Hepatitis C: An In-Depth Guide

Nunavut

Prescription Drug Programs in Nunavut

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

The following hepatitis C treatment medications  are included in the Non-Insured Health Benefits (NIHB) formulary as drugs that are eligible for coverage:

  • 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 a Limited Use Benefit and require special approval before they will be covered by NIHB. For people to access their treatment medications, they must have their specialist submit a written request to NIHB. If the request is approved, people will have their medications covered for up to 48 weeks.

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

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

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).

For more information about NIHB, people can either visit their website or contact them by phone or mail at:

NIHB Northwest Territories and Nunavut Office
Non-Insured Health Benefits
First Nations and Inuit Health
Health Canada
2720 Riverside Drive
Address Locator: 6604C
Ottawa, Ontario
K1A 0K9

Toll-free: 1-888-332-9222

To be eligible to receive health benefits from NIHB, people must first be registered with their Land Claims Organization. People can contact their Land Claims Agreement office using the contact information below to request an application form. Once registered, people can notify their service providers that they have recognized status with their Land Claims Organization so that they can receive benefits from NIHB.  

Service providers are encouraged to bill NIHB directly so that clients are not forced to pay directly for any health services or goods they may require. However, if people must pay for a good or service, they can seek reimbursement from NIHB by completing the NIHB Client Reimbursement Request Form and sending it to the NWT and Nunavut NIHB office. The completed request form must be received within one year from the date they paid for the health service.

If a request for reimbursement is denied, NIHB recipients have the right to file an appeal to have the decision reviewed. More information on the appeals process is available on the NIHB website or by calling the NWT and Nunavut NIHB office.

Land Claims Organizations – Contact Information

Nunavut
Nunavut Tunngavik Incorporated (NTI)
Enrolment Administrator 
Department of Human Resources 
P.O. Box 280 Rankin Inlet, NU X0C 0G0 
Tel: (867) 645-5400
Toll-free: 1-888-236-5400
Fax: (867) 645-3451
Website: www.tunngavik.com

To register, you can also fill out the online application form for the Nunavut Land Claims Agreement (NCLA) and send it to the address above.

 

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.