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(Vancouver) — Arthritis Consumer Experts (ACE) today released its 10^th Annual JointHealth™ Arthritis Medications Report Card and Medications Guide. Over the past year, pharmaceutical policy discussions and announcements at both the national and provincial-territorial government levels have changed reimbursement access to treatment options for Canadians living with an inflammatory arthritis and had an impact on the rankings provinces receive in the Report Card.

Commenting on the changing landscape for reimbursement of arthritis medications, ACE President, Cheryl Koehn stated: “Any new pharmaceutical policy that promises to deliver significant drug plan savings must do so without compromising patient safety and efficacy. ACE has also consistently advocated that any drug plan cost savings related to changes in policy that affect arthritis medication reimbursement access should be reinvested back to drug formulary budgets to support the listing of new arthritis medicines and other non-medication related initiatives to improve models of arthritis care such as creating rheumatology nursing billing codes.”

Research in Canada continues to demonstrate that patients with inflammatory arthritis still have unmet medication needs. The gaps in treatment are a reflection of the fact that inflammatory arthritis is a complicated disease. It is a disease driven by many different biologic processes, so no single treatment is effective for every patient. In fact, a significant number of patients do not respond well or well enough to their initial, or second or third trialed, which underlines the need for continued discovery of other therapeutic targets.

Koehn added: “The scientific evidence that we see presented at the annual conference of the American College of Rheumatology definitively shows how conventional medications and advanced therapies such as biologics (originator and biosimilar) and targeted small molecule medications, deliver value both medically and socially. Used in a timely and appropriate fashion, these medications are life-changing; in some cases, life-saving. For patients, they can mean the difference between being able to work versus living on a disability pension; between having your disease stabilized versus having to visit emergency rooms or undergo surgery; and between deciding to have a family versus not being able to have one.”

About the Report Card

Arthritis Consumer Expert's Annual JointHealth™ Arthritis Medications Report Card is Canada’s only independent patient organization evaluation of public reimbursement access to arthritis medications. Depending on where they live, Canadians living with an inflammatory arthritis may have fewer treatment options or have to “jump through more hoops” to qualify for reimbursement for the medication prescribed by their specialist. The Report Card is designed to help Canadians evaluate where their province ranks in terms of providing reimbursement for medications for inflammatory arthritis such as rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis or juvenile idiopathic arthritis.

The Report Card ranks twelve publicly funded medication formularies based on the number of medically necessary arthritis medications they list out of a possible 20 medication treatments. Formularies are awarded one point for each case-by-case (CBC) listing, three-quarters of a point for a listing that has overly restrictive criteria (ORC), and no points for “Declined” listings or files remaining “Under Review”. In some cases, information about a medication was unavailable. Where this lack of transparency occurred, ACE put “Unknown” and did not award any points.

JointHealth™ Arthritis Medications Report Card Highlights:

• ACE monitors advanced therapy disease modifying anti-rheumatic drugs (or DMARDs) used to treat the most common types of inflammatory arthritis: biologic response modifier (originator or “boDMARDs” and biosimilar or “bsDMARDs”) and targeted synthetic molecule (tsDMARDs)
• Saskatchewan and Ontario share the number one rank in the Report Card, while last year’s number one ranked province, Quebec, is ranked number three, along with Alberta
• Provinces that most improved their ranking include:
  Saskatchewan (1^st in 2017; 4^th in 2016)
  Alberta (3^rd in 2017; 7^th in 2016)
  New Brunswick (5^th in 2017; 8^th in 2016)
• Provinces whose ranking declined include:
  Quebec (1^st in 2016; 3^rd in 2017)
  British Columbia (2^nd in 2016; 5^th in 2017)
  Prince Edward Island (6^th in 2016; 9^th in 2017)

About Arthritis Consumer Experts

Arthritis Consumer Experts (ACE) is a national patient-led organization that provides free science-based information and education programs in both official languages to people with arthritis. ACE serves people living with all forms of arthritis by helping them take control of their disease and improve their quality of life. Founded and led by people with arthritis, ACE actively advocates on arthritis health and policy issues at meetings, conferences and through ACE's JointHealth™ family of programs and its online news channel, Arthritis Broadcast Network. ACE’s organizational and staff conduct is guided by a strict set of publicly available guiding principles as well as seeks council from itsdvisory board comprised of leading scientists, medical professionals and informed people with arthritis.

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For further information:
Kelly Lendvoy
Arthritis Consumer Experts
Vice President, Communications and Public Affairs
Mobile: 604.379.9898
lendvoy@jointhealth.org

Appendix: Ranking Report Table
(This table provides current provincial rankings and their ranking change from the 2016 Report Card.)

PROVINCE	2017 RANKING	2016 RANKING	REASON FOR RANKING CHANGE
Saskatchewan	1st	4th	Approved certolizumab pegol (Cimzia®) for ankylosing spondylitis (AS) and psoriatic arthritis (PsA), infliximab (Inflectra®) for rheumatoid arthritis (RA), AS, and PsA, ustekinumab (Stelara®) for PsA, and tofacitinib (Xeljanz®) for RA. Canakinumab (Ilaris®) for juvenile idiopathic arthritis (JIA) was declined.
Ontario	1st	3rd	As a result of the approval of infliximab (Inflectra®), the status of infliximab (Remicade®) for JIA was changed to overly restrictive criteria. Approved tofacitinib (Xeljanz®) for RA.
Alberta	3rd	7th	Approved certolizumab pegol (Cimzia®) for RA, AS and PsA, infliximab (Inflectra®) for RA, AS and PsA, and tofacitinib (Xeljanz®) for RA. Canakinumab (Ilaris®) for JIA was declined. As a result of the approval of infliximab (Inflectra®), the status of infliximab (Remicade®) for RA, AS and PsA was changed to overly restrictive criteria.
Quebec	3rd	1st	Approved adalimumab (Humira®) for JIA. Belimumab (Belysta®) for lupus and secukinumab (Cosentyx®) for AS and PsA was declined. The criteria for infliximab (Remicade®) for RA, AS, JIA, and PsA are now overly restrictive.
British Columbia	5th	2nd	Approved tofacitinib (Xeljanz®) for RA. Canakinumab (Ilaris®) for JIA was declined.
Nova Scotia	5th	4th	Approved infliximab (Inflectra®) for RA, AS and PsA, and tofacitinib (Xeljanz®) for RA. As a result of the approval of infliximab (Inflectra®), the status of infliximab (Remicade®) for RA, AS and PsA was changed to overly restrictive criteria.
New Brunswick	5th	8th	Approved certolizumab pegol (Cimzia®) for RA, AS and PsA, infliximab (Inflectra®) for RA, AS and PsA, and tofacitinib (Xeljanz®) for RA. Belimumab (Belysta®) for lupus, canakinumab (Ilaris®) for JIA, and ustekinumab (Stelara®) for PsA was declined. As a result of the approval of infliximab (Inflectra®), the status of infliximab (Remicade®) for RA, AS and PsA was changed to overly restrictive criteria.
Newfoundland and Labrador	8th	10th	Approved certolizumab pegol (Cimzia®) for RA, AS and PsA, infliximab (Inflectra®) for RA, AS and PsA, tocilizumab (Actemra®) for JIA, and tofacitinib (Xeljanz®) for RA. As a result of the approval of infliximab (Inflectra®), the status of infliximab (Remicade®) for RA, AS and PsA was changed to overly restrictive criteria.
Manitoba	9th	8th	Approved certolizumab pegol (Cimzia®) for AS and PsA, infliximab (Inflectra®) for RA, AS and PsA, and tofacitinib (Xeljanz®) for RA. As a result of the approval of infliximab (Inflectra®), the status of infliximab (Remicade®) for RA, AS and PsA was changed to overly restrictive criteria.
Prince Edward Island	9th	6th	Approved adalimumab (Actemra™) for JIA and infliximab (Inflectra®) for RA, AS and PsA. As a result of the approval of infliximab (Inflectra®), the status of infliximab (Remicade®) for RA, AS and PsA was changed to overly restrictive criteria.
Yukon	11th	12th	Approved etanercept (Brenzys®) for RA and AS, infliximab (Inflectra®) for RA, AS, PsA, and tofacitinib (Xeljanz®) for RA. As a result of the approval of etanercept (Brenzys®), the status of etanercept (Enbrel®) for RA and AS was changed to overly restrictive criteria. As a result of the approval of infliximab (Inflectra®), the status of infliximab (Remicade®) for RA, AS and PsA was changed to overly restrictive criteria.
Non-Insured Health Benefits or "NIHB"	12th	11th	Approved certolizumab pegol (Cimzia®) for AS and PsA, infliximab (Inflectra®) for RA, and tofacitinib (Xeljanz®) for RA.

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