Folks I need your help ASAP..my brother lives in Ontario , Canada. He has psoriatic arthritis but..because disease has not progressed to point of causing visible joint damage yet he can not get any doctor to prescribe medications to help him. Anybody familiar with laws of medical practice in Ontario or is their anyone who has a very good, recently updated list of symptoms that he could take with him to the next appointment?? or any other info or suggestions would be greatly appreciated. I've given him everything I have and told him everything I know. I am soooooooooooooo glad I never had to endure this hassle ontop of the disease. thanking you all in advance
I would recommend you give your brother a copy of the book recommend up in Book Review above. "The Facts: Psortiatic Arthritis.
It would be wonderful if your brother could get a referral to Psoriatic Arthritis Clinic at Toronto Western Hospital. If I lived back east and was able to attend I certainly would!
I am a resident of Ontario suffering from PsA. My first step was to show my GP the rash that covered two thirds of my body along with swolen wrists and ankle. He had my joints X rayed for signs of arthritis. The X rays confirmed the arthritic damage to the joints. He arranged an appointment with the specialist for my treatment. I was sent for further X rays of joints and chest. The specialist put me on Methotrexate with steadily increasing dose up to ten tablets once a week. This med has caused problems for me,and am being switched to Humira. Ministry of health has to OK the use of Humira so I am still waiting.
I had let it get fairly well advanced before seeking help,I suppose the symptoms were so apparent that the diagnosis was fairly easy. I think that the doctors want to be sure that it really is PsA before treating due to the severe effects these types of drugs can have,believe me.
Hope my experience of the Ontario health system can give you a little insight into its workings.
Dunlayin, the Ministry of Health approval is something I’ve not heard of before, unless you are over 65. In that case, to get it covered under the seniors’ government drug plan, you have to apply for exceptional access, because Biologics like Humira arent on the regular list of drugs they cover.
If Smitty’s brother is under 65, he or his insurance will have to pay if he is prescribed a biologic. If he has no drug coverage insurance, then the Ontario government assistance plan will kick in at some point, but there is a substantial deductible.
I hope your approval comes through soon!
Hi Seenie, I will be 67 in a couple of months, hence the approval. Ministry is backed-up I have been told. Approval could take some time.
Seenie said:
Dunlayin, the Ministry of Health approval is something I’ve not heard of before, unless you are over 65. In that case, to get it covered under the seniors’ government drug plan, you have to apply for exceptional access, because Biologics like Humira arent on the regular list of drugs they cover.
If Smitty’s brother is under 65, he or his insurance will have to pay if he is prescribed a biologic. If he has no drug coverage insurance, then the Ontario government assistance plan will kick in at some point, but there is a substantial deductible.
I hope your approval comes through soon!
That would explain it. 
Meanwhile, you’re achin’. 
holy crap! I am sure glad I do not live in that province anymore. Brother has since I posted this and sent him a ton of info... seen a rheumatologist and she has gotten him a referrral to the PsA clinic in Toronto. Apparently it pays to know the facts and go in prepared for a fight..which he was.
As for the govt part of your medications..We also have govt input into ours but that again is where I am fortunate..I had approval the same day it was faxed to the dept for my Enbrel usage.
I think it is totally deplorable that the doctors and government despite knowing the FACTS about PsA..still let people suffer as they do.
Thank you all for your help
Excellent news, Smitty. He will get the right answers there, and they will work with his rheumatologist. It’s a shame for sure that even some rheumatologists don’t know what they need to know about this disease.
The government approval is only to get them to pay for the biologic, but having to wait like that is a problem indeed.
Glad we could help!
yes Seenie..govt approval is the same here...but like I said I was approved the same day. and in my province this applies to everyone ..not just seniors
Hi, Smitty.
That is great news,hopefully your brother can get help now. Yes the Ontario system is a bit long winded regarding approval for some medications. I have been waiting over three weeks for approval for Humira and have heard nothing yet. I understand it could be several more weeks! Good luck to your brother.
Smitty said:
yes Seenie…govt approval is the same here…but like I said I was approved the same day. and in my province this applies to everyone …not just seniors
Everybody? You mean the Manitoba government picks up medications costs for everybody? Not just when you go over a certain percentage of your income?
no it is income based Seenie. and not all drugs are approved..some need special approval to be covered. but thankfully the process is quick. and biologics are expensive so deductable gets eaten up quickly