Hepatitis C: An In-Depth Guide

Northwest Territories

Prescription Drug Programs in the Northwest Territories

The Government of the Northwest Territories (NWT) provides coverage of prescription drugs through Alberta Blue Cross. People need to have a Health Care Card before they can apply for drug coverage. People who do not have a health card can contact the NWT Health Care Plan.

In the NWT, there are three programs that help eligible residents cover the cost of their prescription drugs:

Métis Health Benefits (MHB)

  • Covers the total cost of eligible health services and prescription drugs, including hepatitis C medications, for indigenous Métis residents.

Prescription Drugs and Dental Benefits for Seniors

  • Covers a portion or the total cost of prescription drugs and dental care for NWT residents who are 65 and older.

Extended Health Benefits (EHB) for Specified Diseases

  • Covers a portion or the total cost of prescription drugs for people living with certain diseases and conditions. People can apply for Extended Health Benefits to cover the cost of their hepatitis C medications.

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.

NIHB is a federal program that provides eligible First Nations and Inuit people with coverage for many prescription drugs and health services.  People can contact NIHB by phone or mail at:

Non-Insured Health Benefits – Northwest Territories and Nunavut Region
Health Canada
2720 Riverside Drive
Address Locator: 6604C
Ottawa, Ontario
K1A 0K9                                                                                            

Toll-free: 1-888-332-9222

Coverage for Hepatitis C Medications

In the NWT, coverage for hepatitis C medications varies depending on an individual's prescription drug program.

Income Assistance (IA) recipients can speak to their case workers to find out about getting their medications covered through their IA health benefits. If people do not have prescription drug coverage, they can apply for Extended Health Benefits (EHB) by completing an EHB application form. A letter will be sent to applicants informing them if their hepatitis C medications will be covered through the EHB program.

The following hepatitis C medications  are included in the NIHB formulary, a list of drugs that are eligible for coverage by both the NWT government and Health Canada:

  • peg-interferon and ribavirin
  • Harvoni (ledipasvir and sofosbuvir)
  • Holkira Pak (dasabuvir and paritaprevir/ritonavir/ombitasvir)
  • simeprevir (taken in combination with peg-interferon and ribavirin)
  • sofosbuvir (taken in combination with peg-interferon and/or ribavirin)

These hepatitis C medications are considered of Limited Use Benefit and require approval before they will be covered by Alberta Blue Cross or NIHB. People must have their specialist submit a written request to Alberta Blue Cross or NIHB for approval. If the request is approved, people will have their medications covered for up to one full course of treatment.

Some of the factors that are considered when approving funding for hepatitis C medications include:

  • whether or not an individual is living with chronic hepatitis C
  • level of fibrosis
  • HCV genotype
  • a positive HCV RNA test
  • whether or not an individual is treatment naïve

For more information about programs that may be able to help cover the costs of hepatitis C medications, contact the NWT Department of Health and Social Services at 1-800-661-0830.

 

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. Merck has the Merck Care program for people taking peg-interferon alpha-2b (known as Pegetron). Hoffman-La Roche has the Pegassist program for people taking peg-interferon alpha-2a (known as Pegasys). Vertex has the Incivek Care program for people taking telaprevir (known as Incivek). Gilead Sciences has the Momentum Support program for people taking sofosbuvir (known as Sovaldi).

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.

Janssen has the Galexos: BioAdvance Patient Support Program for people taking simeprevir (known as Galexos).

AbbVie has the AbbVie Care Program for people taking Holkira Pak.

For more information, contact:

 Pegassist Program

 1-877-PEGASYS (1-877-734-2797)

 Merck Care Program

 1-866-872-5773

 Incivek Care Program

 1-877-574-4298

Momentum Support Program 

1-855-447-7977

Galexos: BioAdvance Patient Support Program

1-855-512-3740

AbbVie Care

1-844-471-2273

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 2014.