Arthritis Consumer Experts

September 30, 2020
For Immediate Release


Reimbursement access for arthritis medications continues to change across Canada – Where does your Province rank?

(Vancouver) - Arthritis Consumer Experts (ACE) today released the new edition of its Arthritis Medications Report Card – designed to help Canadians evaluate where their province ranks in terms of providing reimbursement for medications approved for inflammatory arthritis (IA) such as rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis and juvenile idiopathic arthritis.

Over the past year, pharmaceutical policy decisions 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 ACE Arthritis Medications Report Card.

Commenting on the performance of the public drug plans across Canada, ACE President, Cheryl Koehn stated: “It is the responsibility of our governments to make sure everyone has access to and can afford the medication they need. ACE will continue to closely monitor and meet with the publicly funded drug plans to ensure they are aware of the unmet needs of arthritis patients and provide equitable access to life-changing medications.”

Advanced therapies to treat IA, 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 enable IA patients to manage their chronic disease. However, research in Canada continues to demonstrate that patients with IA still have unmet medication needs. The gaps in treatment are a reflection of the fact that IA is a complex 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 as well as reimbursement for a range of advanced therapies in each province’s drug coverage plan.

About the Report Card

Arthritis Consumer Expert's annual Arthritis Medications Report Card is Canada’s only independent patient organization evaluation of public reimbursement access to inflammatory 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 ranks twelve publicly funded medication formularies based on the number of medically necessary arthritis medications they list from the medication treatments Health Canada has authorized to treat inflammatory arthritis, including:
  • Biologic response modifier (originator or “boDMARD”)
  • Biologic response modifier (biosimilar or “bsDMARD”)
  • Targeted synthetic molecule (tsDMARD)
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.

ACE Arthritis Medications Report Card Highlights:
  • Ontario has retained its top-ranking position due to the addition of six medications to its drug plan, meaning more patients have received affordable access to medications they need.
  • Provinces that most improved their ranking include Quebec (4th in 2019, 2nd in 2020); British Columbia (4th in 2019, 3rd in 2020); Nova Scotia (10th in 2019, 6th in 2020); and New Brunswick (9th in 2019, 6th in 2020)
  • Provinces whose ranking declined include Saskatchewan (1st in 2019, 5th in 2020); Newfoundland and Labrador (6th in 2019, 9th in 2020); and Prince Edward Island (6th in 2019, 10th in 2020)
  • Non-Insured Health Benefits for First Nations (NIHB) and Yukon have retained low positions on the Report Card over the past 12 months with rankings of 11th and 12th respectively. NIHB and Yukon have a low ranking over the past 12 months due to the relative low number of new additions to their formularies and the high number of medications “under review,” reducing affordable access to medications patients need.
About Arthritis Consumer Experts

Arthritis Consumer Experts is a national arthritis organization that provides free, science-based information and education programs in both official languages to people with arthritis. Founded and led by people with arthritis, ACE also actively advocates on arthritis health and policy issues, through ACE’s JointHealth™ family of programs and the Arthritis Broadcast Network, directly to consumers/patients, healthcare professionals, media and government. ACE is guided by a strict set of guiding principles, set out by an advisory board comprised of leading scientists, medical professionals and informed arthritis consumers.

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