Hepatitis C: An In-Depth Guide
General information on drug coverage and benefit programs offered by the provincial, territorial and federal governments can be found here.
Coverage for Hepatitis C Medications
British Columbia offers its residents a variety of comprehensive drug plans through PharmaCare. PharmaCare provides financial assistance to residents for eligible prescription drugs and medical supplies to ensure that people have access to the drugs they need. Residents must be actively registered with the Medical Services Plan (MSP) in order to apply for benefits through any PharmaCare plan.
To apply for PharmaCare, people can either register online 24 hours a day, 7 days a week or can call (604) 683-7151 from Vancouver or toll-free 1-800-663-7100 in the rest of BC for more information.
How do you apply for coverage of Hep C medications?
In British Columbia, the following hepatitis C treatment medications are included in the Limited Coverage Drug Program and are eligible for coverage by PharmaCare:
- asunaprevir and daclatasvir
- daclatasvir and sofosbuvir
- Epclusa (velpatasvir and sofosbuvir)
- Harvoni (ledipasvir + sofosbuvir)
- sofosbuvir (taken in combination with ribavirin)
- Zepatier (grazoprevir and elbasvir)
These hepatitis C medications require prior approval before they can be covered by the program. To apply for approval people can request that their specialist complete and submit the Special Authority Request Form for the medication they want to take and send it to PharmaCare for review.
Some of the factors that may be considered when approving funding for hepatitis C medications include:
- a positive HCV RNA test
- HCV genotype
- elevated ALT levels and/or level of fibrosis
- whether or not an individual is living with chronic hepatitis C
In B.C., a person needs to have a certain level of liver injury (fibrosis stage 2) to qualify for treatment coverage. However, a person does not need to meet this requirement if they have one or more of the following issues:
- Coinfection with HIV or hepatitis B
- Fatty liver disease
- Has previously had an organ transplant
- other health problems caused by hepatitis C that affect parts of the body other than the liver (extra-hepatic manifestations)
- Chronic kidney disease (stage 3, 4 or 5)
- Diabetes and receiving treatment anti-diabetic mediations
- Are of child bearing age and are planning to get pregnant within the next 12 months
The full criteria for hepatitis C medications can be found in the Limited Coverage Drug Program Criteria Information document.
The amount of coverage people can receive for their hepatitis C medications varies depending on the PharmaCare plan for which they are eligible. People who receive Income Assistance from the Ministry of Housing and Social Development automatically receive health benefits and coverage for prescription drugs through Plan C.
What about coverage under the Non-Insured Health Benefits program?
Registered First Nations and recognized Inuit people may be able to access coverage for their hepatitis C medications through the Non-Insured Health Benefits (NIHB) program. For more information, people can visit the NIHB website or be in touch by phone or mail at:
Non-Insured Health Benefits – British Columbia Region
First Nations Health Authority
757 West Hastings Street, Suite 540
The Alberta region currently serves NIHB-eligible Inuit and non-residents living in British Columbia, at 1-800-663-7100.