ODSP and Ont Drug Benefits

konakat

Has anyone had luck getting Ont Drug Benefits program to pay for a drug not in their formulary through the Exceptional Access Program?  While Tykerb is approved for use, the Ont Drug Benefit program doesn't cover the cost and I don't have private insurance for prescriptions.  :-(   Also, does anyone know the pharma company does compassionate funding -- I couldn't find any info on their website.  Thanks for any help.

konakat

I've just learnt that the makers of Tykerb in Canada are not interested in compassionate care/funding anymore.  With Tykerb costing about $4000/month, even with insurance it's not that affordable.  Unless you can get on a clinical trial you're SOL.  Oh well...

Frankie_

This really peeves me! Are there any other drugs that are NOT covered? How does one find out which drugs are on the list? Also I am disappointed that Canada does not offer some of the clinical trails as other countries do. I would LOVE to have more knowledge and facts and bring this to the media! I feel the need to try and do something about this issue. We need access to these drugs to prolong our lives!

Frankie_

What is the difference between the Ont. Drug Program vs the Exceptional access Program? Does one provide certain drugs over the other? If so, why? Isn't this discrimination?

konakat

The ON Drug Benefit Program is for people on disability (i.e., me).  I have a feeling that the Exceptional Access Program relies on negotiating a deal with the pharma companies.  The EAP comes into play when there are absolutely no options left -- I will tap into it, if and when I need to.

This is where healthcare in Canada and the US become the same -- for prescription drugs (Tykerb is a pill, not an IV drug, so it's not automatically covered by OHIP).  You need excellent prescription drug insurance, lots of money, or you do without when it comes to expensive prescriptions. Sucks the big one but it's all about money...  I can get it, I just can't afford it.

konakat

Reminds me of when I posted a complement and thank-you to a woman who got Xeloda (another pill) covered by the ON drug Benefit program a year or so ago (reported in the Globe an Mail).  You wouldn't believe the hostility I faced.  Things like, "I don't want you to die, but...".  Not worth the money.  Money better spent elsewhere...  It was quite hurtful.

Frankie_

That just stinks! People wouldn't make such awful comments if it was them or their loved ones going through the same issues. Cancer can strike anyone-don't they see that?

Do you have other drug options for your HER2 status besides tykerb that you can take? This just makes me so mad.

konakat

Not that I know of -- there are clinical trials though.  Hopefully be on one before the end of the month.  Thanks for your concern Frankie!  So sweet!! 

Dragonfli

Hi Konakat,

 Have you visited the link below to see if Tykerb can be covered in Ontario? http://drugcoverage.ca/p_benefit_on.asp#5

konakat

Yes, I checked and it isn't covered by the ON Drug Benefit Plan.  I don`t have employer or private insurance to help out with th cost.  :-(  Hopefully I`ll be getting it free on the clinical trial soon.  :-)