ARTHRITIS CONSUMER EXPERTS ASKS CANADIANS: HOW DOES YOUR PROVINCE MEASURE UP?
ACE’s Arthritis Medications Report Card helps Canadians evaluate reimbursement access to arthritis medications
(Vancouver, BC) — In its eighth annual JointHealth™ Arthritis Medications Report Card, Arthritis Consumer Experts (ACE) reports that, depending on where they live, Canadians living with an autoimmune arthritis may have fewer treatment options or have to “jump through more hoops” to qualify for reimbursement for the medication prescribed for them by their rheumatologist.
“ACE continues to fight for the rights of people with arthritis, which includes our leadership on timely and equitable reimbursement access to arthritis medications on public and private drug formularies. Studies have found that increases in medication treatment costs for rheumatoid arthritis over the last decade are associated with lower hospitalization rates, better functional status and a lower incidence of work disability,” said Cheryl Koehn, Founder and President of Arthritis Consumer Experts.
The JointHealth™ Arthritis Medications Report Card highlights to government decision-makers this lack of equitable access and patient/physician choice in treating the estimated 600,000 Canadians living with a type of autoimmune arthritis – rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis and juvenile idiopathic arthritis.
Koehn added: “Thanks to the advocacy efforts of people living with arthritis and their rheumatologists, progress has been made in many Canadian provinces. However, in some provinces, arthritis patients’ right to choose with their healthcare team the therapy best suited to their unique health needs is threatened. Our message for those provinces lagging is that it’s medically sound and cost effective to permit the prescribing specialist, in full discussion and agreement with their patient, to select from the full treatment armamentarium the most appropriate medication for the patient’s disease. Medication prescribing and taking is not ‘one size fits all’; it is highly personalized.”
Arthritis Consumer Expert’s annual JointHealth™ Arthritis Medications Report Card is Canada’s only independent patient organization evaluation of public reimbursement access to arthritis medications. In 2014, this landscape has dramatically changed with the introduction of new medication categories and Health Canada’s approvals of two new medications used to treat autoimmune forms of arthritis.
2014 JointHealth™ Arthritis Medications Report Card Highlights:
- ACE is now monitoring three medication categories: biologic response modifiers, subsequent entry biologics, and targeted small molecule medications.
- No Canadian province provides reimbursement coverage for all biologic response modifiers approved by Health Canada. The table in Appendix below provides current provincial rankings and their ranking change from the 2013 Report Card.
- British Columbia, Saskatchewan, Ontario and Quebec share the number one ranking in the Report Card.
- The provinces that most improved their ranking were:
British Columbia (1st in 2014 – 3rd in 2013)
Quebec (1st in 2014 – 3rd in 2013)
Nova Scotia (5th in 2014 – 7th in 2013)
- The province that experienced a ranking decline were:
Alberta (7th in 2014 – 6th in 2013)
New Brunswick (8th in 2014 – 7th in 2013)
Prince Edward Island (8th in 2014 – 7th in 2013)
Commenting on the changes in provincial rankings from year to year, Ms. Koehn said: “Unfortunately, as the provinces go through ups and downs in Report Card rankings, so too does the health of people living with arthritis. It is unacceptable there are Canadians living with autoimmune arthritis unable to access all potential medication options. Standardized reimbursement criteria across Canada, developed with rheumatologist experts, would permanently fix this issue.“
|PROVINCE||2014 RANKING||2013 RANKING||REASON FOR RANKING CHANGE|
|British Columbia||1st||3rd||Improved ranking from last year due to adding adalimumab for juvenile idiopathic arthritis.|
|Quebec||1st||3rd||Improved ranking from last year due to adding adalimumab for juvenile idiopathic arthritis.|
|Saskatchewan||1st||1st||No change in ranking.|
|Ontario||1st||1st||No change in ranking.|
|Manitoba||5th||5th||No change in ranking.|
|Nova Scotia||5th||7th||Improved ranking from last year due to adding adalimumab for juvenile idiopathic arthritis.|
|Alberta||7th||6th||Drop in ranking from last year due to making no changes relative to other formularies.|
|New Brunswick||8th||7th||Drop in ranking from last year due to making no changes relative to other formularies.|
|Non-Insured Health Benefits or “NHIB”||8th||10th||Improved ranking from last year due to adding adalimumab for juvenile idiopathic arthritis and tocilizumab for juvenile idiopathic arthritis.|
|Prince Edward Island||8th||7th||Drop in ranking from last year due to making no changes relative to other formularies.|
|Newfoundland and Labrador||11th||10th||Drop in ranking from last year due to making no changes relative to other formularies.|
|Yukon||12th||12th||No change in ranking.|
About the Arthritis Medication Report Card
Arthritis Consumer Experts ranks twelve publicly funded medication formularies based on the number of medically necessary arthritis medications they list out of a possible 13 medication treatments. Formularies are awarded one point for each case-by-case (CBC) listing, three-quarters of a point for a listing that has overly restrictive criteria (ORC), and no points for “Declined” listings or files remaining “Under Review”. In some cases, information about a medication was unavailable. Where this lack of transparency occurred, ACE put “Unknown” and did not award any points.
About Arthritis Consumer Experts
Arthritis Consumer Experts is a national organization that provides science-based information and education programs in both official languages to people with arthritis. ACE serves consumers living with all forms of arthritis by helping them take control of their disease and improve their quality of life. Founded and led by people with arthritis, ACE also actively advocates on arthritis health and policy issues, through ACE’s JointHealth™ family of programs and the Arthritis Broadcast Network, directly to consumers/patients, healthcare professionals, media and government. ACE is guided by a strict set of guiding principles, set out by an advisory board comprised of leading scientists, medical professionals and informed arthritis activists.
Arthritis Consumer Experts
Vice President, Communications and Public Affairs
Arthritis Consumer Experts
© 2015 ACE Planning and Consulting Inc.