JointHealth™ express November 30, 2011
ACE Report Card Reveals Inequality of Reimbursement Access to Critical Arthritis Medications for Canadians with Arthritis
Earlier this week, Arthritis Consumer Experts (ACE) released its annual print version of the 2011 JointHealth™ Report Card on Provincial Formulary Reimbursement Listings for Biologic Response Modifiers with the November issue of JointHealth™ monthly. The Report Card ranks publicly funded medication formularies based on the number of medically necessary arthritis medications they list out of a possible eight, for four of the most common types of inflammatory arthritis.
The 2011 JointHealth™ Report Card reveals that in the last year while some provinces increased the number of arthritis medications they would provide reimbursement for, others either did not or they continued to make the process for receiving coverage more complicated compared to others.
Since the Report Card was originally published in 2005, many improvements have been made to formularies across Canada, but access to reimbursement for publicly funded arthritis medications still varies across Canada.
Where you live in Canada, may mean the difference between living a full, active life with arthritis and being debilitated by the disease. That is unfair.
For example, Ontario still lags behind British Columbia, Alberta, Saskatchewan, and Quebec in meeting the best clinical standards in reimbursement access. As the province with the largest population, that is unacceptable. While Alberta covers the same number of biologics as BC, Quebec, and Saskatchewan, its criteria for coverage of certain medications is overly restrictive. Also, Manitoba and the Yukon still list the fewest number of medications, having made no improvements in the last year.
The table below provides the current provincial rankings and their status change since the 2010 Report Card.
To address these inequalities in reimbursement access for critical arthritis medications, ACE has informed the media with three press releases, one that describes the national issue, one that specifically deals with Alberta’s overly restrictive criteria, and one about Ontario lagging behind other provinces.
Click here to view the press releases.
Click here to view the Report Card.
You can be a part of the solution. Help raise awareness of this issue by writing a letter to your local newspaper or elected official. For tips, please go to the “What you can do” page of the JointHealth™ website.
ACE Report Card Reveals Inequality of Reimbursement Access to Critical Arthritis Medications for Canadians with Arthritis
Earlier this week, Arthritis Consumer Experts (ACE) released its annual print version of the 2011 JointHealth™ Report Card on Provincial Formulary Reimbursement Listings for Biologic Response Modifiers with the November issue of JointHealth™ monthly. The Report Card ranks publicly funded medication formularies based on the number of medically necessary arthritis medications they list out of a possible eight, for four of the most common types of inflammatory arthritis.
The 2011 JointHealth™ Report Card reveals that in the last year while some provinces increased the number of arthritis medications they would provide reimbursement for, others either did not or they continued to make the process for receiving coverage more complicated compared to others.
Since the Report Card was originally published in 2005, many improvements have been made to formularies across Canada, but access to reimbursement for publicly funded arthritis medications still varies across Canada.
Where you live in Canada, may mean the difference between living a full, active life with arthritis and being debilitated by the disease. That is unfair.
For example, Ontario still lags behind British Columbia, Alberta, Saskatchewan, and Quebec in meeting the best clinical standards in reimbursement access. As the province with the largest population, that is unacceptable. While Alberta covers the same number of biologics as BC, Quebec, and Saskatchewan, its criteria for coverage of certain medications is overly restrictive. Also, Manitoba and the Yukon still list the fewest number of medications, having made no improvements in the last year.
The table below provides the current provincial rankings and their status change since the 2010 Report Card.
| PROVINCE | 2011 RANKING |
2010 RANKING |
REASON FOR RANKING CHANGE |
| BC | 1st | 2nd | Up from last year due to improvement in number of listings and less restrictive reimbursement criteria |
| Quebec | 2nd | 1st | Down from last year due to not adding certolizumab pegol and golimumab for RA, while BC did. |
| Saskatchewan | 2nd | 2nd | Same position (it made improvements, just not as many as BC) |
| Alberta | 4th | 2nd | Down from last year due to overly restrictive coverage criteria for tocilizumab (Actemra®) and abatacept (Orencia®) |
| New Brunswick | 5th | 4th | Down from last year due to declining to list certolizumab pegol; improvements made, but relative to other provinces, not as much |
| Newfoundland and Labrador |
5th | 4th | Down from last year because it hasn't approved certolizumab yet; improvements made, but relative to others not as much |
| Ontario | 5th | 7th | Up from last year due to improved reimbursement coverage criteria, but still lagging behind 4 other jurisdictions |
| Nova Scotia | 8th | 7th | Down from last year due to certolizumab pegol still being under review; improvements made, but relative to other provinces not as much |
| Prince Edward Island | 8th | 9th | Up from last year due to adding golimumab for 3 indications, adding abatacept and etanercept for JIA, and adding rituximab for RA; one of the provinces that made big changes, however, didn't result in much movement in ranking due to ranking being relative to other provinces |
| Non-Insured Health Benefits or “NIHB” | 8th | 9th | Up from last year due to adding golimumab for 3 indications, adding tocilizumab for RA, and adding abatacept and etanercept for JIA |
| Manitoba | 11th | 11th | Same as last year due to the fewest biologic response modifiers covered |
| Yukon | 12th | 12th | Same as last year due to the fewest biologic response modifiers covered |
To address these inequalities in reimbursement access for critical arthritis medications, ACE has informed the media with three press releases, one that describes the national issue, one that specifically deals with Alberta’s overly restrictive criteria, and one about Ontario lagging behind other provinces.
Click here to view the press releases.
Click here to view the Report Card.
You can be a part of the solution. Help raise awareness of this issue by writing a letter to your local newspaper or elected official. For tips, please go to the “What you can do” page of the JointHealth™ website.
Arthritis Consumer Experts
ACE thanks Arthritis Research Canada (ARC) for its scientific review of ACE and JointHealth™ information and education programs.