Financial resources

 

Formularies across the provinces

Health Canada drug product database - A database provided by Health Canada to search for drug identification numbers, product names and company names

Cancer drug access - Cancer drug access and funding in Canada - Shows the levels of access and funding for cancer drugs in each of Canada since 2000; last updated August 7, 2013

BC PharmaCare formulary search - Provides a search engine for the formulary of BC PharmaCare and links to other cancer agencies’ formularies in British Columbia

Alberta drug benefit list - A formulary for the Alberta Health Care Insurance Plan; includes medicines covered under other plans

Saskatchewan cancer agency drug formulary - Saskatchewan Cancer Agency provides a formulary of the anti-cancer drugs and some supportive drugs funded by the agency

Saskatchewan online formulary database - A formulary of all the medicines covered underneath the Saskatchewan Drug Plan

Manitoba drug benefits and interchangeability formulary - A formulary for all the drugs which have been approved as eligible benefits under the Pharmacare drug benefit program.

Ontario drug benefit formulary/comparative drug index - A search engine that shows the formulary of drugs available under the various reimbursement programs in Ontario

Quebec list of medications - A formulary of the medications covered by Quebec’s basic prescription drug insurance plan

New Brunswick prescription drug program formulary - A formulary of the drugs which are eligible for benefits under the New Brunswick Drug Plan

Nova Scotia Pharmacare - A formulary that details the drugs and devices available for benefits under the Pharmacare programs in Nova Scotia

P.E.I. Pharmacare formulary - A formulary of the medications approved for coverage in Prince Edward Island as a public service

Newfoundland and Labrador interchangeable drug products and formulary - A formulary that lists the drugs which are covered by the Newfoundland and Labrador
Prescription Drug Program

Nunavut non-insured health benefits program - The Extended Health Benefits Full Coverage Plan covers those enrolled in the Nunavut Health Care Plan and have a chronic illness or disease; this list approved prescription drugs

North-West Territories health centre formulary - The Extended Health Benefits Full Coverage Plan covers those enrolled in the Nunavut Health Care Plan and have a chronic illness or disease; this list approved prescription drugs

Yukon drug formulary - A search directory of the formulary for the drugs covered by the Yukon Insured Health Services
 

Provincial financial information and resources

Canadian cancer society - Financial help - The Canadian Cancer Society provides financial help and advice specific to the province or territory where the patient and family resides

Wellspring - Money matters – Wellspring provides information on government income programs, community resources and support to help cancer patients cope with the financial difficulty that can come with a cancer diagnosis. 

BC Cancer agency - Financial and healthcare coverage information - Further financial information and assistance for cancer patients residing in British Columbia

CancerCare Manitoba - Financial arrangements - Services are provided by CancerCare Manitoba to help cancer patients understand Manitoba’s drug coverage programs

CancerCare Ontario - Cancer drug reimbursement - Information on programs that approve cancer drugs for Ontario patients that may not otherwise be available for reimbursement

CancerCare Nova Scotia - Finances and other concerns - Information and advice for cancer patients living in Nova Scotia

Cancer care foundation Newfoundland - Patient and family support fund - A support fund established to help cancer patients who are experiencing financial hardship 
 

Federal programs

Federal programs and funding may be eligible for prostate cancer patients should they or a family member qualifies be employed be the Canadian Forces or fall under other criteria of the programs.

Canadian forces health services - The Canadian armed forces drug benefit list - A formulary of the drugs available for coverage to CF members and other eligible persons  

Canadian forces health services - Spectrum of care - Medical and dental benefits and services - Further describes the health benefits and services available to CF members and other eligible persons

Interim federal health program - A limited temporary coverage of health-care costs to protected persons not eligible for provincial or territorial health insurance plans and when a claim cannot be made under private health insurance

Service Canada - Employment insurance compassionate care benefits - Compassionate care benefits are benefits paid to people who have to be away from work temporarily to provide care or support to a family member who is gravely ill and who has a significant risk of death within 6 months; a maximum of six weeks may be paid to eligible people

Health Canada - Non-insured health benefits - Provides a range of medically necessary goods and services to eligible First Nations (including registered Indians under the terms of The Indian Act) and recognized Inuit clients in Canada. 

Veterans affairs Canada - Veterans Affairs Canada (VAC) provides a wide range of benefits and services, including prescription drugs, to qualified veterans, still-serving Canadian Forces members, RCMP members, and certain civilians as well as their dependants and survivors.

Medical expenses tax credit - Medical expenses that can be claimed for oneself, a spouse or common-law partner, or dependent children born in 1996 or later; if a patient or caregiver is spending more than 3 per cent of their income on medical expenses, then they can claim these expenses for the tax credit [9]. 

Health Canada - Disability tax credit - A person with a disability or their caregiver may be able to claim on their income tax and benefit return the deductions and tax credits; here is a list of what they could claim

Health Canada - Special access programme - The Special Access Programme (SAP) provides access to non-marketed drugs for practitioners treating patients with serious or life-threatening conditions when conventional therapies have failed, are unsuitable, or unavailable

Private health insurance

The majority of Canadians have private insurance/third party insurance for prescription drugs as part of health benefits provided by their employers; most plans also cover the employee’s family or dependants. Employers purchase these plans from insurance companies and determine the terms of the plans for their employees.

Private insurance plans will cover some or all of the prescription medications that are used on an outpatient basis. This can include oral, inhaled and injectable medications, or some drugs for intravenous infusion used in an ambulatory setting. Private plans do not usually pay for medications used for patients staying in the hospital [11].

How to find out if the medication is covered


Private health insurance resources

Drugcover.ca - Private insurance - A guide on understanding if a private insurance company will pay for prescriptions, private insurance plans, special authorization, and the reimbursement methods

Health Canada - Drug product database - The drug product database contains specific information on drugs approved for use in Canada

Canadian cancer survivor network - Understanding your health insurance at work - A webinar put on by CCSN that provides insight into work health insurance and medications for cancer patients and their family

Canadian life and health insurances association (CLHIA) - A full listing of Canadian insurance companies 

Patient assistance programs (PAPS)

Pharmaceutical company-sponsored patient assistant programs (PAPS) help a patient find other payment options or provide financial assistance for their own drug plans; navigating private drug plan coverage can be challenging but pharmaceutical companies can provide trained staff members who help patients navigate their available coverage options [13].

Cancer centre coverage

Cancer treatment centres will sometimes provide financial assistance to patients in emergency situations when funding from other sources and services is not available. Contact the Patient and Family Counselling department at the nearest regional Cancer Centre and ask about financial assistance options available for patients.

Medical expenses and out-of-pocket costs

The Canadian Cancer Society identifies four groups of people as being most at-risk of suffering high out-of-pockets costs during cancer treatment: rural residents who must travel for treatments, those not covered with private insurance, those with high drug costs, and those who suffer a significant loss of salary [14].

Travelling for treatment can take a heavy toll on the finances of the patient and their family; in a study of 484 adults presented for cancer care at clinics in Newfoundland and Labrador, 19.5% of rural patients paid more than $1000 in travel-related costs for a single to access cancer care [15]. Factoring in the cost of meals, accommodation, and other medical care necessary for the patient 

Further resources for out-of-pocket costs

Service Canada - Canada pension plan disability benefit - A taxable monthly payment that is available to people who contributed to the CPP and are not able to work regularly at any job because of a disability; the disability benefit does not pay for medications and assistive devices

Service Canada - Employment insurance sick benefits - EI offers up to 15 weeks payment for people who are eligible; this is based on how many weeks have been paid into the plan, and the payments are based on weekly earnings

London health sciences centre - Claiming medical expenses on your income tax returns - Info on what can be claimed as  medical expenses on your income tax return, this can include travel costs, drugs and more

Canadian cancer society - Financial help - Depending on the province, the Canadian Cancer Society may be able to provide financial help with costs of travelling and lodging