Hepatitis C: An In-Depth Guide

Nova Scotia

Prescription Drug Programs in Nova Scotia

Nova Scotia Pharmacare helps eligible residents cover the costs of their prescription drugs. To apply for Pharmacare services, people must first be covered by Nova Scotia Medical Service Insurance (MSI). MSI is the government health insurance program that issues health cards to eligible residents and covers the cost of many necessary health services, such as medical, hospital, dental and optometry services.

There are four main Pharmacare programs in Nova Scotia:

Department of Community Services—Pharmacare Benefits

  • Covers the cost of prescription drugs, including medications for hepatitis C, for Income Assistance clients, people with disabilities and children in the care of child welfare.

Family Pharmacare Program

  • Helps families who have no drug coverage or whose prescription drug costs are high in relation to their income. Recipients have to pay an annual fee, which is capped at a certain percentage based on family income. 

Seniors’ Pharmacare Program

  • Assists seniors by paying a portion of the cost of their prescription drugs and medical supplies, based on their income level.

Drug Assistance for Cancer Patients

  • Helps people pay for certain cancer-related drugs if their gross family income is below a certain amount.

Coverage for Hepatitis C Medications

If people receive benefits from one of the following programs, they can apply to have their hepatitis C medications covered:

  • Department of Community Services Pharmacare Program
  • Family Pharmacare Program
  • Seniors’ Pharmacare Program

Income Assistance clients and people who receive benefits through Services for Persons with Disabilities (SPD) will have their treatment covered by the Department of Community Services Pharmacare Program.

In Nova Scotia, the provincial drug formulary outlines hepatitis C medications that are eligible for coverage.

Some jurisdictions have or are planning to remove restrictions on who qualifies for treatment coverage. Other jurisdictions have restrictions on who qualifies for treatment coverage. This may include requiring a certain level of liver injury (fibrosis stage). However, often a person can receive treatment coverage if they are experiencing hepatitis C-related health issues, are of child bearing age and are planning to get pregnant within the next 12 months, or are experiencing other health issues specified in the restrictions.

Hepatitis C medications may require special authorization before they can be covered.

To apply for coverage of exception status drugs, people can ask their specialist to complete the Standard Exception Drug Form and submit it to Pharmacare. The request will be reviewed against the criteria for coverage to determine if the medications will be paid for.

If the request is approved, people will have their medications covered for up to one full course of treatment. People will need to present a valid health card when accessing their medications at the pharmacy.

For more information about the different drug programs in Nova Scotia, people can contact the Nova Scotia Pharmacare Program at 1-800-544-6191.

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. People can contact NIHB by phone or mail at:

NIHB Atlantic Region Office
Non-Insured Health Benefits
First Nations and Inuit Health
Health Canada
1505 Barrington Street, Suite 1525
Halifax, Nova Scotia
B3J 3Y6                                                                                

Toll-free 1-800-565-3294

 

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). Janssen has the Janssen BioAdvance Program for people taking Galexos (simeprevir). 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

 Janssen BioAdvance Program

 bioadvance.ca

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.