This post is a question for fellow Canadian patients of UC who have applied for prescription drug coverage from the Trillium Drug Program. I have recently applied for the TDP and am awaiting a response. I have been advised by an agent from the TDP help line that it takes up to 10 business to process an application after its reception if proff of income has not been provided.
I am looking for assistance from the TDP to help me pay for treatment with Remicade. I currently have insurance from Manulife (provisioned through my employer) which will cover me for 80% of the cost of the drug. This will still leave me with a 20% share, around $800 per infusion. I cannot currently afford this medication, as I am still a student and earning around $10 000 - $12 000/year as a part-time employee. I have earned significantly less this past year due to a lot of time taken off due to severe illness, as I'm sure many of you understand.
I have been advised that the TDP does not cover the cost of Remicade, however there are special applications that can be filled out by health care professionals to apply for coverage for Remicade (and other drugs not covered by the TDP). This special section is called section 8 (and/or section 16). Does anyone here have any information they can share with me regarding how this process works and what the timeframes for processing are?
I have been advised by an agent from the TDP help line that section 8 can take up to two months to process (too long to wait!). When I contacted the TDP via email, I was advised that in order to inquire about the timeframe associated with the processing of section 8, to speak with my health care provider (nurse and/or doctor). I have been in touch with a local Remicade nurse, who will be in touch with my specialist in order to get the medical records she needs to request special access for myself to receive coverage for Remicade. She advised me to have a TB test and chest x-ray fulfilled, both of which I completed today.
I'm curious if anyone in here has used the TDP, and what their experiences were like? More relevant to my situation, though, would be any personal anecdotes regarding the TDP and special application for normally non-covered drugs like Remicade via submission of a section 8. If it means anything, I live in Ottawa, Ontario. Hopefully, they will process my application expeditiously as I am currently flaring HUGE and would love to try out this new drug as quickly as possible. I'm hoping it is the answer I've been looking for, as I've been sick for the majority of the past two years with varying levels of flaring. Lastly, I was advised by the nurse that the TDP treats UC patients differently than Crohn's patients when it comes to applications for coverage for Remicade. To quote the nurse: "It's be better if you had Crohn's!". What she meant was that Crohn's patients generally have an easier time getting approval for coverage from the TDP for Remicade, and that they get approced for longer periods of time. For example, she told me that Crohn's patients generally get approved for 6 - 12 month timeframes from Remicade, whereas UC patients get approved for 2 month timeframes and need to subsequently re-apply.
I hope my post is clear and easy to understand. Thanks!