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Treatment coverage in your region

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Prescription Drug Programs

General information on drug coverage and benefit programs offered by the provincial, territorial and federal governments can be found here.

Getting My Hepatitis C Medications

What plans are there for me?

If you receive social assistance (Ontario Works or Ontario Disability Support Program), you will get a drug card with your monthly cheque to show that you have prescription drug coverage through the Ontario Drug Benefit Program, which will help pay for your medications.

If you do not receive social assistance, the ODB and the Trillium Drug Program (TDP) are the two main programs that may be able to help cover the costs of your expensive hepatitis C medications.

The TDP is available to all Ontarians who have high drug costs and who do not qualify for drug coverage through a different program.

How do I apply for coverage of my Hep C meds?

No matter what drug program you have, your treatment medications must be approved by the Exceptional Access Program (EAP) before they will be paid for. Your health care provider will need to send a request form to the EAP to see if your treatment will be covered by the ODB.

Your doctor will then receive a letter telling him or her whether or not your medications will be covered, and they will tell you about the decision.

If the request for coverage is approved, you will be able to get your medications from the pharmacy by showing your health card. 

If you would like more information about drug programs in Ontario, you can call the Exceptional Access Program Branch (EAPB)  of the ODB at 1-866-811-9893 or TTY at 1-800-387-5559.

What costs are involved?

Depending on your drug coverage and income, you may be asked to pay a portion of the cost of your medications.

The TDP charges you a fee (called a deductible) based on how much money you make every year, which is paid in four installments throughout the year.

What about the Non-Insured Health Benefit Program?

If you’re a registered First Nations or recognized Inuit person, the Non-Insured Health Benefits (NIHB) program may be able to help cover the cost of your hepatitis C medications. You can contact NIHB by phone or mail at:

Non-Insured Health Benefits – Ontario Region
First Nations and Inuit Health
Health Canada
1547 Merivale Road, 3rd floor
Postal Locator 6103A
Nepean, Ontario
K1A 0L3

Toll-free: 1-800-640-0642

 
Costs and Coverage for Treatment in Canada  

Some national programs in Canada are available to help people with drug costs.

Peg-Care & Pegassist

Two of the pharmaceutical companies that make Hep C medications have programs to help people complete treatment. Merck has the Peg-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).

These programs both have 24-hour phone support for people taking Hep C treatment; part of this support is helping people access the funding necessary to cover treatment costs. They can inform you about local, provincial and federal government programs for accessing treatment. They can also help you find ways to access and use public funding or private medical insurance, including the appeals process if you have a supportive doctor. If you are eligible, they can even help cover the insurance company co-pay fee, provincial or territorial plan's deductible and other expenses, depending on your specific situation.

For more information, contact:

 Pegassist Program

 1-877-PEGASYS (1-877-734-2797)

 Peg-Care Program

 1-866-872-5773

Revised 2011.