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Managing Costs of Medicine

for Inflammatory Bowel Disease (IBD)

KEY POINTS:

  • Medicines used to treat IBD vary in cost ranging from relatively low cost (for example, prednisone), to moderately costly (such as 5ASA enemas), to very costly (such as the biologicals).

  • Your pharmacist can provide information about the costs of different medicines and about coverage through provincial health plans.

  • If the cost of medicine may be a problem for you, be sure to let your doctor know.

  • See the tips for managing the cost of medicine below.

  • Be sure you understand the instructions about taking the medicine. Ask your pharmacist or doctor if you have questions.

 

Tips to manage the cost of medicine

1. Ask your pharmacist about the cost

  • Most doctors are happy to discuss the cost of treatment with you.

  • Be clear with your doctor if you cannot afford a medicine.If your doctor thinks you will be following a treatment plan and you don’t fill the prescription the effect on your health could be serious.If the cost is a problem, your doctor may be able to suggest a different treatment approach.

Use one pharmacy regularly: Your pharmacy has a record of the medicines that you take and can help with information about them.

Table 1: Estimated monthly costs for common medications used for IBD (Manitoba 2016)

 

 

 

 

 

 

 

* G - Generic product, B - Brand name product

Table 2: Sample cost of anti-TNF medications and vedolizumab (biologics) – 1st Year

 

* Note: Estimated cost in Manitoba pharmacies 2016. Specific costs will differ for different doses and different pharmacies.

2. High cost drugs

  • Some of the medicines used to treat Crohn’s disease and ulcerative colitis are very costly.
  • Biologic drugs are among the most costly – with a cost in the range of $25000-40000 per year, depending on the drug and the dose. The drugs covered by the provincial health plan and private insurance in each province vary somewhat.
  • The company making a high cost drug (such as biologics) may have a plan to help people if they have difficulty managing the cost.

  • Ask your doctor about whether the medicine is covered by the provincial plan. Also check what the requirements are for the provincial plan. 

  • If you have extended health insurance that covers prescription drugs, it is wise to check in advance about which drugs are covered.Your pharmacist or the plan administrator in your organization may be able to help with this.

  • There are no federal plans to cover biologic drugs other than the Non-Insured Health Benefits (NIHB) Program that provides drug coverage for First Nations of Canada. Individual Canadian provinces have drug plans that cover these drugs after deductibles are covered.

  • Some pharmaceutical companies may provide some drugs on a compassionate use basis if they are unaffordable to patients. Your doctor should know which companies may have these programs.

 

 

3. Checking dispensing fees

  • Pharmacies charge a dispensing fee for each prescription. This pays for the pharmacy services, including keeping records, making up the prescription, and providing advice about the medicine, other medicines you take, and your health.

  • Dispensing fees and mark-ups vary between pharmacies.

  • In Manitoba, dispensing fees usually range from $4.49 to $15.00. Check the dispensing fee by visiting or phoning the pharmacy.

 

 

4. Arrange the prescription for a three-month period

  • Once you have taken a medicine for a while, are on a stable dose, and find it helpful, you can reduce the cost of the dispensing fee by asking your doctor to write a prescription covering a longer period if possible.

  • Usually the longest period supported by insurance plans is about three months (90 to 100 days).

  • The dispensing fee is usually the same whether you get a prescription for three weeks or three months.

  • If your doctor or pharmacist is reluctant to provide prescriptions for three months at a time, discuss this with your doctor.

Last reviewed: October 2018

For more information and fact sheets about IBD and its treatment please visit: http://www.crohnsandcolitis.ca

Disclaimer: This information is provided for educational purposes only. Always consult a qualified health care professional for your specific care.

Source: This summary provides scientifically accurate information.  It was prepared in a research review by researchers with the IBD Clinical and Research Centre, University of Manitoba with assistance from colleagues in Canada and internationally. 

Acknowledgement: Preparation of this material was supported by funding from the Canadian Institutes of Health Research. 

©2016 Charles N. Bernstein, John R. Walker on behalf of Manitoba IBD Clinical and Research Centre. This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License. You are free to copy and distribute this material in its entirety as long as it is not altered in any way (no derivative works).