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
Saskatchewan Health provides coverage for prescription drugs through the Saskatchewan Drug Plan. Residents with valid Saskatchewan Health benefits can apply for Drug Plan benefits that will help them pay for their hepatitis C medications.
For more information about the different drug plans and benefits in Saskatchewan, can call the Health Registries office at (306) 787-3251 in Regina or toll-free at 1-800-667-7551.
How do you apply for coverage?
In Saskatchewan, the following hepatitis C medications are included in the Saskatchewan Formulary, a list of drugs that are eligible for coverage:
- asunaprevir and daclatasvir
- daclatasvir and sofosbuvir
- Epclusa (velpatasvir and sofosbuvir)
- Harvoni (ledipasvir and sofosbuvir)
- Holkira Pak (dasabuvir + ombitasvir/paritaprevir/ritonavir)
- sofosbuvir (taken in combination with ribavirin)
- Zepatier (grazoprevir and elbasvir)
These hepatitis C medications require Exception Drug Status (EDS) before they can be covered.
To apply for coverage for these EDS medications, people can ask their specialist to complete and submit a request form to the Drug Plan. The request will be reviewed against the criteria for coverage in order to determine if the treatment will be paid for by the Drug Program.
Some of the factors that may be considered when approving funding for hepatitis C medications include:
- a positive HCV RNA test
- HCV genotype
- level of fibrosis
- whether or not an individual is living with chronic hepatitis C
- HIV status
In Saskatchewan, a person needs to have a certain level of liver injury (fibrosis stage 2) to qualify for treatment coverage. However, a person does not need to meet this requirement if they have one or more of the following issues:
- Coinfection with HIV or hepatitis B
- Fatty liver disease
- Has previously had an organ transplant
- other health problems caused by hepatitis C that affect parts of the body other than the liver (extra-hepatic manifestations)
- Chronic kidney disease (stage 3, 4 or 5)
- Diabetes and receiving treatment anti-diabetic mediations
- Are of child bearing age and are planning to get pregnant within the next 12 months
If the request is approved, people will receive coverage for their hepatitis C medications for a period of up to one full course of treatment, depending on their hepatitis C genotype and treatment regimen. They can access these medications at the pharmacy as they would any other prescription drug.
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) Program. People can contact NIHB by phone or mail at:
Non-Insured Health Benefits – Saskatchewan Region
First Nations and Inuit Health
2045 Broad Street, 1st Floor