intron A), beta-1a (Rebif; Avonex) beta-1b (Betaseron; Extavia)
Peginterferon alfa-2a (Pegasys)
Ribavirin/ P-Interferon alfa-2a (Pegasys RBV)
Ribavirin/P-Interferon alfa-2b (Pegetron)
Boceprevir (Victrelis)
Boceprevir/Ribavirin/P-alfa-2b (Victrelis Triple)
Ledipasvir/Sofosbuvir (Harvoni)
Sofosbuvir (Sovaldi)
Prior approval as Exception Status Drugs required
Newfoundland & Labrador
Newfoundland Drug Plan Beneficiaries
Interferon: alfa-2b, recomb. (Intron A), beta-1a (Rebif; Avonex), beta-1b (Betaseron)
Ribavirin/P-Interferon alfa-2a (Pegasys RBV)
Ribavirin/P-Interferon alfa-2b (Pegetron)
Telaprevir (Incivek)
Special Authorization Request required
Yukon Beneficiaries of the
Chronic Diseases Program
Interferon: alfa-2b (Intron A), beta-1a (Rebif )
Ribavirin/ P-Interferon alfa-2a (Pegasys RBV)
Ribavirin/P-Interferon alfa-2b (Pegetron)
Boceprevir (Victrelis)
Exception Drug Status application required
Pag e | 1 6
Province Eligible Beneficiaries Eligible Drugs Other information
Boceprevir/Ribavirin/P-alfa-2b (Victrelis Triple)
Telaprevir (Incivek)
Sofosbuvir (Sovaldi)
Ledipasvir/Sofosbuvir (Harvoni)
Northwest Territories
Beneficiaries of Prescription Drugs and
Dental Benefits for Seniors and
beneficiaries of Extended Health Benefits (EHB) for
Specified Diseases
Interferon: alfa-2b (Intron A)
Peginterferon alfa-2a (Pegasys)
Peginterferon alfa-2b (Unitron PEG)
Ribavirin/ P-Interferon alfa-2a (Pegasys RBV)
Ribavirin/P-Interferon alfa-2b (Pegetron)
Boceprevir (Victrelis)
Boceprevir/Ribavirin/P-alfa-2b (Victrelis Triple)
Telaprevir (Incivek)
Medications classified as limited use and require
approval
Pag e | 1 7
Nunavut Beneficiaries of
Extended Health Benefits
Interferon: alfa-2b (Intron A)
Peginterferon alfa-2a (Pegasys)
Peginterferon alfa-2b (Unitron PEG)
Ribavirin/ P-Interferon alfa-2a (Pegasys RBV)
Ribavirin/P-Interferon alfa-2b (Pegetron)
Boceprevir (Victrelis)
Boceprevir/Ribavirin/P-alfa-2b (Victrelis Triple)
Telaprevir (Incivek)
Medications classified as limited use and require
approval
This table is a summary of information available on CATIE’s Web site and provincial and territorial drug formularies as of
October 31, 2014. With many new drugs in the pipeline, treatments are evolving and changing quickly. For more detailed
information, visit the site: www.catie.ca/en/practical-guides/hepc-in-depth/treatment/treatment-coverage-your-region
Those entitled to federal compensation for individuals infected between 1986 and 1990 are
reimbursed for the share of medication costs not covered by a public or private drug
insurance plan through the January 1, 1986 to July 1, 1990 Class Action Settlements.
Now is a good time to speak to your doctor about new treatments for HCV. Treatment has
progressed significantly, and now may be the right time for you to seek a cure. Recently,
new therapies have been approved by Health Canada that shorten the duration of
treatment, achieve a cure rate of more than 90%, minimize side effects compared to past
treatments, and are interferon free for HCV.
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PROGRAMS OFFERED BY PHARMACEUTICAL COMPANIES
Many companies that make and sell hepatitis C medications have programs to support patients throughout treatment. These programs offer assistance by providing drugs upfront to the 86-90 claimants through their specialty pharmacy. Once the 86-90 plan issues the reimbursement cheques to the patients for their treatment, they, in turn, must reimburse the pharmacy directly. For more information, speak to your doctor or your nurse, visit the CHS Web site (www.hemophilia.ca) or CATIES’s Web site (www.catie.ca), or contact the companies directly.
Program Product Phone number
AbbVie Care Program™ Holkira™ Pak (paritaprevir/ritonavir/ombitasvir) tablets; dasabuvir tablets)
1-844-471-2273
Galexos™: BioAdvance® Program
Galexos™ (simeprevir) 1-866-872-5770
Gilead Momentum HCV Support Program™
Sovaldi® (sofosbuvir) or Harvoni™ (ledipasvir and sofosbuvir in a single tablet)
1-855-447-7977
Incivek Care™ Program INCIVEK™ (telaprevir) 1-877-574-4298
Merck Care™ Program PEGETRON® (ribavirin plus peginterferon alfa-2b); VICTRELIS™ (boceprevir)
1-866-872-5773
Pegassist® Program PEGASYS® (peginterferon alfa-2a) 1-877-PEGASYS (1-877-734-2797)
IBAVYR™ Patient Support Program
IBAVYR™ (ribavirin tablets) 1-844-602-6858
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FIBROSCAN® CENTRES
One of the common exams used to test for liver disease is a liver biopsy. This is an invasive test
that can lead to complications for people with a bleeding disorder. The FibroScan® exam is a
non-invasive technique for testing liver disease. Below is a list of clinics and health centres in
Canada which offer FibroScan® exams. For more information about FibroScan®, visit their Web
site: www.knscanada.com.
British Columbia Lair Centre Fairmont Medical Building. 305-750 West Broadway Vancouver, BC V5Z 1H2 Tel: 604-875-5122
Pacific Gastro Services 770-1190 Hornby Street Vancouver, BC V6Z 2K5 Tel: 604-688-6332
Vancouver General Hospital Health Care Centre 5153 – 2775 Laurel Street Vancouver, BC V5Z 1M9 Tel: 604-875-5705
Prince George 303-2155 10th Avenue Prince George, BC V5M 5J6 Tel: 250-563-8284
PurCuro Clinic Research Ltd. 200-1105 Pandora Avenue Victoria, BC V8V 3P9 Tel: 250-382-6270
St. Paul Hospital 612-1081 Burrard Street Vancouver, BC V6Z 1Y6 Tel: 604-806-9093
BC Children’s Hospital Provincial Health Authority 4500 Oak Street Vancouver, BC V6H 3N1
Kelowna Viral Hepatitis Clinic Dr. Walter Anderson Building 2nd Floor, Room 2195 2252 Pandosy Street Kelowna, BC V1Y 1T1
Alberta CALGARY University of Calgary G I Medical Clinic 3350 Hospital Drive NW Calgary, AB T2N 4N1 Tel: 403-210-9837
South Health Campus 7E Medical Outpatient Clinic 4448 Front Street SE Calgary, AB T3M 1M4 Tel: 403-956-3804
EDMONTON University of Alberta Ledcor Zeidler Centre 130 University Campus Edmonton, AB T6G 2X8 Tel : 780-492-8134
G.I. Research Medicine (Gastroenterology) 11010-101 Street 310 Hys Center Edmonton, AB T5H 4B9 Tel : 780-421-1029
University of Alberta Infectious Disease Department 8440-112 Street Edmonton, AB T6G 2B7 Tel: 780-407-1620
Saskatchewan SASKATOON Royal University Hospital Hospital Drive Saskatoon, SK H1T 2M4 Tel : 306-655-6638
Saskatoon Infectious Disease Care Network 502-402 21st Street Saskatoon, SK S7K 0C3 Tel: 306-956-3444
REGINA Pasqua Hospital G.I Unit, 3rd Floor 4101 Dewdney Avenue Regina, SK S4T 1A5 Tel: 306-766-2762
Ontario HAMILTON Hamilton General Hospital Hamilton Health Science Centre McMaster University 237 Barton St. E. Hamilton, ON L8L 2X2 Tel: 905-528-2564
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LONDON London Health Science Centre Department of Medicine Division of Gastroenterology University of Western Ontario 339 Windermere Rd London, ON N6A 5A5 Tel: 519-663-3858
TORONTO Liver Scan Direct Sun Life Financial Centre 3300 Bloor Street West Centre Tower, 11th Floor, Suite 3140 Toronto, ON M8X 2X3 [email protected] Tel: 416-268-0150 www.liverscan.ca No referral needed
Toronto Liver Centre 1664 Dufferin Street, 2nd Floor Toronto, ON M6H 3M1 Tel: 416-652-0606
Toronto Liver Centre 4040 Finch Avenue Toronto, ON M1S 4V5 Tel: 416-652-0606
Toronto Liver Centre 2901 Eglinton Ave west Mississauga Unit C44040 Tel: 416-652-0606
Toronto Liver Centre 125-7155 Woodbine Avenue Markham, ON L3R 1A3 Tel: 416-652-0606
Toronto General Hospital Division of Gastroenterology University of Toronto 200 Elizabeth Street Toronto, ON M5G 2C4 Tel: 416-340-3834
Toronto Western Hospital Division of Gastroenterology University of Toronto 399 Bathurst Street Toronto ON M5T 2S8 Tel: 416-603-6234
Dr. S V Feinman, M.D., B.SC.,(MED),FRCP(C) Mount Sinai Hospital 600 University Avenue, Suite 1190 Toronto, ON M5G 1X5 Tel: 416-586-5301
Dr. D. Green, MD, FRCPC Oshawa Clinic 117 King Street East Oshawa, ON L1H 1B9 Tel: 905-721-4964 Fax: 905-721-6614
Dr. Benjamin Ho 1101 Brock street Whitby, ON L1N 4M1
Dr. Brien and Dr. Rajendran 26 Hospital Dr., suite 301 Peterborough, ON Tel: 705-740-6861
William Osler Health System 2100 Bovaird Drive East Brampton, ON L6R 3J7 Tel: 905-494-6794
Toronto Hospital for Sick Children 110 Elm Street Toronto, ON M5G 1X8
SUDBURY Dr. K. Tilbe 402-65 Larch Street, Suite # 402 Sudbury, ON P5E 1B8 Tel: 705-670-8911
OTTAWA Ottawa Hospital – Civic Campus 1053 Carling Ave. Ottawa, ON K1Y 4E9 Tel: 613-798-5555, ext. 17050 Fax: 613-761-5408
Ottawa Hospital – General Campus 501 Symth Road Ottawa, ON K1H 8L6 Tel: 613-798-5555, ext. 17492
Quebec MONTREAL Centre Hospitalier del’Université de Montréal 264, boulevard René-Levesque Est Montreal, QC H2X 1P1 Tel: 1-514-412-7377
Royal Victoria Hospital McGill University Health Centre 687, ave des Pins Ouest, Room 2.28 Montreal, QC H3A 1A1 Tel: 514-843-1421
Hospital Maisonneuve Rosemont 5415 boulevard de I’Assomption Montreal, QC H1T 2M4 Tel: 514-252-3406
Foundation Actuel 1001, boulevard de Maisonneuve Est 11th Floor, Suite 1130, Bureau 1000 Montreal, QC H2L 4P9 Tel: 514-992-0338
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Montreal CHEST Institute Chronic Viral Illness Service, 8th floor, 3650, rue Saint-Urbain Montreal, QC H2X 2P4 Tel: 514-654-3955
Jewish General Hospital 3755, chemin de la Côte-Ste-Catherine Montréal, QC H3T 1E2 Tel: 514-340-8264
Hôpital Honoré-Mercier 2750, boulevard Laframboise Saint-Hyacinthe, QC J2S 4Y8 Tel: 450-771-3333 ext 4622
QUEBEC CITY Centre Hospitalier Affilié Universitaire de Québec 1401 18e Rue Quebec City,QC G1J 1Z4 Tel: 1-418-649-0252
Le Centre hospitalier universitaire de Québec (CHUQ) CHUQ Pavillon CHUL 2705, boul. Laurier, Room S-785. Quebec City, QC G1V 4G2 Tel : 418-656-4141 ext 47953, 418-563-1190
New Brunswick MONCTON The Moncton Hospital 135 MacBeath Avenue Moncton, NB E1C 6Z8 Tel: 1-800-233-1008
Nova Scotia HALIFAX Queen Elizabeth II (QEII) Health Sciences Centre Dartmouth General Hospital CDHA Distribution Centre 109 Dorey Avenue Barnside Unit 1 Dartmouth, NS B3B 0B2 Tel: 902-473-289
