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Treatment coverage in your region

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Prescription Drug Programs in New Brunswick

 The New Brunswick Prescription Drug Program (NBPDP) provides prescription drug benefits to eligible residents of New Brunswick. To apply for these benefits, a person must have a valid New Brunswick Medicare card (health card). If a person does not have a valid health card, they can contact New Brunswick Medicare to apply for one.

Ten different drug plans are available to eligible beneficiaries (there is no plan specifically for hepatitis C drugs):  

  • A (Seniors)—for people 65 years of age or older who receive the Federal Guaranteed Income Supplement (GIS) or qualify based on income level
  • B (Cystic Fibrosis)—for people with cystic fibrosis or juvenile or infant sclerosis of the pancreas who do not receive benefits from other sources
  • R (Organ Transplant)—for people who have received an organ or bone marrow transplant and need coverage for certain medications
  • U (HIV/AIDS)—for people with HIV/AIDS who need prescription medications
Coverage for Hepatitis C Medications

Coverage for hepatitis C medication varies depending on the drug plan for which people are eligible.  Eligible Social Assistance clients receive prescription drug coverage through Plan F (Social Development) and can apply to have their medications covered through this plan. Social Assistance case workers may request that their clients obtain a letter from their hepatitis specialist in order to receive coverage. Case workers are able to notify their clients about the documentation that is needed to apply for coverage given the individual’s personal health and financial circumstances.

Low-income families and individuals under the age of 65 who have high drug costs and do not receive Social Assistance will have to obtain coverage for prescription drugs through their place of employment or a private health insurance company, as there is no plan available for these residents.

Peg-interferon and ribavirin are included in the New Brunswick list of drugs that are eligible for coverage under the New Brunswick Prescription Drug Program. This list is known as the NBPDP Formulary. These medications are considered Special Authorization Drugs and therefore require prior approval from the NBPDP before they will be covered.

To apply for special authorization, people can ask their hepatitis specialist to complete and submit a Special Authorization Request Form to the NBPDP’s Special Authorization Unit. The request will be reviewed against the criteria for coverage to determine whether the medications will be covered. To receive coverage for hepatitis C medications, a person who has chronic hepatitis C and has never received treatment for it must have a positive HCV RNA test result. The individual and their specialist will be notified in writing about whether or not the medications will be covered. If the request is approved, a person will receive coverage for up to one full course of treatment, usually for 24 to 48 weeks. People can access their hepatitis C medications at the pharmacy by showing their Medicare health card.

If people require more information about treatment coverage or drug programs, they can call the New Brunswick Prescription Drug Program at (506) 867-4515.

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 – Atlantic Region
First Nations and Inuit Health
Health Canada
Suite 1525, 15th Floor, Maritime Centre
1505 Barrington Street
Halifax, Nova Scotia
B3J 3Y6                                                                                                                                Tel: (902) 426-2656
Toll-free: 1-800-565-3294

 
Costs and Coverage for Treatment in Canada

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.

Merck Care, Pegassist and Incivek Care

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).

These programs have 24-hour 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, these programs can even 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.

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

Revised 2012.