April 21, 2018

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Drug-program cut could cost some people thousands

Provincial health official defends move as fair

JOHN WOODS / WINNIPEG FREE PRESS</p><p>Tara-Lynn Reeves, who has cystic fibrosis, is seen at her home with the medication she takes on a daily basis. She thinks the province’s decision will cost her about $7,000 a year.</p>

JOHN WOODS / WINNIPEG FREE PRESS

Tara-Lynn Reeves, who has cystic fibrosis, is seen at her home with the medication she takes on a daily basis. She thinks the province’s decision will cost her about $7,000 a year.

Tara-Lynn Reeves is crunching numbers on her calculator, desperately trying to figure out how much this will cost her.

The reason Reeves, 36, is reassessing her finances is because she got a letter from the province on Thursday saying the program she’s used to get cystic fibrosis medication since she was a child is being cut.

Effective April 1, everyone on the province’s Special Drugs Program (SDP) will be transitioned onto Pharmacare. That means they’ll have to pay a deductible — based on the cost of their medication and household income — for the life-saving drugs previously covered by the province.

For some, that deductible could be a few hundred dollars, and for others, it could be in the thousands.

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Tara-Lynn Reeves is crunching numbers on her calculator, desperately trying to figure out how much this will cost her.

The reason Reeves, 36, is reassessing her finances is because she got a letter from the province on Thursday saying the program she’s used to get cystic fibrosis medication since she was a child is being cut.

Effective April 1, everyone on the province’s Special Drugs Program (SDP) will be transitioned onto Pharmacare. That means they’ll have to pay a deductible — based on the cost of their medication and household income — for the life-saving drugs previously covered by the province.

For some, that deductible could be a few hundred dollars, and for others, it could be in the thousands.

"I’m trying to think of nice words to use, not swear words," Reeves said, when asked how she reacted to receiving the letter.

"I was shocked and very concerned. My drugs are up to $6,000 to $7,000 per month. All of a sudden, the Province of Manitoba is giving me less than two months to figure this out.

"What I also think is dirty pool is I reached out to my cystic fibrosis team at the Health Sciences Centre and they didn’t have any inclination that this was going on."

The Special Drugs Program, created in 1968 and named the Life Saving Drugs Program (LSDP), is aimed at helping alleviate the financial burden on Manitobans with health conditions associated with high medication costs.

When the province introduced Pharmacare in 1996, the LSDP was renamed the SDP. Anyone who received coverage through the LSDP was grandfathered into SDP. Everyone else accessed their meds through Pharmacare.

Reeves, who was diagnosed with cystic fibrosis (a genetic condition that primarily affects the digestive system and lungs) as a child, was one of those grandfathered into the SDP.

A provincial spokeswoman indicated there are currently 700 families, or roughly 1,100 individuals, receiving coverage through the SDP.

After next month, they’ll be covered under Pharmacare and will be expected to pay a deductible for their meds. While she’s still figuring out the details, Reeves says the change will cost her somewhere in the ballpark of $7,000 per year.

"It is concerning. That’s a lot of money. If I get sicker, the drugs I need will cost more. I’m not working right now due to my condition. If I wasn’t married, I’m not sure what I would do. I wouldn’t be able to afford the drugs," Reeves said.

"What if people can’t afford their medicine? Or have to choose between their medicine and paying rent or buying food? These medications aren’t cheap. If you’re on a pension or a low-income budget, I don’t see how you’ll afford it."

Patricia Caetano, executive director of Manitoba Health’s provincial drug programs, says she sympathizes with concerns raised by those affected, but feels the decision to cut the program is justified.

"Some people on the SDP have chronic illnesses that are no different from people who are in Pharmacare. I think it would be difficult to defend the current situation to a Pharmacare client who struggles to pay a deductible. This is an issue of equity," Caetano said.

She added that roughly 80,000 families are currently covered through Pharmacare and it’s time to bring the 700 families in the SDP into the fold. That will streamline programs offered by the province and cut back on administration costs, she said.

"This is just a small number of individuals who’ve been outside this program (Pharmacare) for some amount of time. These clients have been fortunate to have been included in that program (SDP), and the time has come where we really need to streamline it," she said.

"Drug costs are a reality. We have to pay for our drugs. Those that have benefited from the program for the years it has existed have truly benefited. Now it’s time for everybody to pay a fair share."

But Reeves says she considers the decision shortsighted and believes it may lead to a greater strain on the medical system in the long run. She worries people in precarious financial situations may cut back on medication use to lower their deductible.

On top of that, she said giving people less than two months’ notice doesn’t leave them much time to prepare for the increased financial strain. The bottom line is the decision will negatively impact people’s health and finances, potentially putting them at risk, she said.

"People will think, ‘I’m feeling well, so I’ll save up my pills.’ Then if they get sicker in the interim, they’ll end up in the hospital, putting a strain on the health-care system," Reeves said.

"I think it’s pretty pathetic. It makes me very sad and angry people won’t be able to afford the drugs they need. To me, this seems like we’re going towards (a system) of ‘Let’s just look after ourselves,’ instead of ‘Let’s look after each other.’"

ryan.thorpe@freepress.mb.ca@rk_thorpe

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