The Canadian Life and Health Insurance Association (CLHIA) and the Canadian Rheumatology Association (CRA), together with the Ontario Rheumatology Association, have established a national standard for access to biologic drugs for adult rheumatoid arthritis patients who are members of private insurance plans.
This means that, going forward, unless a plan sponsor instructs otherwise, there will be a standard set of criteria across the country that private insurers will adhere to in providing access to biologic drugs to treat rheumatoid arthritis in adult Canadians.
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“One of the biggest challenges with the current system is the differing standards across Canada governing when a rheumatoid arthritis patient will have access to biologic drugs through their insurance plan,” explains Dr. Jane Purvis, private payer committee chair of the Ontario Rheumatology Association.
“This new national standard will help ensure that the best clinical evidence is used to determine access and help create greater equity in access to needed biologics for Canadians regardless of where they live and who their employer is,” she adds.
“This new national standard is welcomed by adults living with rheumatoid arthritis,” says Linda Wilhelm, president of the Canadian Arthritis Patient Alliance. “It represents a transparent process for people to understand that access to biologics will be made based on clinical evidence.”
The new national standard gives provincial drug plans the opportunity to adopt this standard. The CLHIA and CRA will be speaking with provincial governments on this important matter going forward.
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