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B.C. expanding PharmaCare coverage to include diabetes, heart failure and blood clot drugs

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BC PharmaCare expands coverage for four new drugs
WATCH: BC PharmaCare is expanding coverage of four drugs in a decision that will affect thousands of British Columbians. The expansion covers medication for type 2 diabetes heart failure and blood clots – Jan 5, 2023

Thousands of British Columbians will soon benefit from the B.C. government’s expansion of the B.C. PharmaCare program.

Starting Thursday, drug coverage is expanded to include medications used to treat Type 2 diabetes, heart failure and blood clots.

“This is a very significant step in our province,”  said Adrian Dix, B.C.’s minister of health.

“The medication in question affects 245,000 people. These are much-needed medications in our province.”

Drug coverage for two medications will be expanded from limited coverage to regular benefits — those are dapagliflozin (Forxiga) and apixaban (generics).

Two other medications, empagliflozin (Jardiance) and semaglutide (Ozempic), that are covered by PharmaCare under specific medical circumstances will have their limited criteria expanded, according to the B.C. Ministry of Health.

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“The changes will ensure that coverage is aligned with clinical evidence and will improve patient access to appropriate medications,” ministry staff said in a release.

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Dapagliflozin (Forxiga) is approved by Health Canada to treat several conditions such as heart failure, Type 2 diabetes and chronic kidney disease.

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It was first listed as a limited coverage benefit through PharmaCare for patients with heart failure with “reduced ejection fraction” on Jan. 11, 2022, a condition where the muscle of the left ventricle is not pumping normally.

Currently, approximately 2,000 patients in British Columbia benefit from dapagliflozin under limited coverage, according to the ministry. The expansion to a regular benefit is expected to benefit 5,000 more patients in the first year.

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Apixaban (generics) is a blood thinner medication used to prevent or treat blood clots.

Currently, 45,000 patients in British Columbia benefit from apixaban under limited coverage, according to the B.C. government. The expansion to a regular benefit is projected to benefit approximately 24,000 more patients, officials say.

The expansion of limited coverage criteria for empagliflozin (Jardiance) and semaglutide (Ozempic) will make it easier for patients to apply for coverage of these two medications that work to lower blood sugar levels in adults with Type 2 diabetes, according to the government.

PharmaCare has changed the coverage from third-line to second-line.

Patients now will only have to try one drug, metformin, before their physician can request coverage of empagliflozin or semaglutide, according to the ministry.

PharmaCare is a publicly funded program that helps B.C. residents pay for some prescription drugs, medical supplies and pharmacy services.

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