Report Cards

Same Disease, Different Access: Medication reimbursement in BC compared to other provinces

While British Columbia has made strides in access to medications on the public formulary, the Province is still behind many provinces in providing reimbursement for medically necessary and evidence-based medications. Here are just three examples:

Multiple Sclerosis:
- Interferon beta-1b (Betaseron®): after being under review for two years, this medication was declined in BC yet is listed in many other provinces, including Alberta, Ontario, Quebec and New Brunswick
Parkinson's Disease:
- pramipexole (Mirapex®): not covered in BC, but is included in other provinces, including Alberta, Ontario, Quebec and New Brunswick
Bipolar disorder:
- risperidone (Risperidal M®): has been under review in BC since 2005, but has been listed in other provinces, including Alberta, New Brunswick, Quebec and Ontario

Multiple Sclerosis (updated July 1, 2009)
Medications	natalizumab (Tysabri®)	Interferon beta-1a (Avonex®)	Interferon beta-1b (Betaseron®)	Glatiramer acetate (Copaxone®)	interferon beta 1-a (Rebif©)
Health Canada	2006-09-28	1998-04-06	1995-07-19	1997-09-04	1998
CDR	RTL 25-02-09	NA	NA	NA for MS DNL (for indication of CIS) 25-11-09	NA
BC	Under review 07-12-09 (re-submission from earlier Non-Benefit decision on 31-12-09)	Listed SA 24-03-06 (under review since Dec.05) *still under review for early MS	Listed – SA (Declined 23-12-08 for early or suspected MS diagnosis)	Under review 12/09/06* (MS) Under review for CIS since 21-07-09	Rebif initiation pack listed - SA 19-12-06 (under review since 10-07-06) Rebif (new indication)* Under review 23-03-04
AB	Listed – SA (MS program) July 2009	Listed - SA (MS program) Nov-01	Listed - SA (MS program) 01-11-01	Listed - SA (MS program) 01-10-02	Listed - SA (MS program)
ON	Listed – SA 23-04-10	Listed - SA*	Listed - SA*	Listed - SA	Listed - SA (Note*: Rebif initiation pack declined listing by the CED - Feb. 2010)
QC	Listed - OB	Listed - OB	Listed - OB	Listed - SA 23-02-10	Listed - OB
NB	Listed - SA 11-03-10	Listed - MS Program	Listed - MS Program	Listed - MS Program	Listed - MS Program

OB = Open Benefit (open listing); RTL = Recommend to list; DNL = Do not List; LWC: List with Conditions; I – Interchangeable; NOC = notice of compliance; SA = special authority; NA = not applicable

Major Depressive Disorder (MDD) (updated July 1, 2010)
Medications	bupropion hydrochloride (Wellbutrin XL®)	duloxetine hydrochloride (Cymbalta®)	escitalopram (Cipralex®)	desvenlafaxine succinate (Pristiq®)	quetiapine fumarate (Seroquel XR®)
Health Canada	16-01-06	01-11-07	01-03-06	04-02-09	29-05-08
CDR	NA	LWC 14-08-08	DNL 24-01-07	DNL 23-09-09	NA
BC	Listed – SA 11-04-06 (Under review for criteria changes since 23-10-06)	Under review since 11-03-08	Listed – OB 27-08-09	Under review since 12-05-09	Listed – OB for schizophrenia 09-07-08 (No information on its status for bipolar or depression.)
AB	Listed – OB	Under review (Listed October 1, 2009 for neuropathic pain associated with diabetic peripheral neuropathy)	Declined listing	Declined 01-04-10	No information for MDD Declined for schizophrenia 01-02-08
QC	Listed – OB	Listed – OB	Declined Listing	Under review	Listed – OB
ON	Listed – SA	Listed – OB	Listed - OB November 2008*	Under review	Listed – OB
NB	Listed – OB	Declined Listing 09-02-09 (Listed for diabetes patients with peripheral neuropathic pain)	Declined Listing 24-05-07	Declined 11-03-10	Declined Listing

OB = Open Benefit (open listing); RTL = Recommend to list; DNL = Do not List; LWC: List with Conditions; I – Interchangeable; NOC = notice of compliance; SA = special authority

Parkinson's Disease (updated July 1, 2010)
Medications	Carbidopa / Levodopa (Sinemet®)	entacapone (Comtam®)	pramipexole (Mirapex®)	Carbidopa / levodopa / entacapone (Stalevo®)	Rasagiline mesylate (Azilect®)	Levodopa / carbidopa (Duodopa®)
Health Canada	15/08/00	08/05/01	29/1/98	Feb-08	17/08/06	01/03/07
CDR	Pre-CDR	Pre-CDR	Pre-CDR	RTL 16-10-08	DNL 28-03-07	DNL 22-07-09
BC	Listed - SA (I)	Listed - SA	Declined	Listed – SA 05-06-09	Declined 07-06-07	Under review 14-01-09
AB	Listed - OB 01-01-92 (I)	Listed - OB	Listed - OB 01-10-98 (I)	Listed - OB 01-01-09	Declined	Declined 04-10
ON	Listed - SA (I)	Listed - SA (NI)	Listed - OB (I)	Listed - SA 02-03-09	Declined	Under review
QC	Listed	Listed	Listed	Listed	Listed	Declined 01-06-09
NB	Listed (coverage under certain plans; interchangeable)	Listed - SA	Listed (coverage under certain plans; interchangeable)	Listed - SA 2009	Declined 18-07-07	Declined 11-03-10

OB = Open Benefit (open listing); RTL = Recommend to list; DNL = Do not List; LWC: List with Conditions; I - Interchangeable; NOC = notice of compliance; SA = special authority

Bipolar (Part 1 of 2) (updated July 1, 2010)
Medications	olanzapine (Zyprexa©)	ziprasidone (Zeldox©)	aripiprazole (Abilify©)	risperidone (Risperdal©/ Consta©)
Health Canada	1996	23-12-08	09-07-2009	2003
CDR	NA	NA	NA	NA
BC	Declined Under review Since 8-04-03 (This medication is listed SA for schizophrenia).	This medication is listed SA for schizophrenia. No information on its’ status for bipolar or depression.	NA	This medication is listed SA for schizophrenia. No information on its’ status for bipolar.
AB	Listed - OB (NI)	Listed - OB 01-02-09	NA	Listed – SA
QC	Listed - OB (NI)	Listed - OB (NI)	NA	Listed - OB (NI)
ON	Listed - OB (I/NI)	Under review	NA	Listed – OB for schizophrenia. No information on its’ status for bipolar.
NB	Listed - OB* (I)	Listed - SA*	NA	Declined

Bipolar (Part 2 of 2)
Medications	risperidone (Risperdal M)	lamotrigine (Lamictal©)	quetiapine fumarate (Seroquel XR®)
Health Canada	18-06-03	21-11-94	27-05-09 22-08-08
CDR	NA	NA	NA
BC	Under review since 05-10-05	Listed – SA (plan G)	Listed – OB 30-09-09
AB	Listed – SA	Listed - OB Jan 02, 2009	Listed – OB (only listing information for Seroquel®)
QC	Listed – OB(I)	Listed – OB (NI)	Listed – OB (no information on its’ listing indication)
ON	Listed – OB (no specific indication noted)	Listed - LU	Listed – OB (no information on its’ listing indication)
NB	Listed - SA (NI)	Listed OB (I)	Listed – OB (only listing information for Seroquel®)

OB = Open Benefit (open listing); RTL = Recommend to list; DNL = Do not List; LWC: List with Conditions; I – Interchangeable; NOC = notice of compliance; SA = special authority; LU – Limited Use.

Health Canada: quetiapine: NOC: 29.05.08 for monotherapy bipolar; 22.08.08 for bipolar I and II; 27.05.05 for major depressive disorder Alberta -* in Alberta they use the term restricted benefit

NB: * - Requests for coverage of Zeldox (ziprasidone hydrochloride) will be considered under special authorization. Prescriptions written by psychiatrists do not require special authorization. Subsequent refills may be ordered by other practitionersOntario: Zeldox:
https://www.healthinfo.moh.gov.on.ca/formulary/SearchServlet?searchType=drugName&keywords=Seroquel%20XR&sort=drugName&phrase=exact

Schizophrenia (Part 1 of 2) (updated July 1, 2010)
Medications	Clozapine (Clozaril©)	risperidone (Risperdal©)	olanzapine (Zyprexa©)	quetiapine (Seroquel©)	risperidone (Risperdal© / Consta©)
Health Canada	1991	1995	1996	1998	2003
CDR	NA	NA	NA	NA	NA
BC	Listed - OB	Listed - OB	Listed - SA 25-Jul-2008 (Sub: 25-May-2007)	Listed - OB	Listed - SA 19-Feb-2007 (Sub: 18-Feb-2005) (schiz/psych.epis)
AB	Listed - OB (NI)	Listed - RB	Listed - OB (I)	Listed - OB (I)	Listed - RB
ON	Listed - OB (I)	Listed - OB (I/NI)	Listed - OB (I/NI)	Listed - OB (I)	Listed - RB (NI)
QC	Listed - OB (I)	Listed - OB (I)	Listed - OB (NI)	Listed - OB (NI)	Listed - OB (NI)
NB	Listed - SA (I)	Listed - OB (I)	Listed - SA (I)	Listed - OB (NI)	Listed - SA (NI)

Schizophrenia (Part 2 of 2)
Medications	olanzapine (Zyprexa ©IM)	paliperidone (Invega©)	quetiapine fumarate (Seroquel XR©)	Ziprasidone (Zeldox©)	Aripiprazole (Abilify®)
Health Canada	2004	2007	2007	27.08.07	09.07.09
CDR	NA	DNL 28-May-2008		LWC 14-Aug-2008	DNL 27-04-10
BC	Declined	Listed - OB	Listed - OB 09-Jul-2008 (Sub: 01-Oct-2007)	Listed - SA June 1, 2009	Under review since 06-01-10
AB	Declined	Declined May 23, 2009	Declined Jan. 2, 2008	Listed Feb. 1, 2009	NA
ON	Declined	Declined Nov.08	Listed - OB (NI)	Under review since Mar 08	NA
QC	Listed - OB (NI)	Under review	Listed - OB (NI)	Listed - OB (NI)	Declined 01-06-10
NB	Declined	Under review since Nov.07	Declined	Listed - OB 2009	NA

OB = Open Benefit (open listing); RTL = Recommend to list; DNL = Do not List; LWC: List with Conditions; I - Interchangeable; NOC = notice of compliance; SA = special authority; RB = restricted benefit

Mood Disorders (updated November 1, 2009)
Medications	olanzapine (Zyprexa©)	ziprasidone (Zeldox©)	aripiprazole (Abilify©)	risperidone (Risperdal© / Consta©)	risperidone (Risperdal M©)	lamotrigine (Lamictal©)
Health Canada	1996	27/08/07	Under review	2003	18/06/03	21/11/94
CDR	NA	LWC 14-Aug-2008	NA	NA	NA	NA
BC	Under review Since 8-April-2003	Listed - SA June 1, 2009	N/A	Listed - SA 19-Feb-2007 (schiz/psych.epis)	Under review since 05-Oct-2005	Listed - SA (plan G)
AB	Listed - OB (NI)	Listed - OB Feb 2009	N/A	Listed - RB*	Listed - RB*	Listed - OB
QC	Listed - OB (NI)	Listed - OB (NI)	N/A	Listed - OB (NI)	Listed - OB (I)	Listed - OB (NI)
ON	Listed - OB (I/NI)	Under review	N/A	Listed - OB (for schizophrenia)	Listed - OB (no notes)	Listed - LU
NB	Listed - SA* (I)	Listed – SA *	N/A	Not listed***	Listed - SA (NI)	Not listed **

OB = Open Benefit (open listing); RTL = Recommend to list; DNL = Do not List; LWC: List with Conditions; I – Interchangeable; NOC = notice of compliance; SA = special authority; NA = not applicable

Psoriatic Arthritis (updated July 1, 2010)
Medications	abatacept (Orencia®)	adalimumab (Humira®)	etanercept (Enbrel®)	infliximab (Remicade®)	golimumab (Simponi®)
Health Canada	In clinical trials	20-06-06	08-01-04	07-06-06	07-04-09
Common Drug Review	NA	LWC 29-11-06	Pre-CDR	Pre-CDR	LWC 24-03-10
BC	NA	Listed – SA 12-10-07	Listed – SA 02-04 -07	Listed – SA 14-03-08	Under review 20-01-10
AB	NA	Listed – SA	Listed – SA	Listed – SA	Under review
ON	NA	Listed – SA	Listed – SA	Under review	NA
QC	NA	Listed – SA	Listed – SA	Listed – SA	Listed – SA 01-06-10
NB	NA	Listed – SA	Listed – SA	Listed – SA	Listed – SA 06-10

OB = Open Benefit (open listing); RTL = Recommend to list; DNL = Do not List; LWC: List with Conditions; I – Interchangeable; NOC = notice of compliance; SA = special authority; NA = not applicable

Rheumatoid Arthritis (Part 1 of 2) (updated July 1, 2010)
Medications	abatacept (Orencia®)	adalimumab (Humira®)	etanercept (Enbrel®)	infliximab (Remicade®)
Health Canada	29-06-06	24-09-04	01-12-00	27-09-01
Common Drug Review	LWC 07-06-07	LWC 09-11-06	Pre-CDR	Pre-CDR
BC	Listed – SA 30-06-08	Listed – SA 18-07-05	Listed - SA	Listed - SA
AB	Listed - SA	Listed - SA	Listed - SA	Listed - SA
ON	Listed - SA	Listed - SA	Listed - SA	Listed - SA
QC	Listed - SA	Listed - SA	Listed - SA	Listed - SA
NB	Listed - SA	Listed - SA	Listed - SA	Listed - SA

Rheumatoid Arthritis (Part 2 of 2)
Medications	rituximab (Rituxan®)	golimumab (Simponi®)	certolizumab pegol (Cimzia®)	tocilizumab (Actemra®)
Health Canada	16-06-06	07-04-09	12-08-09	30-04-10
Common Drug Review	LWC 14-02-07	LWC 24-03-10	DNL 05-27-10	Under Review
BC	Listed – SA 30-06-08	Under review since 20-01-10	Under review Since 19-10-09
AB	Listed - SA	Under review	Under review
ON	Listed - SA	Under review	Under review
QC	Listed - SA	Declined 03-02-10	Declined 03-02-10
NB	Listed - SA	Listed - SA	Under review

OB = Open Benefit (open listing); RTL = Recommend to list; DNL = Do not List; LWC: List with Conditions; I – Interchangeable; NOC = notice of compliance; SA = special authority; NA = not applicable

Ankylosing Spondylitis (updated July 1, 2010)
Medications	adalimumab (Humira®)	etanercept (Enbrel®)	infliximab (Remicade®)	golimumab (Simponi®)
Health Canada	17-10-06	NA	NA	07-04-09
Common Drug Review	17-10-06	Pre-CDR	Pre-CDR	LWC 24-03-10
BC	Listed – SA 14-03-08	Listed – SA 14-03-08	Listed - SA 14-03-08	Under review since 20-01-10
AB	Listed - SA	Listed - SA	Listed - SA	NA
ON	Listed 21-04-10	Listed - SA	Listed - SA	NA
QC	Listed - SA	Listed - SA	Listed - SA	Declined 03-02-10
NB	Listed - SA	Listed - SA	Listed - SA	Listed – SA 06-10

OB = Open Benefit (open listing); RTL = Recommend to list; DNL = Do not List; LWC: List with Conditions; I – Interchangeable; NOC = notice of compliance; SA = special authority; NA = not applicable

Juvenile Idiopathic Arthritis (updated July 1, 2010)
Medications	abatacept (Orencia®)	etanercept (Enbrel®)
Health Canada	29-06-06	29-07-03
Common Drug Review	22-04-09 LWC	Pre-CDR
BC	Under review since 18-03-09	Listed - SA
AB	Listed 04-10	Listed - SA
ON	Under review	Listed - SA
QC	Listed - SA	Listed - SA
NB	Listed - SA	Listed - SA

OB = Open Benefit (open listing); RTL = Recommend to list; DNL = Do not List; LWC: List with Conditions; I – Interchangeable; NOC = notice of compliance; SA = special authority; NA = not applicable

Health Canada: www.hc-sc.gc.ca/dhp-mps/prodpharma/sbd-smd/phase1-decision/drug-med/nd_ad_2008_zeldox_078188-eng.php
CDR: paliperidone (Invega©)http://cadth.ca/index.php/en/cdr/search?status=all&order_field=brand_name&keywords=invega; Zeldox (http://cadth.ca/index.php/en/cdr/search?status=all&order_field=brand_name&keywords=zeldox);
BC: olanzapine: This medication has also been listed(Maintenance of bipolar mania)
*since 08-Apr-2003 (Acute bipolar mania)
Under review since 22-Dec-2004 (Maintenance of bipolar mania)
AB: * RESTRICTED BENEFIT - This product is a benefit for patients 18 years of age and older for the management of the manifestations of schizophrenia and related psychotic disorders, as well as in severe dementia for the short-term symptomatic management of inappropriate behavior due to aggression and/or psychosis.
QC:
ON: LU - limited use: https://www.healthinfo.moh.gov.on.ca/formulary/SearchServlet?searchType=luNoteQuery&phrase=exact&keywords=281200059
NB:
*Special authority is not required when prescribed by a psychiatrist; **This medication is listed for epilepsy and Lennox Gastaut syndrome; ***Only listed for schizophrenia or schizoaffective disorder patients

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