Arthritis Consumer Experts

November 29, 2011
For Immediate Release

Arthritis Consumer Experts Provides New Insights Into Ontario's Current Inflammatory Arthritis Treatment Landscape

(Vancouver, BC) — Arthritis Consumer Experts, one of Canada's leading arthritis patient education and advocacy organizations, reveals in its 2011 JointHealth™ Report Card on Provincial Formulary Reimbursement Listings for Biologic Response Modifiers that Ontario lags behind British Columbia, Alberta, Saskatchewan and Quebec in meeting the best clinical standards in reimbursement access to publicly-funded arthritis medications.

According to Cheryl Koehn, President and Founder, Arthritis Consumer Experts and a person living with rheumatoid arthritis, "Canada's largest province falling behind four other jurisdictions is unacceptable. People who depend on financial assistance from Ontario's drug benefit plan are being denied the treatments their physician says they require."

The need to understand the tremendous burden inflammatory arthritis - such as rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis - places on people living with these diseases, their families and society is urgent. Approximately 600,000 Canadians currently live with an inflammatory arthritis.

Added Koehn, "While we wait for cures for inflammatory arthritis, a combination of medications called disease modifying anti-rheumatic drugs (DMARDs) and biologic response modifiers, is the gold standard in treatment for moderate to severe inflammatory arthritis. Unfortunately, provincial drug formulary reimbursement access to biologic response modifiers is unequal across the country, which means some Canadians living with these severe forms of arthritis have fewer treatment options, or have to 'jump through more hoops' to qualify for financial assistance to treat their disease, compared with other citizens with cancer, diabetes and HIV."

Arthritis Consumer Expert's annual JointHealth™ Report Card is the country's only independent patient organization evaluation of public reimbursement access to arthritis medications. The 2011 Report Card raises the question on behalf of all Canadians struggling to live with inflammatory arthritis, "Why is there unequal or unfair access to the medications being prescribed by medical specialists?"

According to Dr. John Esdaile, Scientific Director of the Arthritis Research Centre of Canada, this kind of well-researched report is significant because it confirms where major gaps exist across the country in accessing the various treatment options that could help inflammatory arthritis patients: "Inflammatory arthritis has a profound impact on an individual's quality of life and a tremendous financial burden on Canada's health care system," says Dr. Esdaile. "The Report Card makes it clear that there have to be many medication options equally available to every Canadian. Each person living with inflammatory arthritis responds differently to each medication or combination of medications, and no single biologic response modifier is effective in everyone's disease, as is true in cancer and HIV treatment. Because the criteria for reimbursement on formularies are different across Canada, some people lack the same choices as others. Every Canadian, in consultation with their arthritis specialist, deserves the same right to consider their personal risk factors and choose the best medication for their disease."

Added Koehn: "Moving forward, ACE recommends federal and provincial/territorial governments work collaboratively with the arthritis community to create a national strategy, supported by parallel provincial/territorial strategies that provide coordinated arthritis care. We call on the federal and provincial/territorial governments to meet with us without delay so we can begin the process of improving the outcomes for those living with arthritis and to reduce its impact on the health care system."

2011 JointHealth™ Report Card on Provincial Formulary Reimbursement Listings for Biologic Response Modifiers Highlights

No Canadian province provides coverage for all biologic response modifiers approved by Health Canada. The table below provides current provincial rankings and their status change from the 2010 Report Card.

British Columbia 1st 4th Up from last year due to improvement in number of listings and less restrictive reimbursement criteria
Quebec 2nd 1st Down from last year due to not adding certolizumab pegol and golimumab for RA, while BC did.
Saskatchewan 2nd 2nd Same position (it made improvements, just not as many as BC)
Alberta 4th 2nd Down from last year due to overly restrictive coverage criteria for tocilizumab (Actemra®) and abatacept (Orencia®)
New Brunswick 5th 4th Down from last year due to declining to list certolizumab pegol; improvements made, but relative to other provinces, not as much
Newfoundland and Labrador 5th 4th Down from last year because it hasn't approved certolizumab yet; improvements made, but relative to others not as much
Ontario 5th 7th Up from last year due to improved reimbursement coverage criteria
Nova Scotia 8th 7th Down from last year due to certolizumab pegol still being under review; improvements made, but relative to other provinces not as much
Prince Edward Island 8th 9th Up from last year due to adding golimumab for 3 indications, adding abatacept and etanercept for JIA, and adding rituximab for RA; one of the provinces that made big changes, however, didn't result in much movement in ranking due to ranking being relative to other provinces
Non-Insured Health Benefits or "NIHB" 8th 9th Up from last year due to adding golimumab for 3 indications, adding tocilizumab for RA, and adding abatacept and etanercept for JIA
Manitoba 11th 11th Same as last year due to the fewest biologic response modifiers covered
Yukon 12th 12th Same as last year due to the fewest biologic response modifiers covered

About the Report Card
Arthritis Consumer Experts' annual JointHealth™ Report Card is the country's only independent patient organization evaluation of reimbursement access to arthritis medications on provincial/territorial drug benefit plans across the country. Since it was originally published in 2005, the number of biologics covered across the country has improved greatly.

Link to Report Card:

What's new in this year's Report Card?
Since JointHealth™ produced last year's paper version of the Report Card, a lot changed. Three new medications still under review at the time of printing became available to treat rheumatoid arthritis (RA), psoriatic arthritis (PsA) and ankylosing spondylitis (AS). The new medications are golimumab (Simponi®), which is used to treat all three inflammatory disease types, and certolizumab pegol (Cimzia®) and tocilizumab (Actemra®) for rheumatoid arthritis only. Now, instead of ranking publicly funded drug formularies based on the number of medications they cover out of five, ACE bases them out of eight.

About Arthritis Consumer Experts
Arthritis Consumer Experts (ACE) provides free education and information programs to people with arthritis and is committed to informing, educating and empowering people with arthritis to help them take control of their disease and improve their quality of life. ACE's JointHealth™ family of programs provides evidence-based information in reader-friendly language to people with arthritis, the public, governments and media.



For further information, or to arrange an interview with Cheryl Koehn or Dr. John Esdaile, please contact: Johanna Kendall at or 604-974-1366.