Cost of major Biologics in Canada?

Me and my wife are planning to immigrate to Canada. Because I have a really good job opportunity there. But my wife has pre-existing condition (psoriatic arthritis) and there is chance that she might be rejected because of medical inadmissibility eventhough she is well qualified and can easily get job in canada. If total yearly spending on medication is less $19,600 I think we have a good chance of approval. Hence I wanted to know what is the price of Humira and Enbrel in canada right now.

Thank in advance

Hey formywife. I’m sorry I can’t help you with that question. However you may can get an idea if you Google it. Or call the producer of both. Best wishes.

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I had a hard time finding any info on actual pricing. I did find this article which is very interesting and may help with any sort of justification your wife may need to make:

You may be best served by calling pharmacies in the area where the new job is and speaking to someone directly about pricing and medical approvals.

azurelle

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Yes the UK is certainly into ensuring its health service uses biosimilars, but I’m not sure that Canada is, or indeed there’s any availability in Canada of biosimilars.

Thank you guys for your response. I am getting different prices online for Humira. Some are saying it is less CAD$ 19,000 some are around CAD$ 22000 per year.

How about contacting the Toronto clinic to ask them? They are hot-shot PsA specialists and I imagine they’d be understanding - it’s Toronto Western Hospital I think. One of our Mod Support Team @Seenie would be able to confirm that.

Hello @formywife. The question you ask about the cost of the biologics is a bit of a complicated one, and although the foks at Toronto Western are brilliant, I doubt they will know the answer to that question.

The answer to your question is: it all depends. Helpful, aren’t we? LOL I’ll explain. What you pay depends on who is paying, and what your deductible is on whatever plan you have. In Canada, we do have socialized medicine, but unlike the NHS, ours does not cover drugs. Most (but not all) people have drug coverage insurance for that, and most (but not all) drug coverage insurance has a co-pay that varies greatly.

People with no drug coverage insurance: pay top retail price, which I understand is upwards of $20K per year. In the case of biologics, very few people can afford that, and they resort to the government catastrophic drug costs plan (below)

Those with employer-paid drug coverage: co-pay varies by plan. Some have little or no co-pay. Others have a co-pay that might be 10% or it might be 50%, just depends. I’m guessing that your job will come with drug coverage of some sort. How much the actual drug price is varies, though, according to the price the insurance company has negotiated with the drug company.

Government catastrophic drug coverage: this varies from province to province, because health is administered provincially. This coverage is means tested: they assess your co-pay as a percentage of your disposable income (as calculated on your tax return) The cost of your co-pay is based the price
your provincial government has negotiated with the drug company.

Bottom line is: I have no idea But you may be able to get some better information through one of our major pharmacies with a big online presence: https://www1.shoppersdrugmart.ca/en/Contact-Us
Give them a try.
,
You may also want to have a chat with @Golfnut, one of our members who came to Canada from the UK to work a few years ago.

S

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Oh, and just for the record, something wonderful happens to us when we turn 65: virtually all prescription medications (except in cases where there is a a more cost-effective alternative) are paid for by the government, except for $100 copay and the dispensing fee, which in my case is $6 and change.

But prescription drug cost questions are complicated in this country!

Thank you all for your feedback and also for sharing all the contact information.

Seenie, I will turn 65 in April 2020. I am far more excited about it than when I became legal to vote and drink! Luckily, I am currently maintaining on a drug cocktail within the limits of my own health insurance. It’s nice having the biologics “in my pocket” in the event of the PsA worsening, but I have had my fingers crossed in the three years since diagnosis that I will make it to 65 before that.

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My fingers are crossed for you, @Susan2! The period between starting biologics and turning 65 was a very tough one financially for us. Not taking them, though, wasn’t an option. I remember my wonderful pharmacist’s scheming to time my Humira refills just soooo when I approached my big birthday and that saved me about $1000 out of pocket. Biggest birthday prezzie ever!

I know I am very lucky to have avoided the biologics - funny how one’s definition of “lucky” change after diagnosis! Thanks for the finger crossing!

Susan

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Have you managed to come any closer to a conclusion?

Hi Seenie
I haven’t yet. I will let this blog know what happens when I make some progress.