FAQS
Frequently Asked
Questions
Get answers to frequently asked questions about drug access.
About Drug Access Canada
Drug Access Canada is a knowledge and resource hub with the goal of creating better access to medications for all Canadians. This primarily consists of providing training, resources and education to healthcare providers and Drug Access Navigators (DANs), as well as advocating for improvements to drug coverage through public and private insurance.
Drug Access Canada also advocates for the vital role of DANs in Canadian healthcare, promoting the expertise, efficiency and patient care that DANs provide.
A Drug Access Navigator, or DAN, is a healthcare professional whose primary focus is to connect patients with the drug or treatment they were prescribed. This can include:
- Assisting with applications for public/private insurance
- Enrolling patients into programs to help with cost, as well other services like genomic testing
- Easing the burden of paperwork, applications and appeals, so that patients and providers can focus on treatment and care
A Drug Access Navigator is sometimes referred to as a Drug Access Facilitator, Drug Access Coordinator and Medication Reimbursement Specialist. DANs are mostly found in cancer clinics, but are increasingly found in other therapeutic areas. Currently, there are over 200 DANs in clinics across Canada.
Drug Access Canada provides you access to enrollment forms for 300+ medications in one place. To access them, you must first register. Once you register, you unlock access to an Enrollment Form Hub, where you can view and download the forms you need. You only need to register once – after that, you can use the same log-in credentials each time you visit our website.
Registration is only open to healthcare professionals and public sector employees. Register now
Drug Access Canada offers comprehensive training content covering timely topics in drug access. It is suited to DANs and other healthcare professionals. You must log-in to access the training modules.
Our annual gathering brings Drug Access Navigators (DANs) together to share best practices, exchange ideas and learn from one another. It’s an opportunity to build connections, strengthen the collective voice of DANs and advance their role in helping patients access treatment.
Patient Support and Medication Access
A pharmaceutical manufacturer's patient support program, or PSP, provides support and services to patients receiving their medications. Patients must be enrolled in the PSP to access these services.
The services offered differs by PSP, but common ones include:
- Financial assistance to cover extra costs of a medication, like an insurance co-payment or deductible
- Bridging medication where a drug is provided free of charge until there is public or private coverage
- Medication support, such as check-ins with a nurse, coordinating infusions (if a drug given intravenously), and home delivery (if applicable)
The cost support available to you depends on your particular medication and insurance situation. For specific questions on accessing a medication, we recommend the following:
- For cancer-related medications, see if your cancer clinic has a Drug Access Navigator. Their role is to assess your situation and see what opportunities exist to help you access your treatment. They may go by another title.
- The following websites may provide you with helpful information:
- Ontario cancer patients: visit www.odano.ca
- Quebec cancer patients: visit www.aqcamo.ca
- Atlantic cancer patients: visit www.acodana.ca
- For non-cancer medications, check with your prescriber or pharmacist for guidance on what options may be available to assist you.
Haven by Sentrex is your go-to solution for specialty oncology medication support. Haven streamlines multiple patient support programs under one umbrella, reducing administrative burden and boosting efficiency. Learn more about Haven by Sentrex
Drug Approvals and Coverage
Drug approval is a complex process, as there are many steps to get a drug to market. The basic process is as follows:
- Health Canada reviews a submission from a drug company that contains all the clinical data for a new medication (including its safety and effectiveness)
- If Health Canada approves it, the drug can be marketed (prescribed) in Canada and is given a Drug Identification Number (DIN)
After Health Canada approves a drug, a process called a Health Technology Assessment (HTA) takes place. This is done by Canada's Drug Agency or the Institut national d'excellence en santé et services sociaux (INESSS) for Quebec. They will assess the value of the treatment, which helps determine its cost and coverage.
Pricing is negotiated between the drug manufacturer and government, mediated by the pan-Canadian Pharmaceutical Alliance (pCPA). When a drug’s price is determined, it will then be reviewed by each province and become a public benefit. You can learn more at these websites:
Drugs in Canada are funded in several different ways. Here’s a simplified explanation:
- Drugs provided in hospital are paid for by the hospital at no cost to the patient
- Drugs taken outside of hospital are often the responsibility of the patient. However, they may be covered (paid for) through public drug coverage. This can be either federal (e.g., NIHB) or provincial. Every province has its own system for covering medications.
- If a drug is not covered, a patient’s private health insurance may cover it. This is often obtained through an employer, but can also be purchased by a patient (e.g., travel insurance)
- Sometimes, drugs are paid for out-of-pocket. This means that a patient pays the cost of the drug themselves. This may happen if public or private coverage is not available for a drug.
While government health insurance plans give you access to basic medical services and some drugs, you may also have private insurance to pay for things that government plans don’t fully cover. Private insurance (also referred to as extended health plans) may cover costs for:
- Prescription medications
- Dental care
- Physiotherapy
- Ambulance services
- Prescription eyeglasses
Extended health plans are often provided through an employer, but can also be purchased on their own. You may pay a monthly fee through your employer to obtain these private health benefits.
The Special Access Program (SAP) provides access to drugs that have not been approved for use by Health Canada. In most cases, these drugs are used to treat patients with serious or life-threatening conditions when conventional therapies have failed, are unsuitable, or unavailable.
The SAP authorizes a manufacturer to provide patients a drug that cannot otherwise be sold or distributed in Canada. Drugs considered by the SAP include pharmaceutical, biologic, and radio-pharmaceutical products.
To see if a drug is available through the SAP, you may want to reach out to the manufacturer of your medication directly. Click here to learn more about the SAP.
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