Paying for Biologics in Canada

After 4 months of symptomatic remission after a course of Prednisone, my symptoms are back and my GI is talking biologics. I'm aware of the risks, and after being in a flare for 15 of the last 20 months and several failed meds I'm exhausted and ready to go down that road.

My extended health benefits through work would cover 80% of the cost, but I'm no position to cover 20% out of pocket. My GI works in a research facility and, when I mentioned my concern, said he's fortunate to be able to arrange no-cost biologics for his patients - and not through a clinical trial. I'm worried he assumed I don't have benefits and would therefore be eligible for medication from drug companies through their compassionate care programs. I should have clarified but I didn't, and I won't have an opportunity to clarify with him for another 2 weeks.

Does anyone have helpful information for me? I don't think the medication he's leaning toward is covered via Pharmacare. Are drug companies compassionate care programs available to people with benefits if we can't afford our share?

In the US the pharma that makes Humira has a program to cover most of your co-pay. It would be worth a call to find out if it applies in Canada as well.

/www.humira.com/humira-complete/cost-and-copay

Post Edited (Richard in NY) : 10/12/2016 6:28:58 AM (GMT-6)

I forget the cost but likely a couple of thousand like most biologics.
Yes, you can get it just with OHIP. Your GI & drug company work together to get it covered. Cost isn't nor should it be an issue. If you haven't applied for Trillium Drug program is recommend it as its a lengthy process.

You're welcome Jin. I hope it works out for you!
At one point my IVIG treatment was running upwards of $30000/mth. I'm grateful beyond words for our health care coverage. I never paid a cent. Even when I needed a nurse to visit, it was at no cost to me.