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
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
2720 Riverside Drive
Address Locator: 6604C
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 Tunngavik Incorporated (NTI)
Department of Human Resources
P.O. Box 280 Rankin Inlet, NU X0C 0G0
Tel: (867) 645-5400
Fax: (867) 645-3451
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.