Islanders will have access to more affordable medications October 1 when the new Generic Drug Plan comes into effect, says Health and Wellness Minister Doug Currie.
Under the new program, uninsured Islanders under age 65 will pay a maximum of $19.95 for generic drug prescriptions. Minister Currie said the new plan will address an unmet need for the one-third of Islanders who do not have private drug coverage.
“The Generic Drug Plan will help to ensure that cost is not a barrier for these Islanders when they need medications,” said the minister. “The new drug cost assistance will help them to get well and to avoid bigger health issues that may arise later if they don’t get their prescriptions when they need them.”
PEI Medical Society president Dr. Jill Cunniffe said the new plan will improve health outcomes by making it easier for patients to get their medications and take them as prescribed. “Doctors on PEI are happy to partner with government in programs that will meaningfully improve the health of our patients. This program will alleviate some of the financial burden associated with illness and chronic disease,” said Dr. Cunniffe. “Removing cost barriers will allow patients to participate more fully in managing their own health, something that is good for patients and good for the system.”
The Generic Drug Program is open to all Islanders under age 65 who have no private drug coverage and have a valid PEI health card.
PEI Pharmacist Association executive director Erin MacKenzie said her association is pleased to see the plan come into effect because it will help people who need it the most. “Pharmacists see clients every day who find ways to make their medications last longer, which often results in a much higher cost to the patient and the health system through increased hospitalization, ER use and repeat physician visits,” she said. “Many customers are relieved to turn 65 because of the help they get with the cost of their medications so pharmacists are pleased to see this plan now available for people under 65.”
People must register for the program and be approved in order to receive coverage. Islanders are encouraged to apply online at www.healthpei.ca/genericdrugs or in person at Access PEI locations, pharmacies, physician offices or pharmacare offices.
More than 700 people have already applied and been approved for the plan. Department staff are turning approvals around as quickly as possible.
The Generic Drug Plan will cap the maximum price for the more than 1,000 generics on the formulary at $19.95, with the exception of diabetes drugs which are covered under another plan and controlled substances such as narcotics.
The plan is estimated to cost $4 million annually, but is expected to be largely offset by other savings.
Minister Currie said government is committed to increasing access to affordable medications and has made many improvements to provincial drug programs.
More than 250 drugs have been added to the provincial formulary since 2007, including many new cancer drugs. Several new drugs were added to the High Cost Drug Plan which helps Islanders who need a costly drug, have physician approval and meet the financial criteria. A Catastrophic Drug Plan was established in 2013 to assist families whose drug costs reach a point where they are impacting their ability to maintain essentials. A new Hepatitis C management program began earlier this year to move patients from treatment to cure. Prince Edward Island has played a leadership role in generic drug pricing which has allowed it to reinvest savings in other drug programs.
More than $33 million was invested last year by the provincial government in drug cost assistance.
More information on the Generic Drug Plan is available on the Health PEI website or by calling 1 877 577 3737.
PEI offers a number of drug programs to ensure all Islanders, regardless of their circumstances, have access to affordable prescriptions. Last year, more than $33 million was spent on drug programs.
Generic Drug Program
The Generic Drug Program assists Islanders (under 65) without private health insurance. The program limits out-of-pocket costs for generic prescription drugs to a maximum cost of $19.95. The program covers prescription drugs on the provincial formulary with the exception of diabetes drugs (covered through another program) and controlled substances (due to health and public policy).
Last year, 400,000 prescriptions were written on PEI for generic drugs and one-third of Islanders do not have private drug coverage. Government will invest approximately $4 million in the plan.
Seniors’ Drug Cost Assistance Program
The Seniors’ Drug Cost Assistance Program assists Island seniors (65+) with the cost of prescription drugs. The program provides subsidization to seniors for drug costs, particularly those costs associated with long-term drug use for chronic conditions. Seniors pay the first $8.25 in medication cost and $7.69 of the dispense fee while the rest of the cost is covered.
Government has invested $8.5 million annually in this plan, and last year 23,000 Islanders benefitted.
High Cost Drug Program
The High Cost Drug Program assists Islanders with the purchase of high cost drugs. The drugs covered under the plan include medications for: Cancer, MS, Wet Macular Degeneration, Rheumatoid Arthritis, Crohn’s Disease, Ankylosing Spondylitis, Psoriatic Arthritis, and Pulmonary Hypertension.
The program is income-based and a physician must provide medical information to show the criteria is met. Islanders pay a portion of the drug cost based on the total net household income, plus the pharmacy professional fee. Government has invested approximately $4.5 million a year in the program. Last year, approximately 500 people were enrolled.
*Patients registering for the High Cost Program are also encouraged to apply for the Catastrophic Drug Program (below). The High Cost Program is limited to eligible High Cost drugs where the Catastrophic includes High Cost drugs and more.
Catastrophic Drug Program
The Catastrophic Drug Program assists Islanders whose prescription drug costs are affecting their household’s ability to maintain life essentials. Islanders have their annual drug costs for eligible prescription medications capped at an amount not exceeding a set percentage of their household income.
Prescription medications on the provincial formulary are covered by the program. The program is income-based and applicants must file a tax return for the previous year. Once a household has spent a certain percentage of its income on eligible drug costs, any further eligible prescription drug costs are paid through the Catastrophic Drug Program for the remainder of the program year.