Hepatitis C: An In-Depth Guide

Manitoba

Prescription Drug Programs in Manitoba

Manitoba Pharmacare offers prescription drug coverage to eligible residents. Pharmacare, administered by Manitoba Health, is “a drug benefit program for any Manitoban, regardless of age, whose income is seriously affected by high prescription drug costs.” Manitobans who receive Pharmacare must pay a deductible based on their annual income. Those who cannot afford to pay the deductible in one lump sum may be able to pay it in monthly installments.

To be eligible for Pharmacare, a person must meet all of the following criteria:

  • be eligible for Manitoba Health coverage 
  • have no prescription drug coverage through any provincial or federal drug program
  • have no prescription drug coverage through a private health insurance program
  • have prescription drug costs that exceed the Pharmacare deductible

People who qualify for Pharmacare may be eligible to receive coverage for their hepatitis C medications.

Coverage for Hepatitis C Medications

Once a person's application for Pharmacare has been approved, Pharmacare sends a letter confirming what the person's deductible will be. This is the amount the recipient will pay each year. The deductible is based on the person's level of income. Once a person has paid their deductible, Pharmacare covers the entire cost of eligible prescription drugs. The amount of coverage a person can receive for their hepatitis C medications depends on their deductible. 

Employment and Income Assistance (EIA) clients receive health benefits and prescription drug coverage that will pay for their hepatitis C medications. People may want to talk to their hepatitis specialists and EIA case workers about their coverage options and to get help applying for benefits.

In Manitoba the provincial Exception Drug Status Program (EDS) outlines hepatitis C medications that are eligible for coverage.

There are no restrictions on provincial access to treatment based on level of liver injury (fibrosis stage) in Manitoba. Some other jurisdictions still have restrictions on who qualifies for treatment coverage based on fibrosis level.

For more information about Pharmacare or the EDS program, people can call the Provincial Drug Programs phone line at 1-800-297-8099.

Registered First Nations and recognized Inuit people are able to access coverage for their hepatitis C medications through the Non-Insured Health Benefits (NIHB) program.  People can contact NIHB by phone or mail at:

Non-Insured Health Benefits – Manitoba Region
First Nations and Inuit Health
Health Canada
391 York Avenue, Suite 300
Winnipeg, Manitoba
R3C 4W1
Toll-free 1-800-665-8507

 

Costs and Coverage for Treatment in Canada

Some programs can be accessed by all Canadians. Examples include:

Private health insurance

Some health insurance policies offered through private insurance companies include coverage for prescription drugs. These programs often have their own deductible, or co-pay fee, and may have yearly maximums for prescription drugs.

Programs offered by pharmaceutical companies

The pharmaceutical companies that make Hep C medications have programs to help people complete treatment.

These programs have phone support for people on treatment, and part of this support is helping people to access the funding necessary to cover treatment costs. These programs can inform patients about local, provincial, and federal government programs for accessing treatment and can help the patient find out ways to maximize any public funding or private medical insurance (including the appeals process, if the patient also has a supportive doctor). If a person is eligible, some programs can help cover the insurance company co-pay fee, provincial or territorial plan's deductible, and a number of other expenses, depending on a person's specific situation.

AbbVie has the AbbVie Care Program for people taking Holkira Pak (dasabuvir, ombitasvir, paritaprevir and ritonavir) or Maviret (glecaprevir and pibrentasvir). Bristol-Myers Squibb Canada has the CLAIRE Program for people taking Daklinza (daclatasvir). Gilead Sciences has the Momentum HCV Support Program for people taking Epclusa (sofosbuvir and velpatasvir), Harvoni (sofosbuvir and ledipasvir), Sovaldi (sofosbuvir) or Vosevi (sofosbuvir, velpatasvir and voxilaprevir). Merck has the Merck Care Hepatitis Program for people taking Zepatier (elbasvir and grazoprevir).
 

For more information, contact:

 Merck Care Program

 1-866-872-5773

 Momentum Support Program (Gilead)

 1-855-447-7977

AbbVie Care 

1-844-471-2273

CLAIRE Program (Bristol-Myers Squibb Canada)

1-844-HCV-2559

People who contracted hepatitis C from a blood transfusion between 1986 and 1990 may be eligible to have hepatitis C treatment expenses covered by the Hepatitis C January 1, 1986 - July 1, 1990 Class Actions Settlement. To learn more about these programs, see Compensation.

Revised 2018.