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

Arthritis

Ankylosing Spondylitis (updated April 1, 2011)
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	Listed - SA 10-12-10
AB	Listed - SA	Listed - SA	Listed - SA	Listed – SA 07-2010
ON	Listed 21-04-10	Listed - SA	Listed - SA	Listed - SA
QC	Listed - SA	Listed - SA	Listed - SA	Listed - SA
NB	Listed - SA	Listed - SA	Listed - SA	Listed – SA 06-2010

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 April 1, 2011)
Medications	abatacept (Orencia®)	etanercept (Enbrel®)
Health Canada	29-06-06	29-07-03
Common Drug Review	22-04-09 LWC	Pre-CDR
BC	Listed 01-09-2010	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

Psoriatic Arthritis (updated April 1, 2011)
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	Listed - SA 07-2010
ON	NA	Listed – SA	Listed – SA	Under review	Listed - SA
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 April 1, 2011)
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	Listed – SA 07-12-10	Listed SA 22-02-11	Under Review
AB	Listed - SA	Listed - SA 07-2010	Under review	Under Review
ON	Listed - SA	Listed – SA 28-10-10	Listed - SA 1-10-10	Under Review
QC	Listed - SA	Listed - SA 03-02-10	Declined 03-02-10	Listed SA 01-02-11
NB	Listed - SA	Listed - SA	Declined 30-11-10	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

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Bipolar (Part 1 of 2) (updated April 1, 2011)
Medications	olanzapine (Zyprexa©)	ziprasidone (Zeldox©)	aripiprazole (Abilify©)	risperidone (Risperdal©/ Consta©)
Health Canada	1996	23-12-08	09-07-2009	2003
CDR	NA	NA	DNL 27-04-10	NA
BC	Declined 10-06-10 Under review Since 8-04-03 (This medication is listed SA for schizophrenia).	This medication is listed SA for schizophrenia and related psychotic disorders. No information on its' status for bipolar or depression.	Under review for schizophrenia since 27-04-2010	This medication is listed SA for schizophrenia. No information on its' status for bipolar. However it is being used to treat bipolar.
AB	Listed - OB (NI)	Listed - OB 01-02-09	Declined 07-2010	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 - – SA* (I)	Listed - SA*	Declinced 29-12-10	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	Listed – OB 19-11-10 (Under review since 05-10-05)	Listed – SA (plan G)	Listed – OB 30-09-09
AB	Listed – SA	Listed - OB	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 30-11-10

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; 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

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Hepatitus C (updated April 1, 2011)
Medications	peginterferon alfa-2a and Ribavirin (Pegasys RBV®)	peginterferon alfa-2b / ribavirin (Pegetron Redipen Single Dose Delivery System plus RibavirinV)
Health Canada	noc 10-05-04	na
CDR	List in similar manner to others in class 14-05-04	NA
BC	Listed - SA 07-02-05	Listed - SA 02-02-05
AB	Listed - SA	Listed - SA
ON	Listed - SA	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

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Major Depressive Disorder (MDD) (updated April 1, 2011)
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)	Declined 30-11-10 Under review since 11-03-08	Listed – OB 27-08-09	Declined 06-12-10 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	Listed - SA	Declined	Declined 01-04-10	No information for MDD Declined for schizophrenia 01-02-08
QC	Listed – OB	Listed – OB	Declined	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 11-03-2010	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; NA = not applicable

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Mood Disorders (updated April 1, 2011)
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

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Multiple Sclerosis (updated April 1, 2011)
Medications	natalizumab (Tysabri®)	Interferon beta-1a (Avonex®)	Interferon beta-1b (Betaseron®)	Glatiramer acetate (Copaxone®)	interferon beta 1-a (Rebif®)	Interferon beta 1-b (Extavia®)
Health Canada	2006-09-28	1998-04-06	1995-07-19	1997-09-04	1998	2009-11-27
CDR	RTL 25-02-09	NA	NA	NA for MS DNL (for indication of CIS) 25-11-09	NA	NA
BC	Listed - SA 26-10-10 Under review since 07-12-09	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)	Listed - SA 26-10-10 Under review for CISsince 21-07-09	Rebif initiation pack Listed – SA 19 -12-06 (under review since 10-July-06) Rebif (new indication)* Under review23-March-04	Listed - SA 26-10-10
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)	Listed - SA 01-02-11
ON	Listed – SA 08-2010 *funded through the Exceptional Access Program (EAP)	Listed - SA*	Listed - SA*	Listed - SA	Listed - SA (Note: Rebif initian pack declined listed by the CED-Feb 2010)	Listed - SA 21-03-11
QC	Listed - OB	Listed - OB	Listed - OB	Listed - SA 23-02-10	Listed - OB	Listed - SA 02-11
NB	Listed - SA 11-03-10	Listed - MS Program	Listed - MS Program	Listed - MS Program	Listed - MS Program	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

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Osteoporosis (Part 1 of 2) (updated April 1, 2011)
Medications	teriparatide (rDNA origin) (Forteo®)			alendronate sodium-cholecalciferol (Fosavance 70/5600®)	alendronate sodium-cholecalciferol (Fosavance®)	raloxifene (Evista®)
Indication	Osteoporosis	Osteoporosis (glucocorticoid induced)	Severe osteoporosis	Osteoporosis	Osteoporosis	Osteoporosis
Health Canada	03-06-04	07-07-08	NA	06-08-08	03-02-06	06-11-98
CDR	DNL 22-12-04	DNL 22-07-09	DNL 17-03-10	List in manner similar to others in class	DNL 27-09-06	NA
BC	Declined 22-12-04	Declined 22-07-09	Declined 14-06-10	Listed - SA 17-11-09	Declined 27-09-06	NA
AB	Declined	Declined	Declined	Listed - SA	Declined	Listed - SA
ON	Declined	Declined	Declined	Listed - OB	Listed - OB	Listed - SA
QC	Listed - SA	Listed - SA	Listed - SA	Listed - OB	Declined	Listed - SA
NB	Declined	Declined	Declined	Listed - SA	NA	Listed - SA

Osteoporosis (Part 2 of 2) (updated April 1, 2011)
Medications	teriparatide (rDNA origin) (Forteo®)			zoledronic acid (Aclasta®)	denosumab (Prolia®)
	(Actonel®150mg)	(Actonel®75mg)	(Actonel®5mg/30mg/35mg)
Indication	Osteoporosis	Osteoporosis	Osteoporosis	Osteoporosis	Osteoporosis
Health Canada	24-09-08	17-07-07	5mg 17-07-00 35mg 19-12-09 30mg 18-08-99	30-06-05	06-08-10
CDR	NA	NA	NA	DNL 25-06-08	List (with criteria) 30-03-11
BC		NA	NA	Declined 15-01-11	Under review
AB	Under review since 11-08-09	Declined	Listed - SA	Listed - SA	Under review
ON	Listed - OB	NA	Listed - OB	Listed - SA (for Paget's Disease)	Under review
QC	Listed - OB	Listed - OB	Listed - OB	Listed - SA	Listed - SA
NB	NA	NA	Listed - OB	Listed - SA (for Paget's Disease)	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

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Parkinson's Disease (updated April 1, 2011)
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	Declined 31-03-11
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	Listed – SA 08-2010 *funded through the Exceptional Access Program (EAP)	Declined 10-10
QC	Listed	Listed	Listed	Listed	Listed - SA	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; NA = not applicable

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Schizophrenia (Part 1 of 2) (updated April 1, 2011)
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) (updated April 1, 2011)
Medications	paliperidone (Invega®)	quetiapine fumarate (Seroquel XR®)	Ziprasidone (Zeldox®)	Aripiprazole (Abilify®)	paliperidone palmitate (Invega Sustenna®)
Health Canada	2007	2007	27-08-07	09-07-09	30-06-10
CDR	DNL 28-May-2008	NA	LWC 14-Aug-2008	DNL 27-04-10	Under review since 09-07-19
BC	Listed - OB	Listed - OB 09-07-08 (Sub:01-10-07	Listed - SA 01-06-09	Under review since 06-01-10	Under review
AB	Declined 23-05-09	Declined 01-02=-8	Listed 01-02-2009	Declined	Under review
ON	Listed 01-11-09	Listed - OB (NI)	Listed	Declined	Under review
QC	Declined 23-01-10	Listed - OB (NI)	Listed - OB (NI)	Declined 01-06-10	Under review
NB	Under review since 11-07	Listed - OB 30-11-10	Listed - OB 2009	Declined 12-10	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; RB = restricted benefit

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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