Lucentis Coverage in Ontario and Quebec, Canada

The macular degeneration drug Lucentis has coverage for funding in Ontario and Quebec, Canada.

Shortly after the July 30, 2007 Notice of Compliance issued by Health Canada to Novartis Ophthalmics, Novartis Pharmaceuiticals Canada Inc for its wet macular degeneration drug Lucentis, the province of Quebec, Canada announced it would provide funding for the drug.  Quebec’s funding came even though the Common Drug Review Committee (CDR), the advisory body that determines and recommends which drugs should be covered by provincial health authorities failed to provide a recommendation for Lucentis.

Quebec’s decision to provide funding for Lucentis went against the recommendation of the CDR.  Recognizing the potential of Lucentis to treat the eye disease wet macular degeneration, the Quebec government began providing funding.

Following suit, the Ontario government began to evaluate Lucentis and its benefits for treating the eye disease.  On March 13, 2008, the Ontario government announced that it would be following Quebec’s lead and providing funding coverage for the drug Lucentis.

The CDR later reversed its earlier decision and recommended Lucentis be covered under provincial health care systems drug formularies, paving the way for other Canadian provinces to provide coverage for the macular degeneration drug.  Even while recommending coverage for this eye disease drug, the CDR recognized that Lucentis could potentially cost provincial health care systems millions of dollars and limited the number of Lucentis treatments for the eye disease wet macular degeneration to 15 vials to treat the “better seeing eye”.

While Lucentis had demonstrated its effectiveness at stabalizing vision and in some cases improving vision in those patients suffering from macular degeneration, it is an extremely expensive drug, costing approximately $1,600 per treatment with each vial of the drug providing six Lucentis injections.  With some macular degeneration patients requiring monthly Lucentis injections for an indefinite period of time, the impact on provincial government sysetms could be dramatic.

Currently in Canada, coverage for Lucentis for wet macular degeneration is provided in Ontario and Quebec.