
November 29, 2011
For Immediate Release
ANNUAL REPORT CARD ON REIMBURSEMENT ACCESS TO ARTHRITIS TREATMENTS IN CANADA REVEALS UNMET NEEDS OF CANADIANS
Arthritis Consumer Experts Provides New Insights Into 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 many provinces are failing large numbers of Canadians living with inflammatory arthritis by not meeting the best clinical treatment standards in reimbursement access to publicly-funded biologic response modifiers.
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.
According to Cheryl Koehn, President and Founder of Arthritis Consumer Experts and a person living with rheumatoid arthritis: "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 arthritis specialists?"
"Some provinces still fall behind the rest of the country. People who depend on financial assistance from their province's drug benefit plan are still being denied the treatments their physician says they require," said Koehn.
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 is a tremendous financial burden on Canada's health care system," says Dr. Esdaile. "The Report Card makes it clear that patients with inflammatory arthritis do not have all medication options equally available. Consistent public reimbursement access for biologic response modifiers is vital because each person living with one of these diseases responds differently to a particular medication or combination of medications, as is true in cancer and HIV treatment. Because the criteria for reimbursement on public formularies are different province to province, many patients 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 the federal and provincial/territorial governments work collaboratively with the arthritis community to create a national framework, 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.
PROVINCE | 2011 RANKING | 2010 RANKING | REASON FOR RANKING CHANGE |
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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: http://www.jointhealth.org/programs-jhreportcard.cfm
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.
Website: www.jointhealth.org
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For further information, or to arrange an interview with Cheryl Koehn or Dr. John Esdaile, please contact: Johanna Kendall at kendall@jointhealth.org or 604-974-1366.