JointHealth™ express   April 15, 2021

Most Canadians have some access to insurance coverage for prescription medications through a patchwork of public and/or private insurance plans. The federal, provincial and territorial governments offer varying levels of coverage and decide who is covered and what the patient and plan pays, particularly for more costly advanced therapies such as biologics or targeted small molecule medications. Public drug plans generally provide drug plan coverage for those most in need, based on age, income, and medical condition. Many Canadians and their family members have drug coverage linked to employment and some Canadians may have no effective drug coverage and pay the full cost of prescription drugs.

In this episode, Kelly Lendvoy and Cheryl Koehn discuss a national survey on arthritis medications reimbursement ACE has launched for Canadians living with arthritis to help identify challenges patients are experiencing in getting reimbursement for needed medications.

Public and private dug plans do provide reimbursement for nearly all the advanced therapies for inflammatory arthritis. However, there are differences between provinces, and public and private drug plans may restrict coverage for some medications. Based on the results of this survey, ACE will work with people living with arthritis across Canada to amplify their priorities during policy development and throughout the regulatory approval and reimbursement access process for needed medications.