With the increasing number of medications available in Canada and the large amounts of clinical data required by health care teams, it can be challenging for health care providers to stay current with new developments. That's why we have special Drug Information Pharmacists available at KGH to deal specifically with this drug information. Their job is to obtain as much information as possible and critically assess this information to provide the best recommendations to your health care team. These pharmacists often are involved in many committees like the pharmaceuticals and therapeutics committee (P&T) which determines what medications are used in the hospital. This committee is also involved in developing policies and procedures to improve patient safety, drug efficacy while reducing hospital drug costs.
If you would like more information about the drugs and medications you are taking, it is always recommended that you first speak to your health care provider. However, you can also do some research on your own as the internet can be a great source of information, so long as it is from a trusted medical source. Some reliable and unbiased sources of medical information you may want to refer to are listed below. The information is explained using easy to understand language.
Financial Assistance/Drugs Not Covered
It is important to remember, that sometimes the costs of certain drugs may not be covered. The following links may help with determining if a drug is covered for you:
Drug coverage for Chemotherapy
The complexity of cancer drug coverage can be overwhelming. While most chemotherapy treatments received in the hospital or at the Cancer Centre are funded by Cancer Care Ontario or the hospital, many outpatient medications (including oral, topical and injection/ infusion) medications are paid for through private insurance or government sponsored programs such as Ontario Drug Benefits (ODB) or the Trillium Drug Program. At KGH we have staff members called oncology drug access navigators who work to find appropriate funding for chemotherapy medications for oncology patients. The KGH Cancer Centre drug access navigator will answer your questions and concerns about drug plan coverage and will help coordinate the reimbursement process. They will also:
- Help you understand how different coverage works
- Investigate options available for you
- Answer questions about investigation of private insurance for annual maximums/caps, prior authorizations, percentage of coverage
- Find a program to cover the balance amount that insurance does not cover
- Request bridging supply of drug from patient assistance program, to give you access to drugs while waiting on insurance requests
- Request compassionate supply from manufacturer if no coverage is available
- Inquire if high cost injections or oral medications are covered by Cancer Care Ontario's New Drug Funding Program or by government programs
- Assist in scheduling outside infusion clinics
- Coordinate physician and/or patient signatures in writing letters and filling in forms
- Guide patients, social workers, nurses and physicians through the process and advise on how to move forward with planning treatment needs