Accessing Medications

Now that you have built a treatment plan in conjunction with your doctor or rheumatologist, it is likely that you will have to make a decision about medications. For many forms of arthritis, particularly inflammatory forms such as rheumatoid arthritis and psoriatic arthritis, medications are a central part of a treatment plan. For that reason, access to medications is a critical aspect of managing disease and reducing harm.

The good news is that in the past decade we have seen an increase in new medication options for people living with arthritis, including a new class of drugs called biologic response modifiers (also known as biologics or biologic DMARDS). Even better news is that research has shown that this class of drug provides incredible value, medically and socially for people living with arthritis.

The bad news is that coverage for many medications under provincial and territorial public reimbursement drug plans varies widely. This means that thousands of Canadians who depend on reimbursement by provincial medication benefit plans do not have access to new or improved medications.

A good example of this is the reimbursement of medications for ankylosing spondylitis. As of April 1, 2008 a person living with ankylosing spondylitis in Alberta who requires a biologic medication and does not have private medical insurance would not have this drug covered by the publicly funded provincial drug program. Yet, this same person, if they lived in British Columbia and did not have private insurance, would have access to three different types of biologic DMARDS on the public drug plan to treat their disease. Report Card on provincial formulary reimbursement listings for biologic response modifiers.

One factor that contributes to this delay or denial of coverage is review times. This can occur at the federal level, through lengthy bureaucratic reviews or "do not list" decisions by the Common Drug Review. Provincial review times are another critical issue. In some provinces, medication reviews can take years even though they have already been reviewed and approved by Health Canada and the Common Drug Review. Prescription medication reviews in Canada.

These national differences in reimbursement of medications represent poor public health policy and contribute to the discrimination faced by people living with arthritis and trying to access safe and effective treatment and care.

While we have seen an expansion of the medications covered on provincial and territorial public medication plans over the past year, we can see in the example above that many Canadians continue to fall through the cracks. Governments continue to deny people living with arthritis, reimbursement for medications proved safe, effective, and cost-effective.

Just like HIV and cancer, the treatment of arthritis relies, in part, on medications. Used in a timely and appropriate fashion, these medications are life-changing. They can mean the difference between being able to work and living on a disability pension; between deciding to have a family and not being able to have one.

Essentially, for many people living with arthritis they mean the difference between a life of disability and a life of potential and hope.