New catastrophic drug plan aims to relieve costs
As of Oct. 1 Islanders who struggle to pay for their medications won't have to bear the total cost themselves. Prince Edward Island’s new catastrophic drug plan is now in effect.
Heidi Hutchings-Kays takes a number of prescription drugs each day to help manage Multiple Sclerosis.
She was diagnosed with MS in 2004 and says her drugs cost her family between $26,000 and $30,000 per year.
She has health benefits through her employer, but knows others with MS who don't have coverage.
“There's no way we could possibly afford the medication if we were paying for it out of pocket,” she said.
“For some folks they have to make really tough decisions, they would be sacrificing things that would be considered necessities to most of us, or they choose not to take the therapies. Which, I can't imagine having to make that decision, when you know that that might be the only thing that would help keep you healthy.
Under the new plan a household’s out-of-pocket drug costs will be capped at a set amount, depending on their income.
How it works:
The percentage of household income a family will have to spend before the new provincial program applies will be on a sliding scale.
- Three per cent of an annual family income if that income is $0 - $20,000.
- Five per cent of an annual family income if that income is $20,001 - $50,000.
- Eight per cent of an annual family income if that income is $50,001 - $100,000.
- 12 per cent of an annual family income if it’s more than $100,000
So, for example, a family with an annual household income of $40,000 would have spending on prescription drugs capped at five per cent of their annual income. Costs exceeding $2,000 per year would be covered by the province.
The program will cover about 60 new drugs that are not in the current P.E.I. Pharmacare Formulary. The province estimates 5,000 to 7,000 people will benefit from the new program.
“What I'm being told is that there are a lot of people that are anxiously awaiting this to come online and today is the day,” said Denise Lewis Fleming, executive director of financial services with Health PEI.
P.E.I. was one of only two provinces without such a plan, and the other — New Brunswick —recently announced it has a plan coming.
Hutchings-Kays said it's good to see the program on P.E.I., after years of lobbying by various groups, including the MS Society.
“You just want to see people in P.E.I. have the same opportunities as the rest of Canada,” she said.
Islanders can apply for the catastrophic drug program online, or at any Access P.E.I. site.