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.

Comments

  1. Edward Harpur says:

    I have the dry form of AMD and my eye specialist is recommending Lucentis injections. Any article I have read on the Lucentis injections suggests it is for treating wet AMD. Will I benefit from these injections and will the Ontario Health plan pay for them.

  2. I have dry macular degeneration and also glaucoma. Would I benefit from Lucentis injections . and if so, what would it cost me

  3. Are the injections still covered if the patient is diabetic?

  4. I have CRVO and require to inject the lucentis every month. Will the Ontario heath plan cover that?

  5. I had my first lucentis treatment yesterday, June 7, 2012. The cost at the pharmacy was 1701.00.

    Your information states: “approx. $1600.00 per treatment, with each vial of the drug providing six lucentis treatments.”
    Please excuse my “winnie-the- pooh ” brain, but does that mean that the $1600.00 or in my case
    $1700.00 is the total cost for six treatments? Then if a 7th treatment is needed, the gov’t pays out another $1700.00 . A treatment being therefore 6 injections and not 1 as I was believing.

    My macular is only in the left eye, thank goodness. The right eye is A-ok. My mom had it in both eyes. (thanks mom!!)

  6. Kenneth Smith says:

    I have been having Lucentis injection in each eye since October. I pay 1625. per injection. That is for one injection. Not for a vial. My Dr said that it is not covered except from our insurance company, who just said that they would not cover any more traetments as I have reached my limit. Can some one please clairify where this is covered. Is it under the seniors plan or ohip. Thanks for any help, Ken

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