Hepatitis C: An In-Depth Guide

Saskatchewan

Prescription Drug Programs in Saskatchewan

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
Health Canada
2045 Broad Street, 1st Floor
Regina, Saskatchewan
S4P 3T7

Toll-free: 1-866-885-3933

 

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.