Provincial Drug Programs

Updated: June 14, 2010

Alberta

The Alberta government announced in December 2008 a program to be available in Spring 2009 called the Alberta Rare Diseases Drug Program which appears as though it will cover augmentation therapy. An Alberta Government fact sheet on the program is available here. Sign-up for our newsletter to get more information.when it is available.

British Columbia

British Columbia has a provincially funded system called Pharmacare, which covers most drugs, including augmentation therapy, after the individual meets a deductible that is based on income and other factors. For more information, visit their website.

Ontario

1. Trillium Drug Program

This program is designed to assist people whose drug costs are excessively high in relation to their income. There is no high income cutoff. Instead, each individual is assigned a deductible which is based on income. Once drug costs exceed this deductible, the Trillium Drug Program will assist with costs above the deductible.

The Trillium Drug Program does not replace private insurance plans. You must still submit your claims to your private insurer (if you have one) and then the percentage that your plan does not cover, that is, what you have to pay yourself, comes under the Trillium deductible. Any amounts paid by your insurer cannot be applied to your Trillium deductible amount.

For more information visit the Ministry of Health and Long Term Care website or phone 1-866-532-3161.

2. Request for an Unlisted Drug Product - Individual Clinical Review (ICR) (also know as a 'section 8')

This is a special program for drugs (such as augmentation therapy) which are not listed and not normally covered under the Ontario Drug Benefit Program. You should have already applied for the Trillium Drug Program before you apply for an Individual Clinical Review. Your doctor must submit a letter that details your condition and requests coverage. When approved, coverage is usually for a period of one year at a time and is not retroactive. Therefore, if you are thinking of starting augmentation therapy, you should apply immediately.                                              

For more information, visit their website or phone 1-866-532-3161.

3. Assistive Devices (includes home oxygen program).

For information, telephone 1-800-268-6021 or visit their website.

Saskatchewan

Information on the Saskatchewan Drug Program is available on their website.

Other Provinces