JointHealth™ express   October 17, 2005

Adalimumab (Humira®) now listed on the British Columbia, Alberta and Quebec government drug benefit plans

Beginning in 2002, ACE has been working to bring the important issue of government and private drug benefit plan coverage for biologic response modifiers to the forefront.

The newest biologic response modifier to the market for use in people with rheumatoid arthritis is adalimumab (Humira®). On October 1, 2005, adalimumab received a "limited access" or "special authority" listing on the British Columbia (BC), Alberta (AB) and Quebec (QC) government drug benefit plans, the same listing as the other two biologic response modifiers, etanercept (Enbrel®) and infliximab (Remicade®).

Each province in Canada has its own "limited access" or "special authority" coverage criteria for biologic response modifiers, but the coverage in each province is the same for all three biologics.

Common criteria for "limited access" or "special authority" in all provinces includes:
  • An RA specialist (rheumatologist) must prescribe the drug and follow the progress of the person taking it
  • Must be used in persons with severe, active rheumatoid arthritis
  • Must be used in combination with methotrexate
For information on additional criteria specific to each province's drug benefit plan, click on the following links: It is important to note that most private drug benefit plans provide coverage for all three biologic response modifiers. Private drug plans use similar criteria as the provincial drug benefit plans to establish a person's eligibility for coverage.