A large number of medications are required to treat cystic fibrosis. Across Canada, coverage for CF-related medications by provincial government drug plans can be complete, partial or, in some instances, non-existent.
People with cystic fibrosis and their families should explore medication, equipment, nutritional supplements and enzymes coverage when moving, going to school or making an extended visit to another province.
Some provinces provide full coverage for many CF medications through special provincial CF drug programs, while others offer partial or no coverage through its provincial program. Often provincial drug programs require a deductible or premium to be paid before assistance is provided by the provincial program. Individuals eligible for provincial social assistance programs typically receive medications free-of-charge. Some social assistance programs, however, require individuals to pay a small deductible and/or co-payment.
Examples of provincial coverage are outlined in The Guide: Resources for the CF Community
In cases where provincial drug coverage is incomplete, people look to third party coverage (private insurance or through a group benefit plan). It is important to read the insurance policy carefully as some policies have yearly or lifetime maximums.
Each province has a drug formulary (listing of drugs) it covers. Not all drugs approved by Health Canada are automatically added to a province's drug formulary. When new drugs are introduced, they are evaluated to determine their therapeutic value and cost-effectiveness, compared to drugs already listed. A decision is then made whether the new drug should be included for coverage on the formulary.
Access to CF medications is critical to cystic fibrosis care. We constantly monitor provincial coverage of CF medications and identify gaps in public coverage. We advocate for coverage of vital CF medications. You can help by making us aware of gaps in your province’s drug coverage and by supporting our advocacy efforts to make CF medications more accessible. For more information, please contact the Program Director, Advocacy and Public Policy at our National Office.