WHAT DOES THE NEW ONTARIO PHARMACARE PLAN OFFER CHILDREN AND YOUNG ADULTS WITH RARE DISORDERS?

Main Article Content

Nigel S. B. Rawson

Keywords

Drugs for rare disorders; children; pharmacare; Ontario

Abstract

A publicly-funded pharmacare program (OHIP+) was announced in the 2017 Ontario budget for all children and young adults that will begin in January 2018 and cover drugs in the Ontario Public Drug Programs formulary. In this commentary, drugs indicated for rare disorders commonly occurring in childhood that were reviewed by the Common Drug Review (CDR) between 2004 and 2016 are examined to assess the Ontario reimbursement situation. Although 72% of the drugs are reimbursable, the eligibility criteria are unavailable for >50% of them. The criteria for others are onerous. Providing reimbursement for rare disorder drugs that received a positive CDR recommendation not already covered would likely cost <25% of OHIP+’s projected cost. Children who will benefit most from OHIP+ are those with common conditions whose parents do not presently have access to provincial or private insurance. Children with rare disorders deserve accessible provincial financial support for potentially life-transforming drugs.
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