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Report Card on provincial formulary reimbursement listings for biologic response modifiers Arthritis Consumer Experts (ACE) ranks publicly funded medication formularies based on the number of medically necessary arthritis medications (biologic response modifiers or "biologics") they list out of a possible eight. Biologics are the gold standard in treatment for rheumatoid arthritis, ankylosing spondylitis, juvenile idiopathic arthritis, and psoriatic arthritis. 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. People with arthritis, with the help of the doctors who treat them, deserve to be able to choose the medication most appropriate for their specific risk factors. If after reading the Report Card you are disappointed with your province's performance, consider making your provincial government aware of your concerns. For tips on how to communicate with elected officials or key decision-makers, please visit our "What You Can Do" page within the "Taking Action" section of the JointHealth™ website. |
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| Biologic Chart : November 2011 | |||||
| 1st : British Columbia | |||||
| Generic Name (Brand Name) | rheumatoid arthritis | ankylosing spondylitis | juvenile idiopathic arthritis | psoriatic arthritis | |
| abatacept (Orencia®) | Listed — CBC | Not Applicable | Listed — CBC | In Clinical Trials | |
| adalimumab (Humira®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| certolizumab pegol (Cimzia®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| etanercept (Enbrel®) | Listed — CBC | Listed — CBC | Listed — CBC | Listed — CBC | |
| golimumab (Simponi®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| infliximab (Remicade®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| rituximab (Rituxan®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| tocilizumab (Actemra®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| 2nd : Québec | |||||
| Generic Name (Brand Name) | rheumatoid arthritis | ankylosing spondylitis | juvenile idiopathic arthritis | psoriatic arthritis | |
| abatacept (Orencia®) | Listed — CBC | Not Applicable | Listed — CBC | In Clinical Trials | |
| adalimumab (Humira®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| certolizumab pegol (Cimzia®) | Under Review | Not Applicable | Not Applicable | Not Applicable | |
| etanercept (Enbrel®) | Listed — CBC | Listed — CBC | Listed — CBC | Listed — CBC | |
| golimumab (Simponi®) | Under Review | Listed — CBC | Not Applicable | Listed — CBC | |
| infliximab (Remicade®) | Listed — CBC | Listed — CBC | Listed — CBC | Listed — CBC | |
| rituximab (Rituxan®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| tocilizumab (Actemra®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| 2nd : Saskatchewan | |||||
| Generic Name (Brand Name) | rheumatoid arthritis | ankylosing spondylitis | juvenile idiopathic arthritis | psoriatic arthritis | |
| abatacept (Orencia®) | Listed — CBC | Not Applicable | Listed — CBC | In Clinical Trials | |
| adalimumab (Humira®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| certolizumab pegol (Cimzia®) | Under Review | Not Applicable | Not Applicable | Not Applicable | |
| etanercept (Enbrel®) | Listed — CBC | Listed — CBC | Listed — CBC | Listed — CBC | |
| golimumab (Simponi®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| infliximab (Remicade®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| rituximab (Rituxan®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| tocilizumab (Actemra®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| 4th : Alberta | |||||
| Generic Name (Brand Name) | rheumatoid arthritis | ankylosing spondylitis | juvenile idiopathic arthritis | psoriatic arthritis | |
| abatacept (Orencia®) | Listed — CBC | Not Applicable | Listed — ORC | In Clinical Trials | |
| adalimumab (Humira®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| certolizumab pegol (Cimzia®) | Under Review | Not Applicable | Not Applicable | Not Applicable | |
| etanercept (Enbrel®) | Listed — CBC | Listed — CBC | Listed — CBC | Listed — CBC | |
| golimumab (Simponi®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| infliximab (Remicade®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| rituximab (Rituxan®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| tocilizumab (Actemra®) | Listed — ORC | Not Applicable | Not Applicable | Not Applicable | |
| 5th : New Brunswick | |||||
| Generic Name (Brand Name) | rheumatoid arthritis | ankylosing spondylitis | juvenile idiopathic arthritis | psoriatic arthritis | |
| abatacept (Orencia®) | Listed — CBC | Not Applicable | Listed — CBC | In Clinical Trials | |
| adalimumab (Humira®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| certolizumab pegol (Cimzia®) | Declined Listing | Not Applicable | Not Applicable | Not Applicable | |
| etanercept (Enbrel®) | Listed — CBC | Listed — CBC | Listed — CBC | Listed — CBC | |
| golimumab (Simponi®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| infliximab (Remicade®) | Listed — CBC | Listed — CBC | Not Applicable | Declined Listing | |
| rituximab (Rituxan®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| tocilizumab (Actemra®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| 5th : Newfoundland and Labrador | |||||
| Generic Name (Brand Name) | rheumatoid arthritis | ankylosing spondylitis | juvenile idiopathic arthritis | psoriatic arthritis | |
| abatacept (Orencia®) | Listed — CBC | Not Applicable | Listed — CBC | In Clinical Trials | |
| adalimumab (Humira®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| certolizumab pegol (Cimzia®) | Under Review | Not Applicable | Not Applicable | Not Applicable | |
| etanercept (Enbrel®) | Listed — CBC | Listed — CBC | Listed — CBC | Listed — CBC | |
| golimumab (Simponi®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| infliximab (Remicade®) | Listed — CBC | Listed — CBC | Not Applicable | Declined Listing | |
| rituximab (Rituxan®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| tocilizumab (Actemra®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| 5th : Ontario | |||||
| Generic Name (Brand Name) | rheumatoid arthritis | ankylosing spondylitis | juvenile idiopathic arthritis | psoriatic arthritis | |
| abatacept (Orencia®) | Listed — CBC | Not Applicable | Under Review | In Clinical Trials | |
| adalimumab (Humira®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| certolizumab pegol (Cimzia®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| etanercept (Enbrel®) | Listed — CBC | Listed — CBC | Listed — CBC | Listed — CBC | |
| golimumab (Simponi®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| infliximab (Remicade®) | Listed — CBC | Listed — CBC | Not Applicable | Declined Listing | |
| rituximab (Rituxan®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| tocilizumab (Actemra®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| 8th : Nova Scotia | |||||
| Generic Name (Brand Name) | rheumatoid arthritis | ankylosing spondylitis | juvenile idiopathic arthritis | psoriatic arthritis | |
| abatacept (Orencia®) | Listed — CBC | Not Applicable | Listed — CBC | In Clinical Trials | |
| adalimumab (Humira®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| certolizumab pegol (Cimzia®) | Under Review | Not Applicable | Not Applicable | Not Applicable | |
| etanercept (Enbrel®) | Listed — CBC | Listed — CBC | Listed — CBC | Listed — CBC | |
| golimumab (Simponi®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| infliximab (Remicade®) | Listed — CBC | Under Review | Not Applicable | Declined Listing | |
| rituximab (Rituxan®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| tocilizumab (Actemra®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| 8th : Prince Edward Island | |||||
| Generic Name (Brand Name) | rheumatoid arthritis | ankylosing spondylitis | juvenile idiopathic arthritis | psoriatic arthritis | |
| abatacept (Orencia®) | Listed — CBC | Not Applicable | Listed — CBC | In Clinical Trials | |
| adalimumab (Humira®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| certolizumab pegol (Cimzia®) | Under Review | Not Applicable | Not Applicable | Not Applicable | |
| etanercept (Enbrel®) | Listed — CBC | Listed — CBC | Listed — CBC | Listed — CBC | |
| golimumab (Simponi®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| infliximab (Remicade®) | Listed — CBC | Listed — CBC | Not Applicable | Under Review | |
| rituximab (Rituxan®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| tocilizumab (Actemra®) | Under Review | Not Applicable | Not Applicable | Not Applicable | |
| 8th : NIHB* | |||||
| Generic Name (Brand Name) | rheumatoid arthritis | ankylosing spondylitis | juvenile idiopathic arthritis | psoriatic arthritis | |
| abatacept (Orencia®) | Listed — CBC | Not Applicable | Listed — CBC | In Clinical Trials | |
| adalimumab (Humira®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| certolizumab pegol (Cimzia®) | Declined Listing | Not Applicable | Not Applicable | Not Applicable | |
| etanercept (Enbrel®) | Listed — CBC | Listed — CBC | Listed — CBC | Listed — CBC | |
| golimumab (Simponi®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| infliximab (Remicade®) | Listed — CBC | Declined Listing | Not Applicable | Declined Listing | |
| rituximab (Rituxan®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| tocilizumab (Actemra®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| 11th : Manitoba | |||||
| Generic Name (Brand Name) | rheumatoid arthritis | ankylosing spondylitis | juvenile idiopathic arthritis | psoriatic arthritis | |
| abatacept (Orencia®) | Under Review | Not Applicable | Under Review | In Clinical Trials | |
| adalimumab (Humira®) | Listed — CBC | Listed — CBC | Not Applicable | Listed — CBC | |
| certolizumab pegol (Cimzia®) | Under Review | Not Applicable | Not Applicable | Not Applicable | |
| etanercept (Enbrel®) | Listed — CBC | Listed — CBC | Unknown | Listed — CBC | |
| golimumab (Simponi®) | Under Review | Under Review | Not Applicable | Under Review | |
| infliximab (Remicade®) | Listed — CBC | Unknown | Not Applicable | Unknown | |
| rituximab (Rituxan®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| tocilizumab (Actemra®) | Under Review | Not Applicable | Not Applicable | Not Applicable | |
| 12th : Yukon | |||||
| Generic Name (Brand Name) | rheumatoid arthritis | ankylosing spondylitis | juvenile idiopathic arthritis | psoriatic arthritis | |
| abatacept (Orencia®) | Listed — CBC | Not Applicable | Under Review | In Clinical Trials | |
| adalimumab (Humira®) | Listed — CBC | Under Review | Not Applicable | Listed — CBC | |
| certolizumab pegol (Cimzia®) | Under Review | Not Applicable | Not Applicable | Not Applicable | |
| etanercept (Enbrel®) | Listed — CBC | Under Review | Unknown | Under Review | |
| golimumab (Simponi®) | Under Review | Under Review | Not Applicable | Under Review | |
| infliximab (Remicade®) | Listed — CBC | Under Review | Not Applicable | Under Review | |
| rituximab (Rituxan®) | Listed — CBC | Not Applicable | Not Applicable | Not Applicable | |
| tocilizumab (Actemra®) | Under Review | Not Applicable | Not Applicable | Not Applicable | |
About the report card:
Arthritis Consumer Experts graded each of the provinces by assigning a score based upon number of medications listed, number under review, and number of declined listings. In some cases, information was unavailable from a province or territory's website. This lack of transparency was reflected in grade assignments.
Because provincial formularies change frequently, we encourage you to contact the Ministry of Health in your province with questions you may have about medication listings of concern to you.
Definitions
| Declined Listing: | The formulary does not reimburse patients prescribed this medication. |
| In Clinical Trials: | This medication is undergoing testing for use in treating this disease type. |
| Listed - CBC: | Each province and territory has a process by which medications that are not normally included in the provincial, territorial or federal drug benefit lists are covered (or reimbursed). Approval of this drug is granted on a case-by-case basis. |
| Listed - ORC: | The medication is listed, but the criteria are not supported by medical evidence. Arthritis Consumer Experts considers these overly restrictive criteria (ORC) unacceptable. |
| NOC: | A Notice of Compliance from Health Canada was issued for this medication for this form of arthritis. Notices of Compliance are issued for a medication when Health Canada is satisfied that the manufacturer has complied with certain sections of the Food and Drug Regulations. |
| Not Applicable: | No Notice of Compliance (or NOC) has been issued for this medication for this form of arthritis. |
| Under Review: | This drug has been approved by Health Canada for this disease type and the province is considering whether patients should be reimbursed for it. |
| Unknown: | There is no public information available. |
| CDR: | The Common Drug Review (CDR) is part of the Canadian Agency for Drugs and Technologies in Health. The Common Drug Review (CDR) conducts objective, rigorous reviews of the clinical and cost effectiveness of drugs, and provides formulary listing recommendations to the publicly funded drug plans in Canada (except Qu�bec). (http://cadth.ca/index.php//cdr) |
* Note: People living in the Northwest Territories and Nunavut, who do not have private health insurance, have coverage for those drugs listed on the federal Non-Insured Health Benefits (NIHB) Formulary.
Arthritis Consumer Experts
ACE thanks the Arthritis Research Centre of Canada (ARC) for its scientific review of JointHealth™
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