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Access to Trikafta by Location

Trikafta is finally coming to Canada! 

After nearly two years of hard work from the Canadian cystic fibrosis community to fight for access to Trikafta, and decades of hope for a drug like this, there is now nothing standing in the way of the provinces and territories funding Trikafta. As announcements are made by provinces and territories about public access to this miracle drug, Cystic Fibrosis Canada will provide updates via this page.  

For information about your individual circumstance please reach out to your CF clinic with any questions you may have. 

Current access situation by Location

The federal government has several drug programs which should offer some degree of coverage of Trikafta for eligible people.

Non-insured health benefits for First Nations and Inuit (NIHB)

On November 1, 2021 the Non-insured health benefits (NIHB) for First Nations and Inuit added Trikafta to the formulary from. Coverage under the NIHB will provide access for registered and recognized First Nations and Inuit people across Canada. 

Other federal drug plans

Other groups covered by federal drug plans include eligible members of the Canadian Armed Forces, qualified veterans by Veterans Affairs Canada, members of the Royal Canadian Mounted Police. Please see the Canadian government website for more information on these programs and who is eligible.

1. Is Trikafta available in Alberta through public drug programs?

Yes, Trikafta was added to the Alberta Drug Benefit List (ADBL) on September 24, 2021. Trikafta is available via Special Authorization.

You must have active Alberta Health Care Insurance Plan coverage to qualify for Alberta’s drug programs. Alberta’s drug programs are separate from the Alberta Health Care Insurance Plan (AHCIP). AHCIP pays doctors and other health care providers to provide certain health services.

2. What are the criteria for accessing Trikafta through public funding?

In order to qualify for public funding of Trikafta in Alberta you must be aged 12+ with at least one F508del mutation. Pre-treatment testing and information is required for initial coverage. Please speak to your clinic team for more information.

3. How can I access Trikafta under Alberta’s public drug programs?

To access Trikafta through Special Authorization you must qualify for one of the following Alberta drug programs:

  • Non-Group Coverage (aka Blue Cross)
  • Coverage for Seniors
  • Palliative Coverage
  • Child and Family Services
  • Alberta Child Health Benefit
  • Children and Youth Services
  • Income Support
  • Learners Program
  • Alberta Human Services (AISH)
  • Alberta Adult Health Benefit (AAHB)

Once you have determined which Alberta drug program you may qualify for you need to work out if you need to apply for the program. More information on these programs and their application processes can be found on the Alberta website.

4. How can I/ my child access Trikafta through Non-Group Coverage (Blue Cross)?

The Non-Group Coverage program, administered by Alberta Blue Cross, may pay for some or all of the cost of Trikafta. To qualify, you must live in Alberta and be under 65 years of age.

There is an application for the Non-Group Coverage program and a monthly premium is charged. Single coverage is available to Alberta residents with no dependants and family coverage is available to Alberta residents with eligible dependants.

5. How do I/ my child get Special Authorization to access Trikafta?

Once you are enrolled in Non-Group Coverage or another Alberta drug program, you/your child may qualify for access to Trikafta through Special Authorization. You will need to speak to your CF clinic about accessing Trikafta through this program, as they will have to complete the application form as well as some additional processes and steps in order for you to be considered for public funding.

6. I/my child have private insurance, how can I access Trikafta?

If you or your child have private insurance, you should contact your benefits provider. Individual policies and group benefit plans govern what is and isn’t covered. Private insurers have internal review processes for drugs and can take a while to add new drugs to their coverage. Alberta Blue Cross Non-Group Coverage will coordinate benefits with your private insurance provider.

7. What if I have private insurance but my insurer won’t cover Trikafta?

See question 4. about applying for Non-Group Coverage to access Trikafta through Special Authorization.

Alternatively, please contact us at advocacy@cysticfibrosis.ca and we can refer you to Vertex’s Village, a program that may be able to assist you. Cystic Fibrosis Canada continues to reach out to private insurers regarding coverage.

8. I have private insurance but my insurance won’t pay for the full costs of the drug. What can I do?

See question 4. about applying for Non-Group Coverage to access to Trikafta through Special Authorization.

Please contact us at advocacy@cysticfibrosis.ca and we can refer you to Vertex’s Village, a program that can potentially assist you. Cystic Fibrosis Canada continues to reach out to private insurers regarding coverage.

9. I qualify for coverage under one of Alberta’s drug programs. What do I need to do to get Trikafta now?

To access Trikafta you must undertake baseline testing before you will be considered for the drug. This may take some time. Please speak to your CF clinician about the required tests and paperwork.

There are clinical criteria that must be provided for you to be considered for coverage through Special Authorization. Please speak to your CF clinician about these criteria as they relate to your personal health status. This will help determine what your next steps should be.

1. Is Trikafta available in B.C through public drug programs?

Yes, Trikfafta will be covered through the B.C Expensive Drugs for Rare Disease (EDRD) program on a case-by-case basis, for eligible people living with cystic fibrosis.

2. Are there criteria for accessing Trikafta through public funding?

To qualify for Trikafta, patients must be of the age 12 years and older and have at least one F508del mutation. British Columbia has yet to publish any additional criteria that may be used to determine access.

As funding is provided through theEDRD program on a case-by-case basis, it is ultimately be up to the patient review committee to determine eligibility for funding.

3. How can I access Trikafta through Expensive Drugs for Rare Diseases funding?

EDRDs are considered PharmaCare non-benefits, meaning they are not eligible for PharmaCare coverage and Special Authority is not available for these drugs. However, in exceptional cases, coverage may be requested by a treating physician through the EDRD patient review process. Requests are assessed for approval on a case-by-case, last-resort basis. To request EDRD you must:

To be eligible for EDRD, you need to complete and submit an EDRD Patient Eligibility form (obtained from your physician) to your physician. You must also:

  • Be a resident of B.C.; and
  • Be registered with MSP and Fair PharmaCare; and
  • Your physician will also need to submit a request for EDRD on your behalf.

The EDRD then completes an additional review process which may results in a recommendation to fund a drug. If Trikafta is funded by EDRD, then it is funded at 100% coverage and there is no co-pay or patient deductible.

4. How do I register for Medical Service Plan (MSP)?

You need to enroll in the Medical Service Plan (MSP) for access to Pharmacare in B.C. All residents of B.C. are eligible. Find more information on the MSP and how to register on the B.C. website.

5. How do I register for Fair PharmaCare?

You must be registered for MSP before you can apply to Fair Pharmacare. You must also provide the B.C. government with access to verify your family income from two years prior.

The coverage you will receive will be based on your annual family income. This includes any marriage-like relationship. Find out more about how to register for Fair Pharm care on the B.C website.

Fair Pharmacare also has a deductible based on your family income.

For more information on how to calculate your annual deductible, use the Fair PharamaCare Calculator.

If an individual with Cystic Fibrosis is unable to pay the deductible fees, they may request an income review, which could result in a lower deductible or family maximum. Individuals may also consider applying for Disability Assistance.

6. I/my child have private insurance, how can I access Trikafta?

British Columbia advises that individuals should submit an EDRD Eligibility Form if:

If you or your child have private insurance, you should contact your benefits provider. Individual policies and group benefit plans govern what is and isn’t covered. Private insurers have internal review processes for drugs and can take a while to add new drugs to their coverage.

7.  What if I have private insurance but my insurer won’t cover Trikafta/ won’t cover the full cost of Trikafta?

British Columbia advises that individuals should submit an EDRD Eligibility Form if:

  1. They do not have extended health insurance; or
  2. They do have extended health insurance; however, your plan does not reimburse the requested drug (attach denial letter); or
  3. Your extended health insurance covers the requested drug; however, only partially (attach approval letter); or
  4. Your extended health insurance covers the requested drug; however, you have met your lifetime maximum for drug reimbursement (attach denial letter).

Alternatively, please contact us at advocacy@cysticfibrosis.ca and we can refer you to Vertex’s Village, a program that may be able to assist you. Cystic Fibrosis Canada continues to reach out to private insurers regarding coverage.

1. Is Trikafta available in Manitoba through public drug programs?

Yes, On October 22nd, 2021, Trikafta was added to the Exceptional Drug Status program in Manitoba.

2. Are there criteria for accessing Trikafta through public funding in Manitoba?

In order to qualify for public funding of Trikafta in Manitoba you must be aged 12+ with at least one F508del mutation, be receiving optimized treatment for CF at the time of initiation and demonstrate adherence to your prescribed CF therapeutic regimen.

3. How can I access Trikafta under Manitoba’s public drug programs?

Trikafta is available through the Exceptional Drug Status (EDS) Program in Manitoba. To access drugs through the EDS you must:

  • Be registered for Manitoba Health and Seniors Care
  • Enroll in the Manitoba Pharmacare Program
  • Your physician needs to complete an application process to EDS

4. What is Pharmacare and how do I enroll?

Pharmacare is a drug benefit program for eligible Manitobans, regardless of disease or age, whose income is seriously affected by high prescription drug costs.

You are required to pay an annual deductible for the Pharmacare program, the amount is based on your adjusted family income.

You qualify for the Manitoba Pharmacare program if you meet all of the following criteria:

  • You are eligible for Manitoba Health and Seniors Care coverage.
  • Your prescriptions are not covered by other provincial or federal programs.

You must complete an application form and worksheet and submit them, along with relevant supporting documents to Manitoba Health and Seniors Care. More information and the forms can be found on the Manitoba website.

5. I/my child have private insurance, how can I access Trikafta?

If you or your child have private insurance, you should contact your benefits provider. Individual policies and group benefit plans govern what is and isn’t covered. Private insurers have internal review processes for drugs that they follow in order to add new drugs to their PLA. 

6. What if I have private insurance but my insurer won’t cover Trikafta?

Please contact us at advocacy@cysticfibrosis.ca and we can refer you to Vertex’s Village, a program that may be able to assist you. Cystic Fibrosis Canada continues to reach out to private insurers regarding coverage.

7. I have private insurance but my insurance won’t pay for the full costs of the drug. What can I do?

Please contact us at advocacy@cysticfibrosis.ca and we can refer you to Vertex’s Village, a program that can potentially assist you. Cystic Fibrosis Canada continues to reach out to private insurers regarding coverage.

In a letter to Cystic Fibrosis Canada on October 19th 2021, the Newfoundland and Labrador government announced that it is expediting the listing process for Trikafta so that patients with cystic fibrosis can have access to this drug under the Newfoundland and Labrador Prescription Drug Program in November 2021. They have not yet confirmed the start date in November or details on access criteria. We have requested this information and will provide more information as soon as possible. 

1. Is Trikafta available in New Brunswick through public drug programs?

Yes, On October 14th, 2021, Trikafta was added to the New Brunswick Drug Plan Formulary under Special Authorization.

2. Are there criteria for accessing Trikafta through public funding in New Brunswick?

In order to qualify for public funding of Trikafta in New Brunswick you must be 12 years of age and older with at least one F508del mutation and have an FEV1 of less than or equal to 90%.

Initial requests for people who do not meet the lung function criteria may be considered on a case-by-case basis as outlined in the NB Drug Plans Special Authorization Policy.

3. How can I access Trikafta under New Brunswick’s public drug programs?

To access Trikafta through public funding in New Brunswick you must be under the care of a physician with experience in the diagnosis and management of CF and be enrolled in one of the following drug plans:

  • Seniors
  • The New Brunswick Drug Plan
  • Adults in Licensed Residential Facilities (Special Care Homes)
  • Social Development Clients
  • Children in the Care of the Minister of Social Development and Special Needs Children
  • Nursing Home Residents

4. What is the New Brunswick Drug Plan and how do I enroll?

The New Brunswick Drug Plan is a prescription drug plan that provides drug coverage for uninsured New Brunswick residents who have an active Medicare card.

There is a premium and a cop-payment per prescription which is based on your annual family income.

The New Brunswick Drug Plan is available to New Brunswick residents who have an active Medicare card and meet one of the following:

  • Do not have drug coverage through a private plan or other government program, or
  • Have existing drug coverage with a private plan, however:
    • They have reached the annual or lifetime maximum for drug coverage with the plan, or
    • They have been prescribed a drug that is not listed on their private plan formulary for the
      prescribed condition (indication).

Find out more about the New Brunswick Drug plan and application forms to enroll on the New Brunswick website.

5. I/my child has a FEV1 of over 90% how do I access Trikafta?

Access to Trikafta for those with an FEV1 of above 90% will be considered on a case-by-case basis through Special Authorization. Your physician must submit the Special Authorization request on your behalf. Speak to your CF clinic for more information about applying through this process.

If approved, you will need to be enrolled in one of the New Brunswick drug plans mentioned in question 3.

6. I/my child have private insurance, how can I access Trikafta?

If you or your child have private insurance, you should contact your benefits provider. Individual policies and group benefit plans govern what is and isn’t covered. Private insurers have internal review processes for drugs that they follow in order to add new drugs to their PLA.

7. What if I have private insurance but my insurer won’t cover Trikafta?

See question 4. about applying for the New Brunswick Drug Plan to access Trikafta through Special Authorization.

Alternatively, please contact us at advocacy@cysticfibrosis.ca and we can refer you to Vertex’s Village, a program that may be able to assist you. Cystic Fibrosis Canada continues to reach out to private insurers regarding coverage.

8. I have private insurance but my insurance won’t pay for the full costs of the drug. What can I do?

See question 4. about applying for the New Brunswick Drug Plan to access Trikafta through Special Authorization.

Please contact us at advocacy@cysticfibrosis.ca and we can refer you to Vertex’s Village, a program that can potentially assist you. Cystic Fibrosis Canada continues to reach out to private insurers regarding coverage.

On November 4, 2021, the Government of Northwest Territories announced it will fund Trikafta for eligible people living with cystic fibrosisTrikafta will be covered under the Extended Health Benefit. Please see the Northwest Territories government website for more information on this program and eligibility. 

In addition to this, eligible residents of Northwest Territories may be covered under NIHB. See the section above regarding federal coverage for more information on drug access for First Nations and Inuit people. 

On November 18, 2021, Nova Scotia has become the final province in Canada to confirm public funding of the life changing cystic fibrosis (CF) drug, Trikafta. The government of Nova Scotia had previously indicated in October 2021, that it was in negotiations with the manufacturer and intended to fund the drug. The press release shared by the Nova Scotia government confirmed they will follow the 90% lung function access criterion recommended by CADTH but will consider on a case-by-case basis people who do not meet the lung function criterion. 

Eligible residents of Nunavut may be covered under NIHB. See the section above regarding federal coverage for more information on drug access for Inuit people.

For those who are not covered by the NIHB, cystic fibrosis is listed as a condition covered by the Extended Health Benefit. Please see the Nunavut government website for more information on this program and eligibility.

1. Is Trikafta available in Ontario through public drug programs?

Yes, Trikafta was added to the Ontario Drug Benefit program on September 30, 2021 and is available through the Exceptional Access Program. 

The Ontario Drug Benefit (ODB) programs may pay for some or all of the cost of Trikafta. To qualify, you must live in Ontario and have a valid Ontario Health Card. There are several different ODB programs and each program may have additional rules about who can join to access Trikafta.

These drug programs are separate from the Ontario Health Insurance Plan (OHIP). OHIP pays doctors and other health care providers to provide certain health services.

2. Are there criteria for accessing Trikafta through public funding?

In order to qualify for public funding of Trikafta in Ontario you must be aged 12+ with at least one F508del mutation,  be receiving optimized treatment for CF at the time of initiation and have a predicted FEV1 of 90% or lower. Case-by-case consideration may be provided for patients not meeting lung function criteria.  

3. How can I access Trikafta under Ontario’s public drug programs?

Access to Trikafta is available through the Exceptional Access Program (EAP). Your physician will need to complete and application process on your behalf.  

If approved by the EAP for Trikafta, to access the drug through public funding you must qualify for one of the Ontario Drug Benefit (OBD) programsWhich OBD program you can use to access Trikafta depends on your circumstances: 

  • If you are 24 years of age or younger and are not covered by a private insurance plan you will be able to access drug coverage through OHIP+
  • If you are receiving professional home and community care services you may be eligible for the ODB
  • If you are receiving benefits from Ontario Works or Ontario Disability Support Program you may be eligible for the ODB
  • If you are between 25 and 64 and have a high cost of drugs relative to your income you can enrol in the Trillium Drug Program

Once you have determined which ODB program you may qualify for you need to work out if you need to apply for the program. Here are a few of the more common access routes to Trikafta, you can find more information on other programs on the ODB website.

4. I/ my child is under 25 and we do not have private insurance, how can I access Trikafta through OHIP+?

If you are or your child is 24 years of age or younger and don’t have private insurance, you may qualify for OHIP+. There is no application process for OHIP+. There is no deductible or co-pay, and people under 25 years of age are automatically enrolled if they do not have private insurance.

5. I/my child is under 25 and we do have private insurance, how can I access Trikafta?

If you are or your child is 24 years of age or younger and you have private insurance, you should contact your benefits provider. Individual policies and group benefit plans govern what is and isn’t covered. Some private insurers wait until our public health plans have done their cost-effectiveness studies before they decide if they will cover the drug, but these cost-effectiveness studies are now complete and were not designed to measure cost-effectiveness in the private insurance market. Private insurers also have internal review processes for drugs to add new drugs to their coverage.  

6. Why can’t my child or I qualify for OHIP+ if we have private insurance?

OHIP+ excludes anyone with private insurance. This is a major barrier to access for those under 25 years of age who have private insurance, especially for those whose private insurance does not cover Trikafta.

Cystic Fibrosis Canada is working to change this program, so that no one is left behind. It is not fair nor right to exclude children and youth from accessing medicines. Write to the Premier, Minister of Health and your Member of Provincial Parliament to tell them how not having access to this program is impacting you and your family. Meet with your elected official. Contact local media to share your story. Watch our website and social media channels for news about our advocacy efforts, and please be sure to amplify our collective voices. If you’d like to join our advocacy efforts, please drop us a line at advocacy@cysticfibrosis.ca .

7. I am between 25-64 and do not qualify for any of the other programs, how do I enroll in theTrillium Drug Program?

The Trillium Drug Program may be of assistance if you are between 25-64 years of age and have high drug costs relative your household income. You must apply for Trillium and must meet the eligibility criteria. Among other things, to qualify, you must have valid Ontario Health Insurance (OHIP) not already qualify for the Ontario Drug Benefit program nor have a private insurance plan that pays for 100% of your drugs. You must also spend 4% or more of your after-tax household income on prescriptions drugs. Trillium coverage comes with a deductible and a co-pay.

8. What if I have private insurance but my insurer won’t cover Trikafta?

Please contact us at advocacy@cysticfibrosis.ca and we can refer you to Vertex’s Village, a program that may be able to assist you. Cystic Fibrosis Canada continues to reach out to private insurers regarding coverage.

9. I have private insurance but my insurance won’t pay for the full costs of the drug. What can I do?

Please contact us at advocacy@cysticfibrosis.ca and we can refer you to Vertex’s Village, a program that can potentially assist you. Cystic Fibrosis Canada continues to reach out to private insurers regarding coverage.

The Trillium Drug Program may be of assistance if you are between 25-64 years of age and have high drug costs relative your household income. Trillium will coordinate benefits with your provider. More information on Trillium is provided in Question 7 above.

10. I qualify for coverage under one of the Ontario Drug Benefit programs. What do I need to do to get Trikafta now?

To access Trikafta you must undertake baseline testing before you will be considered for the drug. This may take some time. Please speak to your clinician about the required tests and paperwork.

There are clinical criteria that you must meet to be considered for public coverage. If you don’t meet the criteria, you may be considered for coverage under Ontario’s Exceptional Access Program (EAP). Please speak to your clinician about these criteria as they relate to your personal health status. This will help determine what your next steps should be.

1. Is Trikafta available in Prince Edward Island through public drug programs?

Yes, Trikafta is listed on the PEI Pharmacare Formulary, it is available through the High Cost Drug Program and, if needed, the Catastrophic Drug Program.

2. Are there criteria for accessing Trikafta through public funding in PEI?

In order to qualify for public funding of Trikafta in PEI you must be aged 12+ with at least one F508del mutation, be receiving optimized treatment for CF at the time of initiation, be prescribed through clinical specialist affiliated with a Canadian cystic fibrosis centre and have an FEV1 of less than or equal to 90%.

Case-by-case consideration may be provided for people not meeting lung function criteria.

3. How can I access Trikafta under PEI’s public drug programs?

To access Trikafta through public funding in PEI you will need to:

4. How do I enroll in the PEI High Cost Drug Program?

To access Trikafta through public funding in PEI you must be enrolled in the High Cost Drug Program.

To be eligible for coverage and qualify for assistance according to your household income, you must:

  • be a permanent resident of PEI
  • have a valid PEI Health Card; and
  • have filed your family's most recent income tax return in PEI

Under the High Cost Drug Program your cost of the medication will depend on your household income. You must also pay a pharmacy professional fee, which may vary with each pharmacy.

To apply you need to complete an application form and your physician will complete a Special Authorization Request Form on your behalf. More information on the program and the forms can be found on the PEI website.

5. How do I enroll in the PEI Catastrophic Drug Program?

If the cost of your prescription medication is high relative your household income, you may qualify for coverage of Trikafta through the Catastrophic Drug Program.

You and members of your household are eligible for this program if you:

  • are a permanent PEI resident
  • have a valid PEI Health Card; and
  • filed your most recent income tax return in PEI.

You are required to pay an annual deductible for the Catastrophic Drug Program, the amount is based on your adjusted family income.

6. I/my child have private insurance, how can I access Trikafta?

If you or your child have private insurance, you should contact your benefits provider. Individual policies and group benefit plans govern what is and isn’t covered. Private insurers have internal review processes for drugs that they follow in order to add new drugs to their PLA.

7. What if I have private insurance but my insurer won’t cover Trikafta?

See questions 4. and 5. about applying for the High Cost Drug Program and the Catastrophic Drug Program to access Trikafta.

Alternatively, please contact us at advocacy@cysticfibrosis.ca and we can refer you to Vertex’s Village, a program that may be able to assist you. Cystic Fibrosis Canada continues to reach out to private insurers regarding coverage.

8. I have private insurance but my insurance won’t pay for the full costs of the drug. What can I do?

You or your pharmacy must submit all claims to your private insurer first. The remaining out-of-pocket eligible expense can then be submitted to PEI Pharmacare for assessment. See question 4. about applying for the High Cost Drug Program to access Trikafta.

Please contact us at advocacy@cysticfibrosis.ca and we can refer you to Vertex’s Village, a program that can potentially assist you. Cystic Fibrosis Canada continues to reach out to private insurers regarding coverage.

1. Is Trikafta now reimbursed by the Régie de l’assurance maladie du Québec (RAMQ)?

On Wednesday, September 29, 2021, Trikafta was added to the list of drugs covered by RAMQ. Moreover, because of how the province’s drug insurance plan operates, Trikafta is automatically reimbursed by private insurers, using either the same criteria or less restrictive ones than RAMQ.

2. Who is covered by the Québec public prescription drug insurance plan?

Anyone who is a permanent resident of Québec must be covered at all times by a prescription drug insurance plan. If you are not covered by a private plan, you are usually eligible for the public plan.

To have more details on eligibility for the RAMQ prescription drug insurance plan, go to: https://www.ramq.gouv.qc.ca/en/citizens/prescription-drug-insurance/know-eligibility-conditions-public-plan

3. What are the access criteria for Trikafta in Québec?

To have access to Trikafta, you must be at least 12 years old, have at least one copy of the delta F508 mutation, pulmonary function of 90% or less and not have received a lung transplant.

4. What if I don’t satisfy those criteria?

Alternative access not dependant on the pulmonary criteria is available. With the help of your clinician, you can apply to the Patient d’exception program where funding is examined on a case-by-case basis.
To find out more about the Patient d’exception program, consult this site (available only in French): https://www.ramq.gouv.qc.ca/fr/professionnels/pharmaciens/medicaments/medicaments-patient-exception/Pages/patient-exception.aspx

5. How long would I have access to Trikafta?

According to the official recommendation of the Institut national d’excellence en santé et en services sociaux (INESSS), the initial authorization is given for a period of 6 months, after which a request to continue treatment is required. Subsequent requests to continue treatment are authorized for a maximum of 12 months. For renewal criteria, we recommend that you consult your clinician.

6. What about if I am covered by private insurance?

Because of how the province’s drug insurance plan works, Trikafta is automatically reimbursed by private insurers according to either the same criteria as the RAMQ criteria or even less restrictive criteria.

1. Is Trikafta available in Saskatchewan through public drug programs?

Yes, Trikafta was added to the Exception Drug Status (EDS) program on September 24, 2021.

2. Are there criteria for accessing Trikafta through public funding?

In order to qualify for public funding of Trikafta in Saskatchewan you must be aged 12+ with at least one F508del mutation, be receiving optimized treatment for CF at the time of initiation and demonstrate adherence to your prescribed CF therapeutic regimen.

3. How can I access Trikafta under Saskatchewan’s public drug programs?

Access to Trikafta is available through Exception Drug Status (EDS) in Saskatchewan.

The EDS program may pay for some or all of the cost of Trikafta. To qualify, you must live in Saskatchewan and have a valid Saskatchewan Health Card. Once you have a Saskatchewan Health Card you may be eligible for drug plan benefits, including Prescription Coverage and Extended Benefits. You may then qualify for access to Trikafta through EDS, which is part of the Extended Benefits plan.

You can apply for, replace or update your Health Card as a resident of Saskatchewan. Learn more here.

The Extended Benefits and Drug Plan provides additional coverage for eligible individuals on top of the universal benefits.

There is an application process for EDS to be completed by your clinician. Pre-treatment assessments are required for initial coverage. You will need to speak to your CF clinic about accessing Trikafta through this program, as they will have to complete additional processes and steps in order to be considered for public funding.

You can find more information on other programs on the Saskatchewan website.

4. I/my child have private insurance, how can I access Trikafta?

If you or your child have private insurance, you should contact your benefits provider. Individual policies and group benefit plans govern what is and isn’t covered. Private insurers have internal review processes for drugs and can take a while to add new drugs to their coverage.

5. What if I have private insurance but my insurer won’t cover Trikafta?

Speak to your CF clinic about applying for access through EDS.

Alternatively, please contact us at advocacy@cysticfibrosis.ca and we can refer you to Vertex’s Village, a program that may be able to assist you. Cystic Fibrosis Canada continues to reach out to private insurers regarding coverage.

6. I have private insurance but my insurance won’t pay for the full costs of the drug. What can I do?

Speak to your CF clinic about applying for EDS to cover the remaining amount.

Please contact us at advocacy@cysticfibrosis.ca and we can refer you to Vertex’s Village, a program that can potentially assist you. Cystic Fibrosis Canada continues to reach out to private insurers regarding coverage.

The government of Yukon announced on October 15, 2021, that it is in the process of adding life changing drug Trikafta, to its drug formulary. This process is expected to be completed within the next two months.