Health advocates increase pressure on province to cover HIV drug costs

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This article was published 09/02/2024 (577 days ago), so information in it may no longer be current.

Manitoba’s health minister has promised to increase access to HIV prevention and treatment medication, but there’s no word yet on when 100 per cent coverage might be a reality in the province.

Cost barriers remain for Manitobans who need medication to prevent or treat the blood-borne infection but can’t afford the deductible for provincial health coverage.

Amid some of the fastest-rising infection rates in the country, advocates have been pushing the province to fully cover the medication at no cost to patients.

Manitoba Health Minister Uzoma Asagwara said it’s been a “high priority” for the government to address “very concerning” high rates of HIV and make it easier for Manitobans to access the medication and reduce transmission.

“My department is actively working on making that happen and look forward to bringing some updates in the near future,” Asagwara said.

Asagwara didn’t explicitly confirm 100 per cent coverage is coming, but said the government is working to “eliminate the barriers that currently exist for those who need access to these treatments and medications.”

In 2021, an HIV prevention drug was added to Manitoba’s Pharmacare plan after years of advocacy. At the time, Manitoba was the only province not covering pre-exposure prophylaxis, known as PrEP. Since then, both PrEP and HIV treatment medication have been covered under Pharmacare, but not at 100 per cent.

“There are significant barriers still. We see gaps with people coming off their medications due to financial barriers on a regular basis. We also see people forgo PrEP due to the cost out of pocket,” said Dr. Laurie Ireland, a physician at the Nine Circles Community Health Centre and primary care lead with the Manitoba HIV Program.

The HIV program has been in talks with the provincial government asking to lower barriers to care and expand access to treatment, Ireland said.

The program has benefited from some additional funding for training and staff and they hope to hear back soon about other ways of expanding care.

Without coverage, PrEP costs up to $300 per month. The daily pill reduces the risk of contracting HIV by 99 per cent. Antiretroviral medication to treat HIV is more expensive, costing several hundred dollars each month. Each are subject to Pharmacare deductibles in Manitoba. In some other provinces, including Alberta, B.C. and Saskatchewan, PrEP is available at no cost to eligible patients.

Manitoba is one of the only provinces, along with Ontario and Quebec, that collects a deductible for HIV antiretroviral drugs.

David Lacho moved to Manitoba in 2022 from B.C. He said accessing the medication in Manitoba was difficult and he faces uncertain out-of-pocket costs once his current prescription runs out.

“Honestly, we could see HIV transmission greatly reduced within one generation if this medication was more available,” he said Thursday.

“It’s incredibly important that this is covered at no cost. I know plenty of my friends and now, including myself, who are in precarious financial situations and they are concerned more so about their finances than their sexual health.”

The cost of the deductible is based on a percentage of the individual’s income. At minimum, it costs $100 a year. To be eligible for Pharmacare, Manitobans must have filed an income tax return and confirmed their income via a notice of assessment from the Canadian Revenue Agency.

“This deductible is often insurmountable for many with rising costs of food and housing and we often see patients stop their medications when unable to pay their deductible,” Ireland said.

As a “stop-gap” measure for people who aren’t enrolled in Pharmacare or can’t afford their deductible, Ireland said, the province implemented a temporary coverage program for HIV treatment that lasts between three and 12 months before the deductible goes back into effect.

For Manitobans on social assistance, there’s no deductible and the medication is fully covered, as it is for First Nations and Inuit residents under non-insured benefits.

Newly diagnosed HIV cases in Canada are rising, and Manitoba has one of the highest new-diagnosis rates in the country, second only to Saskatchewan, at more than double the national average, according to the Canadian Foundation for AIDS Research.

The organization released a new strategic plan this week to end Canada’s HIV epidemic by the end of next year.

katie.may@freepress.mb.ca